Royal College of Physicians and Surgeons of Canada: Applying competency-based practices to residency education

To contribute to the success of Canadian physicians and the delivery of high-quality patient care, the Royal College of Physicians and Surgeons of Canada has embarked upon an initiative to introduce competency-based medical education (CBME) in Canadian postgraduate specialty training and in professional practice in Canada. This initiative, called Competence by Design (CBD), aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their education process.

CBD will use time as a framework rather than the basis for progression. It is not anticipated that the duration of training will change for the majority of trainees. Residency programs will be broken down into stagesPDF icon cbd-competence-continuum-diagram-legal-e.pdfand each stage will have a series of milestones based on required competencies. These milestones will create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need.

The Royal College anticipates that all specialty and subspecialty programs in Canada will adopt CBD in gradual phases. All disciplines have been divided into seven cohort groups, each of which will adopt CBD at different times. It is anticipated that national implementation of CBD within certain, individual programs could begin as early as July 2017 - with more disciplines to following in subsequent years.

Please visit the Proposed CBD Rollout Schedule find out when residents entering into Anatomical Pathology could potentially experience CBD.

All programs implementing CBD will continue to undergo the same rigorous accreditation processes as traditional programs. All CBD programs (and traditional programs) will continue to lead to Royal College approved certification. Certification for trainees in both CBD and traditional programs will include the completion of a Royal College examination; however, residents in CBD programs will also be assessed against program milestones throughout their training. Within a CBD program, all milestones (documented within an electronic portfolio) and the Royal College examination must be successfully completed to achieve certification.

For more information, please contact cbd [at] royalcollege.ca (.)

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