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Competency Based Medical Education

Frequently Asked Questions

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No. For most specialties, the examination will become a milestone in the ‘Transition to Practice’ and one of a number of requirements for certification. Passing the exam at the end of the ‘Core of Discipline’ stage will not lead to certification. The RCPSC will only grant certification when the Resident has successfully completed the ‘Transition to Practice’ stage and has received sign off from the Program Director.

More frequent assessment and meaningful supervision by expert faculty.
Clearly defined targets for acquiring competency and meeting standards throughout training, to guide profession to next stage of training.
A more flexible timeframe, which focuses on personal development.
The ability to continuously strive towards excellence throughout practice.
Going forward residents will start to think of their teachers as a coach, someone who helps them develop their skills.  The teacher will incorporate both direct and indirect observation into their work on a regular basis and in a way that is practical for the reality of their environment.  The teacher will give short focused feedback to the residents and complete brief records of the observed performance.

‘Pure’ competency based medical educaiton is time free; however, the RCPSC’s Competence by Design is a hybrid model of CBME.  It is not time free.  Instead, CBD will re-conceptualize time as a framework.  Within CBD, the number of years to complete a residency program is not expected to change for the majority of residents.  Residents will have the ability to achieve competencies (measured by Entrustable Professional Activities (EPA’s / milestones) at their own rate wtihin the defined residency program timeframe

Competency-based medical education is an outcomes-based approach to the design, implementation, assessment, and evaluation of a medical education program using an organizing framework of competencies (e.g. CanMedS 2015). In a CBME system, a curriculum is organized around the outcomes expected of a resident and that resident’s advancement is dependent on having achieved those expected outcomes.

The Royal College is taking a phased approach to CBD rollout and implementation. It is anticipated that all specialty and subspecialty programs in Canada will adopt CBD in gradual phases – a transition that will occur until 2022. See the Competence by Design Launch Schedule here.