Canada celebrates 150, we celebrate T minus 0

June 28, 2017 | Author: Dr. Andrew Padmos

Dear colleagues,

In just a few days, on July 1, medical schools across Canada will launch a new approach to medical education that is years in the making (you could even say 100 years in the making, depending on how you measure it).

It is time to start implementing our collective Competence by Design initiative. After 100 years under a time-based model, postgrad programs in Otolaryngology – Head and Neck Surgery and Anesthesiology will introduce a hybrid, outcomes-based approach to training and assessment that is more flexible and adaptable to societal change. Soon, programs in 65 more disciplines will usher in these same changes and, in time, all aspects of the learning continuum and professional development will be impacted.

Now, I deliberately emphasize this as being “our” initiative. Competence by Design may have been introduced by the Royal College, but it has only advanced this far because of the involvement, collaboration, hard work, leadership and commitment to quality improvement by our partners in Canada’s 17 medical schools, our specialty committees and staff members, and other stakeholders and contributors from the medical education community.

It seems fitting that our implementation date should fall on Canada’s 150th anniversary. This date affords us the perfect opportunity to take stock of our country’s proud heritage and, importantly, to situate this achievement alongside other important moments in the evolution of Canada’s medical education system.

dominion medical council 1929

The Dominion Medical Council of Canada celebrates the establishment of national training standards for Canada’s medical institutes (November 1912, Parliament Hill, Ottawa).

In photos: milestones in Canada’s medical education system 

In our 150 years as a nation, our health care system has become part of the fabric of our country and engrained in our Canadian value system. While we no doubt have our challenges – both those before us and those on the horizon – we truly do have a world-class system. We should all feel proud that Competence by Design will complement and extend this legacy — giving more support to both faculty and learners, and enabling them to better respond to the demands they face in this hectic and changing medical environment.

Together we are pioneers. While this is just the beginning of a long implementation journey, we should all take a moment to celebrate this “milestone.” Together we are shaping the next generation of physicians and surgeons. We are fashioning a reinvigorated training system. It’s ground-breaking. And while we may not recognize the full magnitude of it now, these changes are poised to have the same degree of impact as Flexner, Osler and the members of the Dominion Medical Council of Canada. Perhaps in 100 years from now, people will be talking about this moment in history.


Andrew Padmos, BA, MD, FRCPC, FACP
Chief Executive Officer


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Louis Hugo Francescutti | June 28, 2017
Great message love the style...well done.... Louis Hugo Francescutti Physician & Storyteller 780-932-7187 cell *The University of Alberta respectfully acknowledges that we are situated on Treaty 6 territory, traditional lands of First Nations and Métis people.* "We are making history! EndPovertyEdmonton is excited to share our EndPovertyEdmonton Strategy - a bold plan that will need collaboration from all sectors, in order to reach the goal of ending poverty within a generation. Be a part in shaping Edmonton’s history, be a part ending poverty here in our community. For more information, please visit" [image: Inline image 1] On Wed, Jun 28, 2017 at 2:17 PM, Message from the CEO wrote: > Royal College posted: "Above: The Dominion Medical Council of Canada > celebrates the establishment of national training standards for Canada’s > medical institutes (November 1912, Parliament Hill, Ottawa). Dear > colleagues, In just a few days, on July 1, medical schools acros" >
Dr. Andrew Padmos | July 10, 2017
Thank you, Louis. Always nice to hear compliments from a storyteller such as yourself! -Andrew
Alex Porzecanski, MD FRCSC | June 28, 2017
In a few words, could you define what Competence by Design involves?
Royal College | July 11, 2017
Hi Alex, in a nutshell, CBD will introduce a competency-based approach to medical education, learning and assessment in residency education and specialty practice. This will involve changes to the way physicians are evaluated (e.g. specialty-specific milestones and EPAs, new exams processes) to the way programs are evaluated (e.g. new accreditation processes) and, eventually, the way physicians evaluate themselves (e.g. competency-based continuing professional development). Admittedly, it’s a lot to take in. A good place to start is There, you’ll find more resources, our implementation schedule and other great details. Of course, we’re happy to help in any way. You can contact our CBD team directly at – Royal College Communications