CBD Launches: Adapting to the reality of COVID-19
The Canadian medical education system is exceptional, and in the face of what is arguably the most challenging time our collective profession has ever faced, this could not be more apparent. Our training system, run by a dedicated group of medical educators, continues to ensure our learners are thriving within a significantly challenging learning environment. Even in the face of a global pandemic, the rigours of training in the Canadian postgraduate residency system continue to produce outstanding and skilled physicians.
In March, we launched a series dedicated to the transition to Competence by Design, a new model of training that is a hybrid, outcome-based approach to training and assessment that is more flexible and adaptable of societal change. A lot has changed since then, and we are adapting this series to ensure that it is reflective of our current environment. Stay tuned for an upcoming article in the July issue of Dialogue where we will highlight how your colleagues continue to run thriving residency programs within a pandemic. But for now, it’s important that you understand how the rollout of Competence by Design has evolved to ensure it reflects the realities of COVID-19.
The Process: Decisions driven by tripartite consultations
Deciding which disciplines will launch Competence by Design has always been a tripartite decision between the Royal College, the specialty committees and the faculties of medicine. This past spring we undertook a national readiness survey with planned launch disciplines. We reviewed the combined survey results and feedback with each specialty scheduled to launch on July 1, 2020, as well as that from postgraduate deans and CBME leads. Collectively, we have agreed on the following:
Disciplines that will launch Competence by Design on July 1, 2020 as planned:
- General Surgery
- Neurology (adult and pediatrics)
- Nuclear Medicine
- Orthopedic Surgery
- Pediatric Cardiology
- Physical Medicine and Rehabilitation
- Plastic Surgery
- Psychiatry
Disciplines that will defer for one year (i.e. remain time-based for the 2020-21 academic year):
- Adult Cardiology
- Clinical Immunology and Allergy (adult and pediatrics)
- Neonatal Perinatal Medicine
- Pediatric Surgery
- Respirology (adult and pediatrics)
- Vascular Surgery
** For detailed information on the full rollout of CBD, please see our CBD launch schedule.
The Rationale: Decisions reflect the unique needs of each discipline
Through this process, we have seen the tremendous efforts of postgraduate deans and program directors operating in the current learning environment. However, we know that the impacts have also been variable, and we felt individual decisions were needed for each discipline.
- Why were some disciplines deferred? COVID-19 has significantly disrupted residency training and impacted faculty time. While deferral decisions were driven by a number of unique factors, the mental and physical fatigue experienced by our educators, residents and overall health care system during this time was a major consideration. While these programs will still need to meet the time-based requirements for another year, programs who had been working to prepare for a CBD launch are encouraged to “soft launch” – that is, to incorporate and pilot elements of their CBD design within their time-based training.
- Why are some able to go ahead? We know from our consultations that many programs have a lot of the essential ingredients of Competence by Design in place. The transition to competency-based training during COVID-19 will still take time, patience, and flexibility. Perfection from day one is not the expectation and programs may phase in the new national standards and training requirements as outlined in the provided guidance for a permissive launch.
Adapting to our new reality
Regardless of whether a discipline is proceeding to launch this year or in 2021, the Royal College will work with all programs and their unique situations to co-create innovative and creative solutions to ensure the continued quality of residency education. We continue to focus on developing guidelines in meeting training requirements and faculty development resources that reflect the new realities we are facing.
Looking ahead: Stay tuned as this Competence by Design series continues. We will cover everything from innovative ways that our learners continue to grow within this pandemic, to how Competence by Design is ensuring the best care for all Canadians, including rural populations.
