Mapping out overlap training in Competence by Design
The evolution of double counting in residency education
What is double-counting?
When the Royal College made the decision to transition residency education to a competency-based model, there was a clear commitment to preserve the best parts of the traditional system. This includes recognizing the important role that “double counting” plays in the traditional system and ensuring an evolution of this practice is brought forward into Competence by Design (CBD).
Double counting traditionally recognizes time-based equivalencies in specific training requirements (STRs) between pairs of disciplines. When equivalencies are identified, eligibility for certification can double count towards the requirements of both disciplines. The policy reduces the length of time a resident is in training so they enter the workforce faster, while still meeting certification standards and upholding the health care standards set to protect the Canadian public.
How has it evolved?
As Canada’s training system shifts its structure to competency-based requirements, the double counting policy built on time-based requirements must also evolve. To carry over the same efficiencies in achieving certification in CBD, double counting transformed into the overlap training policy that provides credit for equivalent competencies achieved.
How and when is overlap identified?
The decision to identify overlap between disciplines is made at the national level by specialty committees, with support from the Royal College. Equivalencies can only be identified after both disciplines have a completed suite of Competence by Design specialty standards documents. In cases when residents are training in two programs where competency-based overlap has not yet been identified, the current STR-based double counting models will persist.
Residency education is complex in that impacts of change often differ based on varying local and national circumstances. The most common factors of overlap training are captured in the Impacts of Overlap Training graphic below. Residents are encouraged to work together with their postgraduate offices to explore impacts and solutions related to overlap training in support of their training requirements.
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