Royal College to announce adaptations to Competence by Design in 2023

December 14, 2022 | Author: Royal College Staff

The Royal College of Physicians and Surgeons of Canada launched Competence by Design (CBD) in 2017 to deliver on our mandate to the Canadian public to oversee the system that produces competent specialist physicians who can deliver the highest standards of care.

As we reach year five of implementation, our evaluation activities and conversations with systems partners provide clear signals about persistent challenges related to CBD. While we remain confident in the merits of embracing competency-based medical education (CBME) in Canada and are committed to the implementation across all specialties, we also accept and acknowledge that significant unintended impacts and administrative burdens are being experienced by many in the system. We will be looking at adaptations to address these while also considering the current challenging care delivery models and shortages in health human resources.

Taking action to alleviate pressures

Early in 2023, we will work towards clearly specifying the minimum necessary design requirements for accreditation purposes while clarifying where programs and institutions have flexibility in the implementation of CBME.

We also acknowledge that additional changes in the model are required to improve the learner experience and address the impact on programs and faculty. We will be convening a national dialogue in the new year with our health care partners to further address the issues identified and modify our approach so that our colleagues are better supported in their implementation of CBME. In the meantime, we continue to review our emerging data to identify any immediate improvements that may be helpful.

Working in collaboration with you

Going forward, we will work with key participants to intensify data collection and interpretation to make meaningful change in a thoughtful and deliberate manner. We look forward to this important part of the CBD program.

We welcome your feedback and participation in a series of virtual town halls that we will be holding on CBD to review the most urgent challenges that require resolution and work together to define a collaborative approach to implement the changes that need to occur.

We would like to recognize the extensive work that has been done to date in collaboration with thought leaders across the country who have made significant contributions to the design of CBD and to the ongoing conversation of what it means to be a specialist in the 21st century and how to ensure that educational requirements adapt to evolving societal expectations.

We remain committed to collaboration in the ongoing improvement of the residency training experience for all.


Leave a comment. To reduce spam, comments are reviewed before they are visible on the post.

Your email address will not be published. Required fields are marked *


Concerned Citizen | February 3, 2023
Good day, I am an advocate for IMGs from 2018- 2022, this group is placed in a no where to turn. I have verified time lines in order to full fill requirements and be able to practice in Canada, yet due to COVID and delayed on examinations, the 3 years currency of practice has passed and the only options are: get a clinical practice for a minimum of 12 months, apply for Residency or get a Formal Post Graduate Training for 12 months. Yet some exams required to be a resident and in order to become a resident of Canada you need a minimum of 3 years of leaving in Canada. Furthermore, the need of physician is real and the solution is brining physician from "English speaking countries" have a 3 months clinical practice instead of 6 months, and putting aside qualified physicians already in Canada, that pay taxes working odd jobs, burning the midnight oil studying, that have passed all exams, follow every step, worked hard to achieve their goal and time just does not squares up. Now, I think that an option should be having another program that focus on practice ready assessments which includes physicians out of practice for more than 3 years, at least with the ones that had to go through the hoops during Covid, or even with out Covid the 3 years time line does not work in any scenario. It is become a myth to get a license where as we openly looking and opening doors for physicians from outside not given the opportunity to the ones that are already here and can alleviate the pressure on the Health Care System. Thank you for your time.
Royal College Staff | February 16, 2023
Dear Mariela,

The Royal College recognizes the challenges of internationally trained specialists. We are working to streamline the processes for internationally trained specialists to be certified in Canada through several alternate pathways. We hope these changes will help alleviate the health human resources crisis in Canada.
In January 2023, we announced updates to our Practice Eligibility Route (PER). PER is for internationally trained specialists who have started practice and it allows them to apply for an assessment for Royal College exam eligibility and, ultimately, certification. We have recently simplified this process for candidates, including allowing them to take our written exam before moving to Canada. We’ve also changed the requirements for the five years of practice that’s required. Candidates can apply after two years of practice in their home jurisdiction.

In addition, we are

• improving our processes to review applications, grant exam eligibility, and provide recognition for internationally trained specialist physicians;
• modifying the training model to provide more flexible opportunities for in-practice assessment;
• scaling up our operations to process applications;
• establishing the ability for medical schools to nominate candidates who have been successful in a Practice-Ready Assessment (PRA) for examination eligibility; and
• working on the design of a new in-practice assessment, modelled on existing PRA in Family Medicine, Psychiatry and Internal Medicine, in certain jurisdictions in Canada.

Read more about these changes and what we plan to do in the near future.

Kind regards,
Royal College Communications
Alfred Sisto | January 25, 2023
Teaching competence by design to maintain continuity and quality of care in the next chapter of remodeling the Canadian healthcare system