Together we are making history: Competence by Design to reach mid-point in 2020

December 2, 2019 | Author: Royal College Staff

We’ve got a lot of celebrating to do.

The Royal College is predicting that on July 1, 2020, 13 more disciplines will launch their training programs under a competency-based approach to medical education. Not only does this bring us to a point where half of all disciplines in Canada will now be teaching and learning through a competency-based model, but it is also the largest number of disciplines to launch in a single year.

The following disciplines are expecting to launch on July 1, 2020

  1. Cardiology (adult and pediatrics)
  2. Clinical Immunology and Allergy (adult and pediatrics)
  3. General Surgery
  4. Neonatal-Perinatal Medicine
  5. Neurology (adult and pediatrics)
  6. Nuclear Medicine
  7. Orthopedic Surgery
  8. Pediatric Surgery
  9. Physical Medicine and Rehabilitation
  10. Plastic Surgery
  11. Psychiatry
  12. Respirology
  13. Vascular Surgery

When you take a look back, it’s truly amazing how far we’ve come together. It was only two and a half years ago that the first two disciplines launched. Now we have more residents than ever  learning under the Competence by Design system. In hospitals around the country, CBD residents are on the front lines, delivering world-class care to patients.

Growing and evolving together

With any change of this size, challenges are inevitable. Competence by Design is the evolution of a recognized need, one that aligns medical training in Canada with the realities of 21st century health care. Canada has continuously pledged an unwavering commitment to bettering our health-care system and CBD is no exception.

Since we first launched in 2017, not only have the number of residents grown, but the overall model of CBD has also evolved to adapt to feedback from those on the ground. Our community has shared important feedback and this has helped guide significant advances, a few examples of which include

– ensuring the manageability of the number of specialty-specific competencies that require assessment;

– increasing the number of bedside observations;

– identifying of areas for improvement – protecting patient safety, helping trainees succeed, decreasing trainees requiring additional funding; and

– supporting, engaging and developing all faculty who will be assessing residents.

As we approach a new year, the Royal College is also looking back and recognizing the significant contributions the medical education community has made to advance CBD. Reaching the half way point is no easy feat, and we never could have come this far without the significant contributions of all of those involved in the implementation. Thank you for not only making CBD possible, but also for making history in health care in Canada.

CBD Launch Schedule

See when other disciplines are scheduled to start the CBD process.



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Catharine Dewar | December 12, 2019
I have just retired from practice a few weeks ago. I am turning 69 soon and it was time to make way for younger colleagues. My patients were very loyal and they would not leave me for my recruit unless I retired, it was time to create the opportunity for her. In the last 5 years, I felt that many of the younger specialists in my field were so ‘consumed’ by EHR and IT that they were not engaging with seniors like myself, during bedside or hands on mentoring opportunities. All they can think of is the EMR and IT and AI, and all of this is not the same face time with patients, that I found so important during my practice. If you read the article in the most recent NEJM, by Dr. John Noseworthy, he is sounding the alarm bells regarding these tech changes in our profession. The EMR in particular, and probably more so in the US where the onerous EMR data collection by HMOs is interfering with an MDs ability to deliver care (AND enjoy a medical career) is very worrisome. This Shattuck Lecture by Dr. John Noseworthy should be mandatory reading for all MDs and all Hospital/clinic/HMO administrators. Time to look back and reflect on what has changed our profession, not necessarily improved it al all.