The rigors of training in the Canadian postgraduate residency system lead to exceptional and skilled physicians dedicated to patient care. Even years after residency, as you continue to acquire new skills and knowledge, what you learned as a resident is not forgotten. Neither are the memories of writing the exam. We are a profession of individuals committed to advancement and evolution.

We achieve great standards and serve our patients well, and yet when you look at our training model, all the way back to Flexner, it remains virtually unchanged. The resident learning environment and medicine overall have changed dramatically in the past 100 years, and the transition to Competence by Design is ensuring that Canadian residency training reflects the realities of 21st century practice.

Fundamentally, this is why Competence by Design matters. And why you should care.

The world is watching Canada

Both within Canada and across the world, there is a movement towards realigning medical education with a competency-based approach. For specialists training in Canada, this new system is called Competence by Design — a hybrid between time and competency-based systems. In a world that is constantly changing, you belong to an organization that continues to set the highest standards for cutting-edge specialty training.

Canada’s new postgraduate medical educational model outlines four stages of training, each of which have specific entrustable professional activities (EPAs) — basically, skills you should master as you progress. The stages are progressively set out as Transition to Discipline, Core, Foundations and Transition to Practice, and movement between stages is deliberate, providing a concrete framework on what a resident should be achieving in each stage. However, it’s not all about tick-boxes. With this new model comes a culture shift towards increased direct observation, coaching assessments geared towards promotion of learning, and learner-driven education. Learning rotations continue to take place in a variety of settings, including community hospitals and clinics. These frequent points of contact with mentors are also ensuring that if deficiencies do exist, they are identified early, allowing Fellows and supervisors to execute learning plans to fill these gaps in a structured way.

And you have a role to play as all disciplines convert to CBD.