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Status recommendations

The primary reviewer will recommend a learner status based on the documented observations and will initiate a discussion on the issues arising from their review.

Competence committee members will discuss the status recommendation and vote on the learner’s official status in the program. (i.e., progressing as expected, not progressing as expected, progress is accelerated, failure to progress or inactive) and any resident action required (i.e., monitor, modify or promote).

If a learner’s status is not progressing as expected, progress is accelerated, failing to progress or inactive then the PG Dean needs to be aware. If the learner is progressing as expected but is eligible for the Royal College exam or is eligible for Royal College certification the PG Dean is also notified.

Learner Status Learner - Resident Action PG Dean approval / awareness
Progressing As Expected Monitor Learner - Resident Not required
  Modify Learning Plan – Suggested Focus on EPA/IM observations or RTE Not required
  Promote Learner - Resident – to Stage 2 Not required
  Promote Learner - Resident – to Stage 3 Not required
  Promote Learner - Resident – RC Exam Eligible* Awareness
  Promote Learner - Resident – to Stage 4 Not required
  Promote Learner - Resident – RC Certification Eligible Required*
Not Progressing As Expected Modify Learning Plan – Additional Focus on EPA/IM observations or RTE Not required
  Formal Remediation Required
Progress Is Accelerated Modify Learning Plan – Modify required EPA/IM observations or RTE Awareness
  Promote Learner - Resident – to Stage 2 Awareness
  Promote Learner - Resident – to Stage 3 Awareness
  Promote Learner - Resident – RC Exam Eligible Awareness
  Promote Learner - Resident – to Stage 4 Awareness
  Promote Learner - Resident – RC Certification Eligible Required*
Failure to Progress Modify Learning Plan – Additional Focus on EPA/IM observations or RTE Awareness
  Formal Remediation Required
  Withdraw Training Required
Inactive Monitor Learner - Resident (i.e. expected return - parental leave, sick leave, etc.) Required
  Withdraw Training Required

Reporting back

The competence committee chair will report the recommended status of each resident to the RPC. The RPC will be asked to ratify the recommendations and action any implications (e.g., status/promotion, formal remediation, inform the PG office, etc.)

The decisions of the competence committee must be shared with the learner followed by a discussion of what they should work on next.

Suggested resource(s)

The article Reviewing residents' competence: a qualitative study of the role of clinical competency committees in performance assessment1 looks at how Competence Committees actually work. This paper was written very early in the transition of CBME, but has some interesting findings. Drs. Frank, Snell and Sherbino discuss this article in KeyLIME Episode #124.


Managing a competence committee
How they deliberate

1Hauer KE, Chesluk B, Iobst W, Holmboe E, Baron RB, Boscardin CK, Cate OT, O'Sullivan PS. Reviewing residents' competence: a qualitative study of the role of clinical competency committees in performance assessment. Academic Medicine. 2015 Aug;90(8):1084-92.