Competence by Design and accreditation
The challenges of the existing accreditation system
In 2013, in response to calls for system transformation from postgraduate deans, specialty committees and surveyors, the Royal College joined with the College of Family Physicians of Canada and the Collège des médecins du Québec to review the residency accreditation system.
This review — the first of its kind in 20 years — identified a number of challenges and frustrations, including
- Paper-based, labour-intensive processes;
- An episodic, workload cycle with large peaks and valleys for universities and programs;
- A need for improved consistency and reproducibility of decision-making from program to program; and
- A need for better supports for surveyors, program directors and postgraduate offices
Recognizing the opportunity to improve the system, the three colleges have joined together for form The Canadian Residency Accreditation Consortium (CanRAC).
CanRAC has developed a proposal to redesign residency accreditation. The aim is to align accreditation with 21st century care needs and support the shift to a competency-based model of education delivery.
A proposal based on feedback
The proposed plan builds on stakeholder feedback to-date and aims to
- Preserve the strengths of the current system, like national standards, onsite evaluation of programs, and peer review.
- reduce the workload of faculties, program directors and managers, surveyors, committees and volunteers;
- promote continuous assessment and improvement;
- integrate innovative practices;
- streamline processes;
- align with the new CanMEDS 2015 Framework; and
- reduce or eliminate paper-based processes and tools.
The proposed plan aligns with the move to competency-based medical education (CBME). Any changes to the accreditation system will support the integration of competency-based practices.
Gradual and iterative implementation — no effect on 2015 or 2016 accreditation visits
Transitioning to a new accreditation system is complex. The three colleges understand this and commit to providing all schools and programs with time they need to prepare.
The proposed changes will NOT affect schools with accreditation visits in 2015 or 2016. The earliest possible testing phases for the proposed changes will be 2017.
All schools will have the time to review, understand, prepare for and integrate the new standards and practices before they are expected to demonstrate compliance
As work progresses, the partners will ensure that all stakeholders are regularly informed and engaged and have the opportunity to shape and refine an accreditation system which is focused on quality improvement, practical and relevant.