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CBD implementation

There is no one size fits all approach to how Competence by Design (CBD) will be implemented. Each program and faculty has its own opportunities, challenges, timeframe and local context. We are committed to an iterative and thoughtful implementation approach, which enables co-creation and mutual learning with our partners and Fellows.

The postgraduate deans of Canada’s 17 medical schools and the Royal College have agreed that the following 12 disciplines will proceed with plans to launch their residency training under the CBD design on July 1, 2019:


  1. Critical Care Medicine
  2. Gastroenterology
  3. General Internal Medicine
  4. Geriatric Medicine
  5. Internal Medicine
  6. Radiation Oncology
  7. Rheumatology


  1. Cardiac Surgery
  2. Neurosurgery
  3. Obstetrics and Gynecology


  1. Anatomical Pathology
  2. General Pathology

This agreement was reached during a May 7, 2018, teleconference between Royal College leadership, some of the specialty committee chairs, the postgraduate deans and Competency-Based Medical Education (CBME) leads. Decisions were based on the readiness of each discipline’s specialty committee and local programs.

In an effort to allow more time for planning and implementation support, the Royal College and postgraduate deans advanced this decision-making process six months earlier than in the past. Doing so, they recognized that not all disciplines would have their CBD standards documents completed before the teleconference. Over the next several months, we look forward to continuing to work collaboratively with our postgraduate medical education partners, particularly those disciplines and schools still finalizing their documents, to ensure readiness to launch. We will continue to meet regularly throughout 2018 and into 2019 to discuss progress and identify any additional support we can provide before the July 1, 2019, launches.

This agreement builds on our 2017 launch and our upcoming 2018 launch.


  • Anesthesiology
  • Otolaryngology — Head and Neck Surgery


  • Emergency Medicine
  • Forensic Pathology
  • Medical Oncology
  • Nephrology
  • Surgical Foundations
  • Urology

This announcement is another important step in our journey to transform specialty medical education to a competency-based model.

We sincerely appreciate the time and effort of faculty members, committee members and stakeholders, who are diligently working through the process and engaging their communities to define their new national standards. Change is always challenging, and we appreciate your commitment to enabling the necessary time to make sure the end results are effective for advancing specialty medical education and patient care.

When is your specialty targeted to launch CBD?

Even if your discipline falls into one of the later cohorts, it makes sense to start planning today. Looking for a great resource to help you get started? Check out the CBD Meantime Guide.