Follow us

Benefits of Competence by Design

Better education. Enhanced skills. Improved care.

Competence by Design (CBD) aims to make specialist training and lifelong learning more flexible, relevant and practical. It will help ensure that physicians have the skills they need at every stage of their careers, and that they can provide the best possible patient care. Ultimately, CBD is about a better way to train health professionals.

“CBME will make our evaluation better.… [It’s] going to take away the personal, subjective aspect of evaluation and make it more objective.”

Erin D. Wright, MDCM, MEd, FRCSC; member of the Royal College Specialty Committee in Otolaryngology — Head and Neck Surgery; professor, Department of Surgery, University of Alberta

Benefits for educators

CBD will build on the updated CanMEDS Framework to introduce competency markers in residency training and lifelong learning. Specialties and subspecialties will divide their residency programs into outcome-focused stages. And for each of those stages, they will create specialty-specific milestones and entrustable professional activities (EPAs).

Milestones and EPAs will be tracked, allowing educators to

  • easily recognize learners who need more training and respond accordingly,
  • change the “failure to fail” culture,
  • identify and communicate an explicit and transparent learning path,
  • employ simpler and standardized assessment and feedback methods, and
  • provide meaningful, concrete feedback to improve performance.

Benefits for learners

The systems, milestones and resources created for CBD will provide learners with

  • more frequent assessment and meaningful feedback from expert faculty,
  • well-defined learning paths and clarity around the competencies needed to progress to next stages of training,
  • a flexible environment that focuses on personal development,
  • the chance to hone skills and work more independently during the final stage of residency in preparation for independent practice, and
  • the capacity to organize and track learning activities, patient encounters and achievements throughout an entire career.

Benefits for practising physicians

CBD will better align education and lifelong learning with 21st-century, competency-based practices, making it easier for practising physicians to

  • assess their own abilities,
  • address gaps in their knowledge through continuing medical education,
  • stay current with evolving medical research, technologies and procedures,
  • know when to adopt new skills and technologies into their practice, and
  • plan and track learning activities to demonstrate their competence throughout multiple career transitions.

Get engaged

The Royal College can’t implement CBD without the involvement of the medical education community.