Primary and subspecialty standards documents
The Royal College specialty standards documents, referred to as the specialty suite, define the discipline. The audience for the specialty suite includes residents in training, program directors, teachers and exam committee members, as well as government and regulatory authorities.
Specialty standards documents
- Describe the associated knowledge base and skill set
- List the required clinical and academic experiences to obtain those competencies
- State the expectations of a resident’s performance at the successful completion of training
- Outline the appropriate structure and organization of a training program in the discipline
The specialty suite for primary specialties and subspecialties consists of four discrete but inter-related documents
The OTR describes a discipline recognized by the Royal College and outlines the unique constellation of competencies needed to practice as a specialist in this discipline. The OTR opens with the formal definition of the discipline.
Specialty/Subspecialty Training Requirements (STR)
The STR outlines the required duration, content and sequence of training in the form of a rotation-based road map. A trainee who has successfully completed the STR should be able to demonstrate all of the competencies outlined in the OTR.
Final In-Training Evaluation Report (FITER)
The FITER is a summative evaluation tool that attests that the resident has met all of the competencies for the discipline as outlined in the OTR. The FITER is used to identify if a resident is qualified to sit the certification exam in anticipation of being able to proceed to independent practice.
Specific Standards of Accreditation (SSA)
The SSA describes the requirements that the residency program must meet to achieve Royal College accreditation. Building upon the Royal College General Standards of Accreditation for Residency Programs (the “Blue Book”), the SSA outlines the specialty or subspecialty specific resources needed to provide adequate experiences for the trainee.
It also identifies any specific administrative requirements, clinical, academic and scholarly content, and evaluation methods. A program that meets the requirements of the GSA and SSA will be able to provide the appropriate training as required by the STR.
CBD Specialty Standards Document Suite
The specialty suite for primary specialties and subspecialties that have implemented Competence by Design in their training programs consists of the following documents
The (Discipline) Competencies document contains a high-level description of the competencies of a graduate of a given Royal College-accredited discipline or special program. This document also provides a definition of the discipline and the context of practice in which the competencies are relevant and applicable.
The Pathway to Competence document illustrates the progression of a resident’s competence through four stages of training in a given discipline or special program. The pathway identifies milestones (both generic and discipline-specific) that the resident must acquire in order to attain the exit competencies outlined in the (Discipline) Competencies.
The Training Experiences document outlines the mandatory and recommended training activities that support a resident’s acquisition of competence. The document identifies clinical activities such as inpatient care; ambulatory clinics, and surgical procedures; as well as non-clinical activities such as a scholarly project, journal clubs, and simulation exercises.
The ePortfolio provides evidence of a physician’s development and maintenance of competence from residency until retirement. It tracks the learner’s progress as he or she meets milestones and develops competencies, and it identifies assessment strategies to evaluate the performance of Royal College entrustable professional activities (RC EPAs).
The Standards of Accreditation document describes the requirements that a given residency program must meet in order to deliver training and thus achieve and maintain Royal College accreditation.
Areas of Focused Competence (AFC) standards documents
The AFCs also have a set of specialty standards documents, which define the AFC. The audience for the specialty suite includes AFC trainees, AFC directors, teachers and AFC assessors, as well as government and regulatory authorities.
AFC standards documents
- Describe the associated knowledge base and skill set
- List the required clinical and academic experiences to obtain those competencies
- State the expectations of a trainee’s performance at the successful completion of training
- Outline the appropriate structure and organization of an AFC program
The specialty suite for AFCs consists of three discrete but inter-related documents
Competency Training Requirements (CTR)
The document describes the unique constellation of competencies needed to practice as a specialist in each AFC. It is written as competency-based training (not time-based). It may include recommended experiences for guidance. The document needs to outline in detail the observable competencies required by a trainee.
The Portfolio document outlines the key portfolio outcomes and standards of assessment. It also collects the evidence of achievement of competence.
AFC Standards of Accreditation (AFC-SA)
The AFC-SA outlines what requirements a program must meet in order to offer training. Building upon the Royal College General Standards for Areas of Focused Competence (AFC) Programs, the SA outlines the AFC specific resources needed to provide adequate experiences for the trainee.
Document review process
Step 1: Submission to the Specialties Unit
Step 2: The Specialties Unit document specialists will prepare the document(s) for clinician educator review
Step 3: The revised draft document(s) will be submitted to the Office of Specialty Education for a final assessment
Step 4: Review by the Specialty Standards Review Committee (SSRC)
Step 5: Finalization based on SSRC feedback, versioning, translating, and reposting
It is important to note that each of the stages above involves an iterative review process with the specialty committee or AFC committee/subcommittee. The Specialties Unit posts and disseminates revised documents once all steps in the process have been completed.
