Implementing CanMEDS 2015

Implementation of the CanMEDS 2015 Physician Competency Framework is occurring as part of the Royal College’s Competence by Design (CBD) initiative. CBD is being implemented through multiple cohorts and over an extended period of time because it involves major systems changes, which require careful planning and ongoing consultation and coordination.

Several disciplines are already revising their training standards (including CanMEDS 2015) as part of the CBD implementation plan, but many disciplines have not yet started the process. The final cohort is expected to transition to CBD no earlier than 2022. Rather than waiting for all disciplines to implement CanMEDS 2015 as they revise their standards for CBD, the Royal College and partners have agreed to create a temporary and generic CanMEDS 2015 Special OTR addendum. This approach will ensure the major highlights of CanMEDS 2015 are incorporated into training in a timely way, without over-burdening our stakeholders many of whom are also involved in the broader changes associated with CBD.

The addendum approach was reviewed and approved by all specialty committees and the Education Committee in November 2015, after months of discussions and careful consideration of viable options for implementation.


Key details of the OTR addendum are as follows (download here):

  • The OTR addendum features only the KEY content areas introduced/featured in CanMEDS 2015. This selective approach highlights the important additions to the Framework while streamlining the process for change and minimizing the burden on specialty committees, programs, faculty and staff. Important refinements to the Framework and the use of CanMEDS milestones will be implemented in concert with the CBD roll-out.

  • The CanMEDS 2015 Special OTR addendum applies to disciplines that transition to CBD after July 2018. Specialties in cohorts 1 and 2 are not affected because they have already begun their transition to CBD, which includes the full implementation of CanMEDS 2015.

  • The CanMEDS 2015 Special OTR addendum will come into effect on July 1, 2016 with the expectation that it will become part of the programs’ standard educational practice thereafter.

    Accountability for ensuring the curriculum is taught in accordance with the Generic OTR addendum and the Discipline-Specific OTR remains with the faculty and program.  Program Directors will be responsible for demonstrating that their programs incorporate the CanMEDS 2015 Special OTR Addendum into their teaching and assessments of residents.

  • General accreditation standards will not change as a result of this addendum. Surveyors will, however, seek to determine how the CanMEDS 2015 OTR addendum has been integrated into training. Programs reviewed after July 1st, 2017 will be expected to demonstrate that these requirements have been integrated in the program’s curriculum.

  • Once a discipline has transitioned to CBD and begins to accept trainees into its revised competency based training programs this addendum will no longer apply. 


Supporting Implementation

The Royal College is committed to helping with the implementation of CanMEDS and CBD. To this end, we are developing tools, resources and programs to help all disciplines learn, share, teach and implement CanMEDS. Here are some of the tools, resources and programs that are already available to you:



For more information about the OTR Addendum, contact