Competence by Design
Technical Guides

The following technical guides have been developed to clarify expectations regarding the fundamental elements required to implement a Competence by Design (CBD) program. The guides — created in collaboration with CBME leads across the country — also identify where programs have flexibility to proceed with implementation in a way that acknowledges local context, is feasible and encourages innovation. Each technical guide also includes tips on accreditation.

If you have questions regarding CBD implementation, please contact your school’s CBME lead.

Technical GuideSubjectDescription and Link
Guide 1Requirements for EPA observation forms

In order for a program’s competence committee to assess a resident’s development of competence in the context of Entrustable Professional Activities (EPAs), an expectation of CBD involves the documentation of EPA observations. This technical guide focuses on the essential components of EPA observation forms.

Guide 1.0: Requirements for EPA observation forms (Sept. 2020)

Guide 2Applying standards when a program has both time-based and CBD trainees

As CBD is implemented, programs will be required to manage the training of both time-based and competency-based trainees. This technical guide identifies what you need to do to ensure that residents meet the specialty-specific standards for their cohort.

Guide 2.0: Standards for time-based and CBD trainees (Sept. 2020)

Guide 3Competence committees

Competence committees collate, synthesize and appraise qualitative and quantitative data from multiple documented observations to reveal the broad picture of a resident’s progression toward competence. This technical guide identifies the requirements of competence committees.

Guide 3.0: Competence Committees (Sept. 2020)

Guide 4Transfers

Guide 4.0: What is required when a resident transfers to another university for training, or a different program within the same university? (March 2022)

Guide 5Exam Readiness

Guide 5.0: When is a resident ready to sit the Royal College specialty examination? (March 2022)

Guide 6Leaves

Guide 6.0: What is required when a resident takes leave from a program? (March 2022)

Did you know?

  • A national group of competency based medical education (CBME) leads has been established to support implementation of CBME across the country. Located at each university, CBME leads work collaboratively to support and guide local programs and faculty as they transition to CBD. Find out who the CBME lead is at your school, and how to contact them, using the CBME leads Directory
  • Links to key resources have been included throughout these technical guides and additional resources can be found on the CBD resource page on the Royal College website.
  • Each technical guide also includes tips on accreditation. To read more about the general standards of accreditation, you may refer to the CanERA website.