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Competence by Design Launch Schedule

When is your specialty targeted to launch CBD?

CBD Start, Launch and Exam Schedule

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2020 Launch Status:

COVID-19 is impacting every aspect of medical education and the Royal College recognizes the significant efforts that our educators are taking to support the best interest of our residents. Deciding what disciplines will launch Competence by Design has always been a tripartite decision between the Royal College, the Specialty Committees and the Faculties of Medicine, and following detailed consultations this spring, collectively we have agreed on the following:

Disciplines that will launch Competence by Design on July 1, 2020 as planned

  • General Surgery
  • Neurology (adult and pediatrics)
  • Nuclear Medicine
  • Orthopedic Surgery
  • Pediatric Cardiology
  • Physical Medicine and Rehabilitation
  • Plastic Surgery
  • Psychiatry

Disciplines that will defer for one year (i.e. remain time-based for the 2020-21 academic year):

  • Adult Cardiology
  • Clinical Immunology and Allergy (adult and pediatrics)
  • Neonatal Perinatal Medicine
  • Pediatric Surgery
  • Respirology (adult and pediatrics)
  • Vascular Surgery

Through this process, we have seen the tremendous efforts of program directors operating in the current learning environment. However, we know that the impacts have also been variable, and we felt individual decisions were needed for each discipline.

Why were some disciplines deferred?

COVID-19 has significantly disrupted residency training. While deferral decisions were driven by a number of unique factors, the mental and physical fatigue experienced by our educators, residents and overall healthcare system during this time was a major consideration. While these programs will still need to meet the time-based requirements for another year, programs who had been working to prepare for a CBD launch are encouraged to “soft launch” – that is incorporate and pilot elements of their CBD design within their time-based training.

Why are some able to go ahead?

We know from our consultations with you that many programs have many of the essential ingredients of Competence by Design in place. This being said, the transition to competency-based training during COVID-19 will take time, patience, and flexibility. Perfection from day one is not the expectation and programs may phase in the new national standards and training requirements as outlined in the attached guidance for a permissive launch.

This agreement builds on our previous launch cohorts:


  • Anesthesiology
  • Otolaryngology — Head and Neck Surgery


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


  • Critical Care Medicine
  • Gastroenterology
  • General Internal Medicine
  • Geriatric Medicine
  • Internal Medicine
  • Radiation Oncology
  • Rheumatology
  • Cardiac Surgery
  • Neurosurgery
  • Obstetrics and Gynecology
  • Anatomical Pathology
  • General Pathology

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.