Dear colleagues,

Last month, I sent you a message about the Royal College’s work to usher in a new era of competency-based medical education (CBME) in Canada. As always, we appreciate your engagement on these important issues and I would like to thank all of you who took the time to send comments. Overwhelmingly, your remarks requested details about our next steps for CBME as well as more information about the evidence that has informed our decisions and strategic direction. Please know that your feedback will serve to guide our forward planning as we initiate our CBME efforts.

First, I am pleased to announce that we are now ready to officially begin implementation of the multi-year CBME initiative I outlined last month. It will be led by Dr. Ken Harris, our Executive Director of Education. As an overarching plan, our CBME initiative encompasses a comprehensive multi-year program to plan, design, develop, implement and sustain all components of a new medical education system.

Initially, implementation includes developing and piloting new competency milestones with “early adopter” specialties and university programs as part of CanMEDS 2015, hosting national consultations with residents, Fellows and others in the medical education community. Developing competency milestones with a pilot specialty will allow us to learn alongside our Fellows about how best to define new education and assessment processes that contribute to continuous learning. This will also ensure the changes to our practices and policies are guided by evidence and shared practical experience.

As part of our piloting activities, the Royal College is building the next generation of MAINPORT—a specialty-specific ePortfolio within which each physician will store his or her plans and achievements in meeting the CanMEDS milestones and other personal learning priorities. The ePortfolio will extend beyond residency across the continuum into practice. Once a physician is certified, the individual can continue to demonstrate how they have sustained and progressed in competence within their defined scope of practice.

Evidence and learning more

Many of you asked for the evidence to support our statement that advancing from proficiency to mastery requires dedicated effort throughout a specialist’s career to prevent deterioration across the breadth of practice. In response, we are committed to providing Fellows with a comprehensive online summary of the key research that informed our strategic decision. We expect that this resource will continue to grow over time.

Meanwhile, for those looking for more immediate learning opportunities, two excellent sources include:

The Aging Physician: Changes in Cognitive Processing and Their Impact on Medical Practice, EVA, KEVIN W., Academic Medicine. 77(10):S1-S6, October 2002. Review Paper Session (Co-Sponsored With the Society for Academic CME)

Viewpoint: A Performance-Based Conception of Competence is Changing the Regulation of Physicians’ Professional Behavior, Klass, Daniel MD, CM, FRCPC, Academic Medicine: June 2007 – Volume 82 – Issue 6 – pp. 529-535

New web pages for CBME and CanMEDS 2015 are now online, which further describe our rationale, process and plans. Our 2013 International Conference on Residency Education will devote substantial time and energy to continuing important discussions around CBME, including town hall-style sessions on the broader CBME initiative and CanMEDS 2015 project.

We plan to announce our pilot specialty group(s) within the next 4-6 weeks and look forward to sharing our learnings as they develop their specialty-specific competency milestones. As we begin to realize the larger benefits of our transformation into CBME, the Royal College will continue its process of collaboration with Fellows and others, ensuring a transparent process that is grounded in a thorough understanding of your learning needs. Inarguably, such engagement is our surest route to success.

As always, I invite you to share your ideas with us and read other Fellows’ perspectives by using the blog comment function below.


Andrew Padmos, BA, MD, FRCPC, FACP
Chief Executive Officer