CBD : 3 Years After its Implementation, Negative Impact Still Outweighs Theoretical Advantages

Since July 2017, the FMRQ has been following very closely the implementation of Competence by Design (CBD), a new approach to medical education. Unfortunately, despite the numerous recommendations we have made since 2017, far from improving, the situation appears instead to have worsened. That is what we document in this report: Year 3 of Implementation of CBD: Negative Impact Still Outweighs Theoretical Benefits.

You will find in it some disturbing observations. What our members tell us is very far from the promises of enhanced quality of training which the Royal College (RCPSC) dangled in front of the faculties when it convinced them to adopt the competency-based approach. Not only does CBD appear to bring no pedagogical benefits, but it also manifestly has a negative impact on resident doctors’ wellness. Many of our members feel they are being used as guinea pigs who are paying the price of an implementation process that was cobbled together in a rush. 

We find this situation unacceptable. Over the coming months, we will be meeting with the main organizations involved in medical education to put forward our 13 recommendations and ensure that concrete steps are put in place to help our members under CBD. 

We should like to thank the resident doctors who took part in the surveys and discussion groups, as well as the members of the FMRQ’s Academic Affairs Committee – Specialties, who worked on drawing up the report.

>> Read the year 3 report of implementation of CBD: Negative Impact Still Outweighs Theoretical Benefits


The FMRQ has been following the implementation of the CBD since its arrival in 2017

In 2017-2018, the FMRQ carried out semi-structured interviews among the first two cohorts (anesthesiology and OTO/HNS in CBD. In 2018-2019, we continued to monitor the implementation of CBD through a survey among resident doctors in these two programs and six others, including emergency medicine, forensic pathology, medical oncology, nephrology, surgical foundations and urology.

>> Read the year 1 report of implementation of CBD: Impact of Competence by Design

>> Read the year 2 report of implementation of CBD: Ongoing Issues