Queen’s School of Medicine to become competency based

University first in the country to adopt a competency-based medical education system

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The CBME system promotes medical residents once they’ve demonstrated the required competency level.

Queen’s University has committed to an innovative new style of training, education and promotion in its medical school — making it the first Canadian university to adopt the new system.

The Faculty of Medicine is set to transition their resident education programs from a time-based training system to competency-based medical education (CBME).

The CBME system, an initiative by the Royal College of Physicians and Surgeons of Canada, promotes medical residents once they’ve demonstrated the required competency level instead of completing a prescribed timeline of education. 

Dean of the Faculty of Health Sciences Richard Reznick said CBME starts with the principle that students should be trained until they’re properly prepared and confident in their skills. 

This contrasts with the traditional medical education model, where residents are trained for a predetermined number of years and complete a mandatory number of hours.

Reznick said when someone finishes medical school in the traditional system they must complete two to seven years of extra training to become a specialist or family physician.

“Those training programs have been fairly traditional for probably 50 or more years, and haven’t changed all that much, certainly in their basic architecture,” he said. 

Instead of introducing CBME specialty by specialty in its School of Medicine, Queen’s application for all its 29 specialties to adopt CBME at once was approved by the Royal College in November.

Reznick said the need for CBME arose from “four drivers”: training programs producing professionals that society needs, a shift in trainee work hours, an emphasis on patient safety and rapidly evolving technology.

When he was trained 30 years ago, it wasn’t uncommon for Reznick to spend 100 hours at the hospital each week, he said. Since then, the status quo has changed, but the system has not.

“Now, in every country in the world, there are regulations that limit the number of hours of work. In Canada it’s roughly 72 hours a week.”

Reznick said the method of testing medical residents has become dependent on infrequent exams, and daily or weekly assessments are no longer a part of the medical education culture.

In the new system, he says, the number of assessments will be increased “by sixfold”. 

“You could imagine if you’re getting constant checks, both you — a student — and the teacher, are more confident you’re reaching those milestones,” he said. 

Reznick added that faculty development will be an essential piece in the transition to CBME.

“Our surgeons, cardiologists and anesthesiologists aren’t necessarily born educators, so we need to invest a lot into faculty development.”

While the implementation of CBME is targeted for July 2017, Reznick says there’s 18 months of hard work to do to get the program in gear.

“Assessment tools have to be built of every programs. Workshops need to be held for every faculty member. Curriculum needs to be looked at in every program.”

In terms of support, Reznick said the Royal College will be involved in the implementation of the CBME model. 

“[The Royal College] will be donating some of their expertise and time, and Queen’s School of Medicine will be putting some of their resources behind it,” he said.

Despite the “bundles of work to do”, Reznick said he’s confident that the program — the first of its kind in the country — will make Queen’s a leader in medical education. 

— With files from Jacob Rosen


CBME, Medical education, Queen's School of Medicine

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