Designing the future of medical education

By Dr. Alison Fox-Robichaud, director, medical education

On July 1, Hamilton Health Sciences welcomed a new cohort of physician residents: bright, talented, curious and ready to put their medical knowledge into practice. It’s a distinguished path trekked by young doctors for centuries as they transition toward becoming full physicians.

But unlike those who came before, members of this group are riding a sea change in the way physicians are trained and evaluated across Canada.

Arguably the biggest change to medical education in 100 years, these pioneers will be assessed through a new program called competency-based medical education (CBME). It was designed by the Royal College of Physicians and Surgeons, the regulatory college that oversees medical education of specialists in Canada.

The focus of the training is now on outcomes, not the process of getting there.

The difference? In the previous system a resident needed to log a certain number of hours to complete a rotation, like emergency medicine or intensive care. Although skills and knowledge were evaluated, the focus was on time spent rather than how competent the resident was at each task. CBME is all about demonstrating competency in specific clinical tasks or activities required in a department, such as resuscitating a patient or suturing a wound. Residents will only proceed if they can show that they’re capable of performing these tasks.

This means that some will be able to move through their training faster than their predecessors, while others will progress at their own speed. It allows residents to take full responsibility for their learning, which will build confidence in their abilities as they grow in their practice. Medical faculty members will provide coaching along the way.

From a patient-care perspective, CBME is a progressive step forward. The focus of the training is now on outcomes, not the process of getting there. It puts patients at the centre by bringing efficiency to medical learning. Most importantly, by adding certainty to the training, CBME provides a consistent way to measure clinical skill.

Let’s be clear: the Canadian medical training system has always ranked among the globe’s top tier. It has produced generations of world-class physicians, surgeons, researchers and innovators who continue to improve the health care we benefit from today. However, as health care and patient needs constantly evolve, so must our training. We’re confident that CBME will place our future physicians at the forefront of clinical excellence for the next century and more.

To our new residents, welcome to our hospital. We look forward to working together and learning from one another. Best of luck on this next stage of your medical journey.