Your top five questions about CBME in UME Answered

What’s changing?

During the next four years, the Doctor of Medicine (MD) Program will change its curricular structure and processes to align with Competency Based Medical Education (CBME) principles and practices.

In doing so, the Program will fulfill the goal set out by the Dean that all Schulich Medicine education Programs across the continuum will be competency based. This will move our School into a national leadership role in medical education and better meet the needs of society, our faculty and our learners, as envisioned in national and international educational guiding documents.

We see this change as ensuring the School meets evolving national education practices for the next decade.

What does this mean?

This process will mean a substantial realignment of student learning, student assessment, learner and faculty deliverables across all years of the MD Program curriculum.

We will be starting to implement CBME in the MD Program through Clerkship, starting in September 2018, with a three year plan for implementation of assessments and eventually structures that deliver a competency based model.

The MD curriculum will move from a course-based progression model to one based on programmatic assessment. In this model, each learner will have a coach to better support their learning outcomes while their competency and program progression will be overseen and decided by a new central MD Program Competence Committee composed of faculty, staff and students.

The new MD Program curriculum in first, second and fourth years, will move to a new model that is less lecture focused to one that includes large group learning, small-group, and team-based models where students are more individually accountable for achieving defined outcomes through time in each MD Program competency.

New learning modalities will include more team and small-group learning (case-based and team-based education) with expectations for delivery of projects, research and understanding patient and system issues impacting outcomes to demonstrate competence aside from traditional assessments.  

We see these changes as translating into a process where we better support all learners as evolving professionals, including their professional development, from day one as independent, active, continuous learners and team players who understand how to integrate the clinical context of an encounter with the necessary foundational science. Each student will grow within a curriculum program that delivers integrative learning as a continuum across body systems, systems and years of education. It is an integration that must and will be evident to the learners, educators and public that is thoughtfully planned and executed.

Why change?

The MD Program curriculum was created in the midpoint of the past decade by outstanding educators who drew from national and international models that were cutting edge as we entered the 21st century.

Much has changed since 2005. While grounded in best practices, we see our present model that has continually evolved and is fully accredited as needing refreshments to meet the new and evolving key principles of Canadian and international medical education.  

As we look forward to educating doctors during the next decade, as a School and Program, we need to meet the demands of social responsibility and competence in all graduates to deliver and lead in Canadian patient care and scholarship. In addition, we must address all learners’ ability to meet our outcome competencies to educate learners well-grounded as generalists, who can function in any area of medicine.

Currently, we do well in supporting our learners. We identify and support high achievers while addressing learners with academic or personal needs impacting their careers. However, the middle of each cohort will greatly benefit from a new education model.

Developing processes to support advanced career skills, ensure learner academic success and support all students in meeting Program outcome objectives so they can function in the new reality of Canadian health care, will be enhanced by the new MD Program CBME model.

As CBME is centered on more formative individual feedback – from day one of their medical education – it pushes learners to internalize active decision-making.

Students will be better skilled to contribute in care, education and scholarship by taking responsibility for their personal independent growth and meeting all the objectives of structured curricular outcome-driven learning.

With this model, we envision each of our graduating learners excelling as decision makers and as team members in all aspects of medicine, and as effective life-long learners and leaders.  

What assessments will we use to define competency?

Many of the current assessments are meeting the needs of CMBE: The new twelve Association of Faculties of Medicine of Canada (AFMC) Entrustable Professional Activities for undergraduate medical education (UME) in Canada; multi-source feedback; focused clinical and individual assessments that will be recorded electronically using tools on your smartphones or tablets; and accountable independent learning.

What will our new UME curricular structure resemble?

We are excited to partner with our colleagues in PGME, CPD, Admissions, Distributed Education and with Schulich Medicine faculty, staff, students and other health professionals in developing and delivering a new model of learning that will transform our school over the next decade.

We appreciate the contributions to date of faculty, staff and students and are looking for more interested faculty to join in the creation and operations of the new UME.  

We hope to discuss this with each Department over the next few months. If you have interest or questions please contact Dr. Gary Tithecott.