Competency Based Medical Education

Competence-By-Design
The Royal College of Physicians and Surgeons of Canada (RCPSC) has transitioned to the model Competence-By-Design (CBD) implementing a competence based medical education (CBME) approach to residency training and specialty practice in Canada. The RCPSC website provides a comprehensive description of Competence-By-Design (CBD).
OBGYN residency programs will continue to span five years, shifting the focus to ensuring each resident acquires the necessary competencies before they progress through each of four stages measured and evaluated using the concept of entrustable professional activities (EPA’s) and milestones.
- Transition to Discipline (TTD) – approx three months
- Foundations of Discipline (FOD) – approx 21 months
- Core of Discipline (COD) – approx 30 months
- Transition to Practice (TTP) – approx six months
Roll-out of CBD for all Obstetrics and Gynaecology programs across Canada commenced on July 1, 2019. This included all our PGY1 residents, however all residents in our Program are participating in CBME and achieving their entrustable professional activities.
Quick Links
The University of Ottawa PGME website provides many useful resources on CBME/CBD as well as a resource library on the RCPSC website on all things CBD/CBME
Entrustable Professional Activities
EPAs are activities that physicians do every day that the OBGYN Royal College Subspecialty Committee has identified as key tasks of the discipline. Faculty will now be completing EPA forms (on ELENTRA) when opportunities for observation and feedback arise throughout the rotation.
EPAs are designed to be developmental and progress from basics tasks to complex tasks as trainees move through the stages of training. The Obstetrics and Gynaecology EPAs by stage can be found in our Program’s CBD Curriculum Map and in each Stage linked below.
Within each EPA are a number of milestones. These are individual skills that are needed to accomplish the EPA. The language around milestones, as it is derived from the RC’s CanMEDS framework (e.g. medical expert, communicator, collaborator, leader, etc.).
ITER EPA Map by Rotation (2021)
RCPSC EPA Guide and Milestones (2021)
Some helpful Links:
Foundations (FND) - 10 EPAs
FND EPA 1 - Providing routine prenatal care to a low-risk, healthy population (5)
FND EPA 2 - Performing assessments of antenatal fetal well-being (10)
FND EPA 4 - Managing labour and childbirth (5)
FND EPA 5 - Performing uncomplicated cesarean sections with a skilled assistant (5)
FND EPA 6 - Providing early postpartum care (10)
FND EPA 8 - Counselling and management for patients requiring family planning (5 + 2 IUDs)
FND EPA 9 - Providing consultation for patients with gynecologic conditions (5)
FND EPA 10 - Performing minor gynecologic operative procedures (10)
Foundations Special Assessment - 1 EPA
FND SA 1 - Performing critical appraisal of health literature and initiating scholarly projects (2)
Core - 19 EPAs
C EPA 1 - Providing preconception and antenatal care to women with high risk pregnancies (10)
C EPA 3 - Managing complex vaginal deliveries (10)
C EPA 4 - Performing complex cesarean sections (10)
C EPA 5 - Diagnosing and managing postpartum complications (5)
C EPA 6 - Performing obstetric and gynecologic ultrasound (5)
C EPA 7 - Providing definitive management for patients with acute gynecologic emergencies (3)
C EPA 9 - Assessing and initiating management for patients with reproductive challenges (5)
C EPA 11 - Providing care for patients with pelvic floor dysfunction (5)
C EPA 13 - Assessing and managing patients with gynecologic malignancies (5)
C EPA 14 - Performing advanced hysteroscopy (5)
C EPA 15 - Performing major vaginal and vulvar procedures (10)
C EPA 16 - Performing major laparoscopic gynecologic procedures (5)
C EPA 17 - Performing major open abdominal gynecologic procedures (10)
C EPA 18 - Managing patients with surgical complications (5)
Transition to Practice - 2 EPAs
TTP 1 - Managing complex patients, including those requiring longitudinal care (4)
Transition to Practice Special Assessment - 2 EPAs