Competency Based Medical Education


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.

  1. Transition to Discipline (TTD) – approx three months 
  2. Foundations of Discipline (FOD) – approx 21 months 
  3. Core of Discipline (COD) – approx 30 months 
  4. 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:

EPAs and CanMEDs Milestones

CanMEDs Milestones

FAQ:  Milestones and EPAs  


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