LAUSR

Practice makes perfect, most people would agree. But what makes a great doctor? What type of practice and which types of skills make a competent doctor? A series published in Medical Teacher, June 2017, has started to answer these challenging questions through discussion around the transition to competency-based medical education. Residency training programs have traditionally been time-based. At the end of the training program, residents write their final certification examination to become independent practitioners. While residents may demonstrate satisfactory knowledge, our medical education system does not systematically evaluate the application of this knowledge and requisite skills to real-world clinical scenarios and real patients. Without a clear definition of the clinical experiences, skills, and procedures that define a specialty, how is one to know where they stand on their journey to competency? As residents, we are keenly interested in knowing what we need to accomplish to have a successful career and care for our patients at the highest standard. Competency-based medical education offers a path forward. As resident members of our curriculum committee, we are building capacity for a more transparent, defined, and personalized approach to residency training. It aims to deliberately define the goals of the program, and allow for tailoring of the curriculum to meet individual learning needs. This will help ensure all residents gain the necessary competencies before moving on to a successful independent practice. We believe the benefits of a competency-based medical education system are vast and will stretch well beyond residency. It starts with a set of core competencies broken down into a series of demonstrable skills, knowledge, and behaviors, provides frequent on-the-job assessments and directly-observed patient interactions, integrates enhanced faculty coaching and feedback, and personalizes education to individual learning needs. By transitioning our medical education system to a learner-centered model, we will empower residents to become meaningful participants in their training, education, and future practice. It will require ongoing faculty and resident engagement. Offering professional development training for enhanced feedback and more rigorous assessment methods, collaborating across specialties and health professions, and identifying further opportunities for improvement will facilitate this process. While this transition may not be easy, a competency-based medical education system will help create self-reflective, adaptable, and scholarly physicians who engage in lifelong learning to provide the best possible care to all patients, always.