Competence by Design FAQs

How can I check when my specialty is launching CBD? Do you have a schedule?

The CBD Start, Launch and Exam Schedule shows when specialties are starting their CBD workshops, and those specialties with confirmed launch dates and exam timing changes, updated bi-annually.

How do I access Royal College EPA guides, pathway documents and/or assessment templates?

These copyright-protected documents are available to postgraduate medical education (PGME)offices in Canada. To be granted access, you must complete a brief online Terms and Conditions form on the Royal College website. Immediately upon submitting the form, a link will be sent to your email address to provide you with instant access to all EPA guides, pathway documents, and assessment templates that are currently available.

Can international institutions request copies of Royal College EPA guides, pathway documents and observation templates?

Any international institution accredited by the Royal College can access and use EPA guides, pathway documents and observation templates freely. For institutions that are not accredited, due to issues of intellectual property, we are not able to immediately share entrustable professional activity (EPA) guides, pathway documents and observation templates internationally. We encourage unaccredited international institutions to contact Royal College International (RCI) at We strongly value international collaboration in advancing medical education and will work with institutions to provide support and information where possible. More information about RCI can be found on our website.

Where can I find CBD faculty development resources specifically for my role?

The Royal College Resource Directory has a listing of resources that is searchable by topic or by role. We also have a CBD webpage that breaks down how to implement CBD and its impacts. Although some materials are created for program directors, others are always welcome to use any information here and attend webinars and events where your questions can be answered. Some key resources include:

Your school CBME lead is also available to support you.

How do I run a competence committee?

The Royal College has developed a set of faculty development resources that will highlight everything you will need to know about running a competence committee.

How can I help my residents understand entrustment scale ratings and the idea of progression over time?

The Royal College has developed a set of faculty development resources for residents designed explain concepts related to CBD.

What are the impacts of CBD on workplace-based assessment, coaching and feedback?

The Royal College has developed a set of faculty development resources designed to help program directors and clinical teachers understand workplace-based assessment and coaching and feedback in competency-based training.

How can I understand what is required in CBD vs. where there is flexibility?

Flexibilities are purposely built into CBD, which allows schools and programs to blend a competency-based approach into their current scope of training. It is recognized, however, that having flexible answers can sometimes feel unstructured for schools looking for specific direction. CBD Guidance is designed to help programs attain clarity around what is a required policy of CBD versus where there are flexibilities in implementation. It contains CBD Policy documentsCBD Technical Guides that expand on existing policies, and CBD Support Guidelines where the Royal College does not require a policy but can provide guidelines or best practices shared from local contexts that may offer options, considerations and direction to help programs make decisions within their own local context.

What is the Royal College policy on Academic Advisors?

The Royal College does not have a policy for academic advisors in Competence by Design. Schools and programs can choose whether or not academic advisors should be incorporated into residency training. Your local CBME lead can be contacted for further support for direction within your school. A full listing of CBD-related policy, technical guides and guideline documents can be found on our website page CBD Guidance.

Does the Royal College still require the use of ITERs (in-training evaluation reports) for competency-based residency education or has the terminology shifted to ITARs (in-training assessment reports)?

The terminology used is not a mandatory accreditation standard. However, the Royal College uses “assessment” for individuals and “evaluation” for programs now. Therefore, we no longer use “ITERs” (in-training evaluation reports), though some people may still use the previous term from time to time. Instead, there is a shift towards workplace-based assessment using assessment templates. To learn more about the CBD assessment strategy, please refer to our resource directory and our website. You can also complete this form to see sample observation templates for CBD.

How do I know when to progress a resident to the next stage of training?

Under competency-based medical training, in most cases, the length of training for a resident is expected to stay the same as the traditional model. However, CBD does offer flexibility in training. If a resident is able to complete EPAs ahead of schedule, it is possible that the trainee would complete training sooner, depending on various factors. The Role of Time in CBD should help explain how time-based training changes in CBD.

Decisions on resident progression through the stages of the competence continuum are made by the local Residency Program Committee on the recommendation of the Competence Committee. Visit the Royal College website to access the CBD resource directory for information on Resident progression, or details on Competence by Design and exams.

Be sure to connect with your local CBME lead for additional support and information about the implementation of CBD in your school and program, or get in touch with your PGME office for local CBD information.

I’m a resident. How do I know what version of EPAs I should be following?

The National Standards for training applicable to you would depend on when your training under CBD began. The relevant documents can be found on the information by discipline page on the Royal College website, labelled according to date. Additionally, you can contact your program director or local PGME office for additional information regarding CBD implications for your training.

Can I be added to or removed from your mailing list?

To receive CBD-related correspondence from the Royal College, please enter your information on our sign-up page. To be removed from the mailing list, please visit our unsubscribe page.

Could I request an outreach visit for a Royal College CBD representative to speak at my school?

Yes, if your school or program requires additional support in the implementation of Competence by Design, the Royal College would gladly arrange a meeting. Please contact in conjunction with your institution’s CBME Lead.