Competence By Design: Physical Medicine & Rehabilitation
Competence by Design (CBD) is a Royal College of Physicians and Surgeons of Canada (RCPSC) initiative to transition postgraduate medical education and professional practice in Canada into a model of competency-based medical education. More information about CBD can be found in the Royal College CBD Residents Guide and the CBME Terminology Reference Sheet
In this model, residents will be required to complete Entrustable Professional Activities (EPAs), which are tasks that can be delegated to a resident and observed by a supervisor. At the end of each rotation, residents will also be evaluated by an In-Training Assessment Report (ITAR). ITARs are linked to the Rotation Plan, which specifies the goals and objectives of each roation. Further details can be found in the Assessment section below.
PM&R Residency will continue to be 5 years in duration. It will be split into 4 stages:
- Transition to Discipline (TTD) 2 blocks in PGY 1
- Foundations of Discipline (FOD) 16 blocks in PGY 1-2
- Core of Discipline (COD) 36 blocks in PGY 2-5
- Transition to Practice (TTP) 11 blocks in PGY 5
The Royal College Exam will take place during the Core stage.
The Competence Committee (CC) is responsible for making overall assessments for each resident, and recommendations regarding promotion, coaching and remediation, at multiple time points throughout residency (CC Terms of Reference). The committee is made up of faculty members from various sites. The PD also sits on this committee. They use all the assessments (e.g. EPAs, ITARs, exams, etc.), as well as other relevant criteria (e.g. attendance records, emails to the PD), to make decisions. Residents are reviewed by the CC at least three times per year. The CC provides their overall assessment and recommendations to the RPC and PD. The PD will meet with the resident (after the CC meeting) to review these recommendations.
All EPAs are completed on the Elentra e-platform and can be initiated by faculty or the resident. Your login credentials for Elentra are your UTORID and password.
If you are unable to login to Elentra or do not know your UTORID, please refer to the Elentra FAQ
EPA Tips for Residents: At the start of each week review your Elentra dashboard to identify 1-2 possible EPAs for completion and plan the timing with your supervisor. Refer to your individual schedule/learning plan.
EPA Details by Stage
- TTD EPA 1: Performing physiatry-focused histories
- TTD EPA 2: Performing physiatry-focused physical examinations
- TTD EPA 3: Generating a problem list based on the International Classification of Functioning (ICF) Framework
- TTD EPA 4: Completing clinical documentation
- TTD EPA 5: Providing patient handover
- FOD EPA 1: Assessing and managing patients with non-emergent commonly encountered medical and surgical issues
- FOD EPA 2: Identifying, assessing and providing initial management of patients with emergent and urgent medical issues, and recognizing when to ask for assistance
- FOD EPA 3: Performing procedures
- COD EPA 1: Performing consultations and developing comprehensive management plans for patients with complex presentations
- COD EPA 2: Providing ongoing assessment and management for patients with complex presentations
- COD EPA 3: Identifying, assessing and managing patients with emergent and urgent medical issues
- COD EPA 4: Providing consultation and developing management plans for children with common pediatric rehabilitation conditions
- COD EPA 5: Performing common physiatric procedures
- COD EPA 6: Selecting and interpreting investigations relevant to physiatry
- COD EPA 7: Leading inter-professional meetings
- COD EPA 8: Facilitating the learning of others
- TTP EPA 1: Managing a physiatric practice
- TTP EPA 2: Developing a strategy for continuing professional development
- TTP SA 1: Planning and completing personalized training experiences aligned with career plans and/or specific learning needs
- TTP SA 2: Contributing to the improvement of health care delivery for persons with impairments/disabilities
- TTP SA 3: Conducting a scholarly project from inception to completion