Competency-based education in family medicine

Background: As a way of demonstrating an objective assessment of trainee competence, the College of Family Physicians of Canada has recently approved a competency-based framework known as CanMEDS-FM. All training programs in family medicine in Canada will be required to demonstrate the development of curriculum and evaluation methods based on the roles defined by the framework. Aim: This article describes the rationale and the approach used to develop a competency-based education curriculum in the postgraduate family medicine program at the University of Toronto. Method: The authors describe a systematic approach to curriculum development which includes the formation of a central steering committee, content development by faculty experts, mapping of curriculum to an accreditation framework, and a faculty consensus exercise. We discuss challenges to development and implementation of a competency-based framework as well as areas that require further work and development. Conclusions: The competency-based curriculum is both a new method of learning for residents and, a new method of teaching for faculty. While there are many potential benefits and challenges, this article focuses on the model's utility in terms of flexible learner-centered educational design, as well as its ability to identify learners' strengths and needs.