As Canadian residency programs near the 2026 milestone of fully transitioning to the Competency by Design (CBD) model, institutions across the country are grappling with a shared reality: Competency-based medical education (CBME) is not just a curriculum reform—it’s a systemic shift that requires the right people, tools, and culture to succeed.
To help institutions navigate this transformation, the 2025 International Congress on Academic Medicine (ICAM) hosted a panel titled "Empowering Learners and Faculties: Navigating the Shift to Competency-Based Medical Education (CBME)."
In this article, we break down the key insights shared by the panel’s expert contributors:
- Lisa St. Amant, Project Manager of Curriculum at the University of Toronto
- Lisa Persaud, Senior IT Project Manager at McMaster University
- Dr. Davies, CBME Lead and Associate Professor at Dalhousie University
What are the primary benefits of CBME compared to traditional medical education?
Lisa St. Amant highlighted that CBME allows institutions to define clear learning outcomes, improve benchmarking for success, and intervene early when learners struggle. "Competence committee chairs have reported more confident decision-making," she shared, emphasizing how data-backed insights enhance feedback and support individualized learning plans.
Lisa Persaud noted that "on-the-fly evaluations" and mobile-friendly systems significantly increase data collection, contributing to a more holistic view of learner progress.
Dr. Davies underscored the clinical perspective: “Before, you just had to get through your program… but now assessments are tied to promotion.” This shift ensures residents acquire the competencies they truly need for independent practice.
What are the biggest practical challenges when transitioning to CBME?
Dr. Davies emphasized the time commitment and cultural shift involved. “Even years after launch, we’re still trying to breed the culture,” he said. Adapting to CBME requires ongoing advocacy and support, especially from busy faculty.
Lisa St. Amant echoed this, noting the heterogeneity of medical education across specialties and institutions, necessitating tailored implementations. She stressed the importance of continuous quality improvement (CQI) to address programmatic challenges.
Lisa Persaud pointed to change management as the greatest challenge on the tech side: “Administrators, faculty, and even learners can be resistant… having a strategy and strong communication plan is paramount.”
What innovations or technologies are critical to the future of CBME?
Lisa Persaud sees data visualization dashboards as a game-changer: “We have mountains of data… programs need customizable, easy-to-use tools to make sense of it.”
Dr. Davies agreed, emphasizing user-friendly, adaptable systems for both learners and competence committees. "Anything that makes the process easier helps. If it’s hard to use, it becomes just another task."
Lisa St. Amant added that the next generation of e-portfolios must go beyond EPA reporting. “We need platforms that integrate multiple sources of data—communication, professionalism, and more—into a comprehensive summary for the resident.”
How can academic institutions and tech providers work more effectively together?
Lisa Persaud highlighted the importance of having a technical team that can bridge both worlds—understanding educational needs and communicating them to developers. Regular communication, training, and support in various formats are essential.
Lisa St. Amant shared similar experiences at the University of Toronto, where close collaboration between systems and education teams helps address problems swiftly and creatively. She emphasized that tech solutions in medical education must be flexible and context-aware.
Dr. Davies suggested institutions and bodies like the Royal College could define minimum standards for e-portfolios, helping guide development while allowing customization.
What are the key steps to successfully implement CBME?
Dr. Davies offered a practical metaphor: “CBME isn’t an excisional biopsy—it’s more like core sampling. You don’t need to evaluate every interaction; you need a good, representative sample.” He emphasized starting small and manageable, and buy-in from faculty, and iterative quality improvement.
Lisa St. Amant advocated for piloting components early, even before the official launch. “Even training senior residents helps onboard new ones.” She also highlighted the need to assess departmental readiness and reallocate support proactively.
Lisa Persaud added that strong relationships with faculty, clear communication, and a central CBME faculty lead are essential for managing the inevitable turbulence during transition.
Conclusion and key takeaways
The panel discussion made one thing clear: successfully implementing CBME requires more than just updated curricula—it demands coordinated effort, adaptable technology, and a culture of continuous improvement. As each panelist emphasized, the shift to competency-based medical education is as much about supporting faculty and administrators as it is about empowering learners.
The future of CBME lies in collaboration between institutions, educators, and solution providers who understand the unique challenges of medical training.
Join the conversation
If your institution is reconsidering the tools that support your competency-based educational programs, we invite you to watch the recording of our latest webinar, Choosing a Medical Learner Management Platform in 2025: 10 Key Criteria. For more information on LGI Education, don't hesitate to explore the platform.
