Competence by Design (CBD)

What is CBME?

Competency Based Medical Education, or CBME, is a nationwide cooperative effort by the Royal College of Physicians and Surgeons and medical faculties across Canada that changes the way residents are trained, evaluated, and promoted. This is a transition away from the current time-based model of medical education and toward assessment that is based on demonstrated competencies of professional activities.

What is CBD?

Competence by Design, or CBD, refers to the hybrid version of CBME and the traditional time-based model that the Royal College of Physicians and Surgeons is using. It’s not time-free. Time is instead a resource for learners and programs rather than as a key determinant of program requirements.

CBD is a multi-year initiative that began in 2017 in the Department of Medicine and is ongoing. The goal of CBD is to enhance patient care by improving specialist training and lifelong learning, ensuring physicians demonstrate the skills and behaviours required to continuously meet evolving patient needs.


CBME and CBD are often used interchangeably. While CBME is time-free, the Royal College’s hybrid model is not time-free. Medical Education in Canada is being transitioned to Competence by Design: CBD.

Research in CBD

The Department of Medicine and its residency programs work closely with the PGME office’s CBME Evaluation Lead, Dr Deena Hamza on several ongoing research initiatives. As studies are published, they will be listed below.

Faculty Development

In collaboration with Dr. Anna Oswald, Director, CBME in the Postgraduate Medical Education Office, the Department of Medicine presents a Competence by Design faculty development curriculum on a variety of topics.

Faculty Development in CBME

Resource Cabinet

Developed in consultation with Dr. Anna Oswald, Dr. Steven Katz, and Dr. Vijay Daniels, the Department of Medicine's Resource Cabinet provides support for all faculty, residents, and program coordinators.

DoM CBD Resource Cabinet

Reimagining CBME

Reimagining CBME logo

Reimagining CBME is an educational podcast where we explore the theory, concepts and ideas of Competency Based Medical Education, and endeavor to give you some tools and ideas as you move into a Competence by Design residency educational environment with ease and confidence. Reimagining CBME is a new alternative to traditional models of professional development for faculty, administrators, and residents.

About the Hosts

Hosted by Tessa Cocchio, CBD Coordinator in the Department of Medicine, and Karee Moffatt, CBD Coordinator in the Department of Pediatrics. Tessa & Karee have a unique approach to CBD in their institution, and respective programs, wherein they work collaboratively (with each other and numerous stakeholders) to implement new and innovative concepts and ideas, and to reimagine what already exists or is being done by other programs, other departments or other Universities. They do this with a few main goals always in mind: make it simple, make it accessible, make it versatile, and make something good even better.


This podcast project is supported by the Department of Medicine and the Department of Pediatrics, with recording equipment and hosting funded by the Postgraduate Medical Education Office. Season One is written, hosted, and produced by Tessa Cocchio and Karee Moffatt, with audio engineering by Tessa Cocchio. Our visual design and art assets are by Mathias Grelli. Our theme music is composed by Emily E. Meo.

Release Schedule

Episodes are released twice per month. Season One is 15 episodes long, releasing from August-December 2021. Season Two will launch in early Spring 2022.


In order to remain accessible, transcripts for all episodes are provided. Click here to access.

Contact Information

Jennifer Staniland
Assessment Specialist
Office of Medical Education, Department of Medicine