Implementing a competency based medical education curriculum in diagnostic radiology: Challenges and Pearls of Wisdom

In 2014, The Royal College of Physicians and Surgeons of Canada (RCPSC) began a national initiative to rollout Competency-Based Medical Education (CBME) for all postgraduate medical programs. This represents a paradigm shift in the approach to resident training and transformative changes on many levels. In 2017, the department of Diagnostic Radiology at Queen's University became an early adopter of the CBME training model. The department began curricular planning using program specific Entrustable Professional Activities (EPAs), milestones based on the CanMeds roles, and an assessment framework. Associated processes were created to support implementation, with formation of a new competence committee, structure and process for academic advisors, and faculty development. In July 2018, the model was implemented using an electronic portfolio system, Elentra. In July 2022, the RCPSC launched the national implementation of their CBME CBD model, which was implemented for the incoming cohorts in the department of Diagnostic Radiology. Drawing from CBME implementation in the department of Diagnostic Radiology at Queen's University, we highlight the challenges encountered at our institution, methods for addressing these challenges, and corresponding outcomes. From our experience, we aim to provide a roadmap for the reader that will aid in planning for CBME implementation at other institutions.