Rethinking Competency-Based Medical Education in Radiation Oncology: Early Lessons and Future Directions

Competency-based medical education (CBME) represents a global shift in post-graduate medical education over the last few decades. As a specialty requiring precise technical skill and interdisciplinary collaboration in longitudinal patient care, radiation oncology (RO) provides an informative context within which the benefits and challenges of CBME can be explored. In Canada, CBME in RO has been operationalized by the competence by design (CBD) initiative where specialty-specific competencies and entrustable professional activities (EPAs) are used to determine progression in residency training. The assessment of competence in RO is essential and challenging, given both technical and cognitive competencies required for independent practice. By highlighting early lessons learned from CBME implementation in RO, this commentary highlights how these insights can be applied in refining future iterations of educational curricula. By asking the right scholarly questions, the educational community can guide policymakers and improve learning outcomes, ensuring the licensing of competent radiation oncologists that are meeting the demands of the patient populations they care for.