Eight-year outcomes of a competency-based residency training program in orthopedic surgery

Med Teach. 2018 Oct;40(10):1042-1054. doi: 10.1080/0142159X.2017.1421751. Epub 2018 Jan 18.


Background: The Division of Orthopaedic Surgery at the University of Toronto implemented a pilot residency training program that used a competency-based framework in July of 2009. The competency-based curriculum (CBC) deployed an innovative, modularized approach that dramatically intensified both the structured learning elements and the assessment processes. Methods: This paper discusses the initial curriculum design of the CBC pilot program; the refinement of the curriculum using curriculum mapping that allowed for efficiencies in educational delivery; details of evaluating resident competence; feedback from external reviews by accrediting bodies; and trainee and program outcomes for the first eight years of the program's implementation. Results: Feedback from the residents, the faculty, and the postgraduate residency training accreditation bodies on the CBC has been positive and suggests that the essential framework of the program may provide a valuable tool to other programs that are contemplating embarking on transition to competency-based education. Conclusions: While the goal of the program was not to shorten training per se, efficiencies gained through a modular, competency-based program have resulted in shortened time to completion of residency training for some learners.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accreditation
  • Attitude of Health Personnel
  • Canada
  • Clinical Competence
  • Competency-Based Education / organization & administration*
  • Curriculum*
  • Humans
  • Internship and Residency / organization & administration*
  • Orthopedics / education*
  • Pilot Projects
  • Program Evaluation