Emergency Medicine: Program Director's Post - November 2016

CBD... our era’s Flexner revolution

Who is a fan of The Knick? The HBO series about a surgeon, Dr. Thackeray, at the turn of the 19th century is a riveting commentary on medical society and culture of the times.

There is a scene that sticks out in my head. Dr. Thackeray is standing over a man, with multiple Kelly’s retracting the man’s scalp, about to start a surgery. He looks at his audience in the operating room and says, “It’s never been proven to work, but we are going to do it anyway!”

A lot has changed since then, and the reasons for that are rich, complex and intertwined. One of the many reasons is that medical education has changed. The Flexner report published in 1910 slowly transformed medical training from an ad hoc wild-west system into a structured apprenticeship model with more rigorous regulation and control — the one we have inherited today. The Flexner report, though controversial at the time, makes sense to us now. When we watch The Knick, we are relieved to know that its culture of medicine belongs to the past.

Competence by Design (the Royal College’s brand of Competency-Based Medical Education or CBME) is our era’s Flexner revolution. For the first time we are being asked to define what competencies and outcomes we have to achieve during residency, and ensure that those competencies are attained and measured in a standard fashion. Read more about the CBD Continuum, Entrustable Professional Activities, and Milestones 

Additional document: Terminology for Competence-based Medical Education

I invite you to watch an episode of The Knick. It’s fascinating! I also invite you to join us in our CBD journey.  

Please pen in Dec. 6 in your calendars to attend our Visiting Professor Day!