Competence By Design: Physical Medicine & Rehabilitation


Competence by Design (CBD) is a Royal College of Physicians and Surgeons of Canada (RCPSC) initiative to transition postgraduate medical education and professional practice in Canada into a model of competency-based medical education.  More information about CBD can be found in the Royal College CBD Residents Guide and the CBME Terminology Reference Sheet

In this model, residents will be required to complete Entrustable Professional Activities (EPAs), which are tasks that can be delegated to a resident and observed by a supervisor. At the end of each rotation, residents will also be evaluated by an In-Training Assessment Report (ITAR). ITARs are linked to the Rotation Plan, which specifies the goals and objectives of each roation. Further details can be found in the Assessment section below.

CBD Stages

PM&R Residency will continue to be five years in duration. It will be split into four stages:

  • Transition to Discipline (TTD) 2 blocks in PGY 1
  • Foundations of Discipline (FOD) 17 blocks in PGY 1-2
  • Core of Discipline (COD) 35 blocks in PGY 2-5
  • Transition to Practice (TTP) 11 blocks in PGY 5

The Royal College Exam will take place during the Core stage.

CBD Physical Medicine & Rehabilitation Curriculum Map

Competence Committee

The Competence Committee (CC) is responsible for making overall assessments for each resident, and recommendations regarding promotion, coaching and remediation, at multiple time points throughout residency (CC Terms of Reference)The committee is made up of faculty members from various sites. The program director (PD) also sits on this committee. They use all the assessments (e.g. EPAs, ITARs, exams, etc.), as well as other relevant criteria (e.g. attendance records, emails to the PD), to make decisions. Residents  are reviewed by the CC at least three times per year. The CC provides their overall assessment and recommendations to the RPC and PD. The PD will meet with the resident (after the CC meeting) to review these recommendations.


List of PM&R EPAs for all stages

All EPAs are completed on the Elentra e-platform and can be initiated by faculty or the resident. Your login credentials for Elentra are your UTORID and password.

Elentra Login and User Guides

If you are unable to login to Elentra or do not know your UTORID, please refer to the Elentra FAQ

EPA Tips for Residents: At the start of each week review your Elentra dashboard to identify one to two possible EPAs for completion and plan the timing with your supervisor. Refer to your individual schedule/learning plan.

Royal College EPA Documents