The Canadian medical education system is structured by a logical progression from breadth to depth of knowledge and training. As such, Canadian medical education has traditionally followed a pre-planned course of training where a student moves across a continuum that is grounded on time-based curricula and final assessments prior to entering a less structured and longer phase of learning in practice.
While to some extent dependent on individual and program, the training pathway typically follows the phased journey as follows:
2-4 years University Undergraduate
3-4 years Medical School
2-5 Years Residency (post-MD)
Following residency, learners also have the option to complete subspecialty training (typically 1-3 years) and/or complete training in an Area of Focused Competency (AFC).
Canada has an international reputation for producing competent and highly skilled physicians. An examination of the medical education system in Canada must acknowledge and respect the many successes of the current system of training. There are several key valued features of the system, including:
The contemporary medical education system in Canada is the product of a series of developments and major changes throughout history. However, since the early 20th century, few major revolutions in the medical education system had been enacted. The system is facing a number of contemporary pressures. New demands are emerging, owing to the increased complexity of the society that the system serves.
The section below details current pressures on the Canadian medical education system, the impact, as well as the desired state moving forward.
Exponential increase in the wealth of knowledge required by trainees and practicing professionals alike.
The health care system is increasingly pressured to provide preventative care and care for complex, chronic illness.
The health care system is increasingly team-based and interprofessional, but our training systems are not.
An era of fiscal restraint, which is experienced both in terms of staffing constraints and limited budgets.
Traditional models of medical education are built to prepare health care professionals for the health care systems of the past. The implementation of CBME programs offers the ability to adjust and focus training curricula based on the current and evolving needs of the population. Such an update is essential to ensure this fundamentally important system is positioned to keep pace with the dramatic evolutions of our contemporary society.
The list below illustrates several adaptations of CBME in various Canadian contexts.