PGME Guidelines for Competence Committees¹

Date of original approval: March 23, 2018
Date of last revision and approval: 
Date for next review: 

1. Each residency program committee (RPC) accredited by the College of Family Physicians of Canada (CFPC) or the Royal College of Physicians & Surgeons of Canada (Royal College) will establish a Competence Committee.
2. The Competence Committee will be responsible for reviewing residents’ readiness for increasing professional responsibility, promotion, and transition to practice.
3. There will be a documented Terms of Reference for the Competence Committee approved by the residency program committee.
4. The Competence Committee will:
   1. work within the processes outlined in “Guidelines for the Assessment of Postgraduate Residents of the Faculty of Medicine at the University of Toronto” (PGME Assessment Guidelines),
   2. use data to make judgements about a resident’s progression through residency (e.g. competence stages, promotion from one year/level to next, identification of needed improvement or remediation, identification of needed enhancement, or enrichment, readiness for certification examinations), and
   3. review assessment and performance data patterns and trends (e.g. across residents, stages, sites, rotations, or assessment tools/approaches) to identify areas of excellence and areas needing improvement for individual residents and the residency program.
5. The Terms of Reference will document the following:
   1. Purpose
   2. Structure
      1. i. Title of the committee
      2. ii. Membership of the committee
      3. iii. Process of selecting the Chair of the committee
      4. iv. Role of the Program Director in the committee
      5. v. Confirm that residents will not be members of this committee²
      6. vi. Confirm that members must not have COI (e.g. be parent/partner of a resident)
   3. Roles and responsibilities/Committee Guidelines
      1. i. e.g. confidentiality
   4. Operational processes
      1. i. Meeting format (e.g. face-to-face or phone)
      2. ii. Quorum for a decision
      3. iii. When and how residents are to be selected for review
      4. iv. How files are to be reviewed and presented
      5. v. Acceptable voting formats (e.g. e-mail voting or ratification)
      6. vi. How a tie is broken (e.g. by Chair of committee or by Program Director)
      7. vii. Role of RPC in ratifying committee decisions and if so, that resident members of the RPC are not present during this process
   5. Decision making process
      1. i. How data is collected, circulated, and stored
      2. ii. Documents to be considered by the committee
         1. i. E.g. Assessment data from the period under consideration, review of previous assessment data to identify pattern of performance over time
      3. iii. Additional data / information to be considered
         1. i. E.g. patient safety needs, service needs of clinical teams, need for different approaches to resident supervision
      4. iv. Whether individual member experience with a specific resident is to be used
      5. v. How decisions are to be recorded and reported to RPC
      6. vi. How decisions are to be reported back to the residents
   6. Possible decisions and judgments
      1. i. E.g. progress between competence continuum stages, promotion
6. Guidelines for Agenda topics
   1. Mandatory topics, such as regularly timed reviews, special cases, follow-up from previous meeting, planned follow-up from current meeting
   2. Regular monitoring of Competence Committee information, systems, processes, and residency program functioning (e.g. annually, bi-annually, semi-annually review; sample topics include: EPAs that may need revision, sites where EPA assessments were low/high).
       

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¹These guidelines apply to programs when they formally implement Competence by Design (CBD). Other programs may use this guideline if approved by the RPC.

²The RPC may elect to include a non-voting resident member when the resident is appointed to a senior or chief role (e.g. Department of Medicine Chief Resident), they are fully oriented to the Competence Committee and serve on the CC for a long period of time (e.g. a year or more).