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Fall 2019 (Volume 29, Number 3)

Diary of a Program Director

By Dana Jerome, MD, MEd, FRCPC

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It is my non-patient day and, like all program directors I am sure, I have a pile of things sitting on my to-do list, much more than can be ac- complished in a single “non-patient day.” But that is not what is causing me anxiety today. As I write this, it is now almost three weeks since rheumatology programs across the country launched their Competency by Design (CBD) curriculum. We program directors and other members of the Royal College Specialty Committee have been thinking about this for years. Others, probably some of you, heard about this new curriculum at the last CRA meeting, where it was the topic of the CRA Great Debate. For some of you, it was probably a new concept at the time.

I must say that it has been my deepest fear that even now, three weeks into July, after CBD has already launched, it would still be a “new concept” for some of our rheumatology faculty. I have spent months preparing the documentation, travelling to all of our hospital sites to present faculty development sessions, and coaching our trainees on how to “ask” for an entrustable professional activity (EPA) assessment to be completed.

Has any of this information actually been absorbed or remembered? Are faculty going to participate in what has been viewed to be a more labour-intensive evaluation process?

So with some trepidation, I clicked through to the website where all of our evaluation data is held. Is anyone actually doing this? I wondered. I was eager to check. I opened the file of “Trainee Number 1”. Phew – there is at least one evaluation complete! Nowhere near enough, but at least it wasn’t zero. I clicked through to Trainee Number 2… and 3… and 4… and I was pleasantly surprised. Each had a handful of evaluations completed! These students were well on their way, and the faculty were participating. I felt a wave of relief and, in that moment, felt confident that the curriculum launch was going to be okay.

Such has been the stress of a program director working toward the launch of the new CBD curriculum.

What makes we wake up in a cold sweat at night, though, is the thought that maybe we won’t get it right. That we won’t work out the growing pains. I feel like I could use some of the feedback and coaching I have been trying so hard to provide to our faculty and trainees. Wouldn’t it be nice if someone could tell me, “You should consider doing it this way” or “Next time, try asking for that differently”? But there are no colleagues with years of experience in CBD. As program directors and educators, we are orienteering, trying to find the way forward. So far, a few weeks in, it seems to be working.

So, tonight, I will sleep better and worry a little less about whether or not I can be “entrusted” to roll out this new curriculum.

Dana Jerome, MD, MEd, FRCPC
Program Director,
Rheumatology Training Program
Assistant Professor of Medicine,
University of Toronto
Toronto, Ontario

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