While competency-based programmatic assessment systems have become widespread worldwide, there are few comparisons of competence assessment in orthopaedic surgery between countries. In this paper, we provide a narrative overview of current systems in the United States, Canada, United Kingdom and Ireland, and Australia. We explore what types of workplace-based assessments are used, how many data points are gathered to inform entrustment and progression decisions and whether there is validity evidence using a modified Kane framework. Significant concordance and some variation were found between the programs, and the issues identified are discussed along with the challenges and potential solutions for enhancing competence assessment.
Ashman et al. (Wed,) studied this question.