The University of Manitoba Orthopedic Surgery Training Program is a 5-year program comprised of 24 months of core rotations in affiliated specialties and 36 months of orthopaedic surgery.  There is a ratio of 12 residents to 36 Faculty.  The Program is based out of the Health Sciences Centre, Pan Am Clinic, Concordia Hip and Knee Institute and Children’s Hospital.  We primarily service the City of Winnipeg, but also provide services to the Province of Manitoba, Northwestern Ontario and Nunavut resulting in a catchment population of over 1 million people. The program includes rotations in adult reconstruction, pediatric orthopaedics, hand surgery, trauma, spine surgery and other subspecialties. There are no mandatory rural rotations. Four months are devoted to elective opportunities one month of which is an internal elective period to augment training in one of the orthopedic subspecialties.  There are opportunities for interprovincial and international electives. Competency Based  Education Residents entering the University of Manitoba Orthopedic Surgery residency program will experience competency-based training. To contribute to the success of Canadian physicians and the delivery of high-quality patient care, the Royal College of Physicians and Surgeons of Canada has embarked upon an initiative to introduce competency-based medical education (CBME) in Canadian postgraduate specialty training and in professional practice in Canada. This initiative, called Competence by Design (CBD), aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their education process. CBD uses time as a framework rather than the basis for progression. It is not anticipated that the duration of training will change for the majority of trainees. Residency programs are broken down into stages, and each stage has a series of milestones based on required competencies. These milestones create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need. All CBD programs continue to undergo the same rigorous accreditation processes as traditional programs. All CBD programs (and traditional programs) will continue to lead to Royal College approved certification. Certification for trainees in both CBD and traditional programs will include the completion of a Royal College examination; however, residents in CBD programs will also be assessed against program milestones throughout their training. Within a CBD program, all milestones (documented within an electronic portfolio) and the Royal College examination must be successfully completed to achieve certification. Training Sites Health Sciences Centre A newly constructed Emergency Department streamlines care at the Health Sciences Centre, while the cast clinic has been remodeled to improve cast and fracture care. The Orthopaedic offices, located in AD4, include a resource room with a library for residents. Concordia Hospital New, state-of-the-art operating rooms with video integration have recently been added to the Arthroplasty Group at Concordia Hospital. Adjacent to the Hospital is the Concordia Hip and Knee Institute, housing research facilities as well as offices for the surgeons and their support staff. Pan Am Clinic Expanded four times within the last six years, the Pan Am Clinic is a state-of-the-art Sports Medicine Centre. Enhancements include video integrated operating rooms for arthroscopy and a state-of-the-art conference room. In addition, the Pan Am Foundation Research and Skills Lab floor houses research equipment for biometrics motion analysis, strength testing, and material properties. Its stations for skills training include virtual reality arthroscopy training. All training sites are video linked to ensure access to all teaching rounds at all sites. Educational Resources Library facilities are available at the Medical College, Health Sciences Centre along with the Section of Orthopedic Surgery library Funding is provided to allow attendance at one conference per year Resident’s lounge with computers   RESEARCH All residents are expected to be involved in ongoing clinical research projects and to give a formal presentation on their work at the Orthopedic Surgery Residents Research Day. Orthopedic Surgery Research Day is a combined day with the University of Saskatchewan. Residents are also expected to submit their research for presentation consideration at the annual Department of Surgery Resident Research Day.