Background <p>In 2017, the General Surgery program began implementing the Competence by Design model as outlined by the RCPSC. As this program was an early adopter of CBME, we identified an opportunity to learn from this experience by examining the experiences of this change process. We explored the experiences of program leaders, faculty and residents in the implementation of Competency-Based Medical Education (CBME), compare planned versus enacted CBME implementation, and identify adaptations for effective CBME implementation.</p> Methods <p>Rapid Evaluation methodology and the Core Components Framework were employed to evaluate CBME implementation. Interviews and focus groups were conducted with program leaders, faculty, and residents. They were transcribed and analyzed abductively. We met with program leaders to review themes and discuss current and future adaptations. The study was conducted at a tertiary care centre in Southeastern Ontario, Canada. We sent email invitations to participate all program leaders/staff, faculty, and residents of the General Surgery program. Nineteen program members (program leaders/staff and faculty <i>n</i> = 9; residents <i>n</i> = 10) participated in the study.</p> Results <p>Participants highlighted challenges enacting the planned implementation of CBME. Three themes represented participants’ perceptions and experiences of CBME implementation: (a) complex systems change, (b) opportunities for growth, and (c) paving the way forward. Themes were subsequently mapped to adaptations identified by the program.</p> Conclusions <p>This study provides insight into how CBME was enacted within a Canadian General Surgery training program. We identified adaptations that can be used to address challenges and enhance the quality of CBME implementation.</p>