Background: Canadian neurology residency programs recently transitioned to Competence Based Medical Education (CBME), designed to provide residents with stage-appropriate learning to develop and demonstrate competence. The successful implementation of CBME requires iterative evaluation as the adoption process may differ from the intended design due to systemic or program-specific factors. This study aims to (1) examine the variability in CBME implementation across Canadian neurology residency programs; (2) determine the barriers toward uptake of CBME; and (3) identify the benefits and pitfalls of CBME in neurology residency programs. Methods: A separate national survey was developed for residents and staff neurologists who participated in CBME for at least six months. Surveys were distributed through email, and responses were anonymized. Quantitative data were analyzed by response frequency and mean, where applicable. Free-form responses were analyzed qualitatively. Results: Staff neurologists felt prepared for CBME, but were divided on its fairness and impact on education quality. Residents experienced frequent but not necessarily timely or high-quality feedback. Barriers to implementation included increased paperwork, dissatisfaction with online platforms used to facilitate CBME, and bidirectional burden of initiating evaluations. Conclusions: Staff and residents have expressed unique perspectives on the first iteration of CBME. There remain opportunities for improvement in subsequent iterations.