Competency-based Medical Education in India: Between Promise and Practice

Competency-Based Medical Education (CBME) in India has shifted medical training towards outcomes that emphasise self-directed lifelong learning as a core attribute of a competent physician. Self-Directed Learning (SDL) encourages learners to identify gaps in knowledge, access and evaluate relevant resources, reflect on their learning needs, and integrate knowledge into clinical practice. This paper aims to review the conceptual foundations, implementation strategies, benefits, and challenges of SDL within the CBME framework in undergraduate medical education in India. This narrative review is based on the National CBME guidelines of India, and published literature on SDL in medical education. Key themes included learner readiness, faculty roles in facilitating SDL, assessment methods aligned with SDL, and institutional strategies for integration. SDL improves learner engagement, critical thinking, and adaptability by promoting reflective practice and autonomous learning behaviours. CBME tools such as reflective portfolios, formative feedback, and workplace-based assessments provide opportunities for SDL; however, effective implementation is constrained by limited faculty training, traditional reliance on teacher-centred instruction, and variable student readiness for autonomous learning. SDL is integral to CBME and requires structured approach, faculty development, and institutional support to fulfil its potential in producing reflective, competent, and lifelong learners in medical practice. International Journal of Human and Health Sciences Vol. 10 No. 02 Apr’26 Page: 78-81

Background: Since the implementation of Competency-Based Medical Education (CBME) for undergraduate medical education in India, stakeholders have expressed diverse perspectives. While many appreciated its structured framework and emphasis on competency development, others voiced concerns about implementation challenges, assessment strategies, and overall institutional readiness. Objective: The present qualitative meta-synthesis explored the converging and diverging factors influencing the implementation of CBME. Methods: Using a systematic search strategy, we selected seven qualitative and mixed-methods studies published between 2019 and 2025 from PubMed, Scopus, and Google Scholar. The integration of qualitative findings across studies was guided by Critical Interpretative Synthesis. A total of 130 descriptive codes were developed and categorized under six curricular components: competencies, curriculum content, teaching-learning methods, assessment, curriculum governance, and student support and faculty development. Results: Key challenges included difficulties in framing competency objectives, overlapping content in foundation courses, limited faculty training in self-directed learning and assessments, inadequate support for simulation-based teaching, and misalignment between student priorities and curricular goals. Notable enablers included small-group teaching, simulation-based sessions, well-organized timetables, motivated faculty, and constructive student engagement. However, systemic issues such as infrastructure constraints, inadequate staff, their training in new methodologies, and poor interdepartmental coordination hindered full-scale implementation. Conclusion: The study explored the collective dissonance experienced by stakeholders across various curricular components. Effective implementation of CBME would require committed faculty, adaptive leadership, and a context-sensitive regulatory framework that enables innovation and local relevance. This synthesis offers insights for educators, curriculum planners, and policymakers to refine CBME design and foster improvements in medical education in India.

Recent reforms in competency-based medical education in India - IJFCM- Print ISSN No: - 2394-6768 Online ISSN No:- 2394-6776 Article DOI No:- 10.18231/j.ijfcm.2023.018, Indian Journal of Forensic and Community Medicine-Indian J Forensic Community Med

Background: Competency based medical education (CBME) is implemented recently in India. The study was conducted to evaluate the perspectives of undergraduate medical students towards CBME curriculum at a Government Medical College in Maharashtra. CBME is helpful in expanding the dimensions besides basic medical knowledge to the core competencies of a high-grade skilled clinical graduate. Moreover, value addition with other competencies such as empathy, professionalism, altruism, communication skills, ethics, and humanities that focuses on health systems as a National goal ‘Health for All’. Objective: To explore medical student’s perspective on Competency based medical education (CBME) curriculum at Government Medical College in Maharashtra. Methodology: This cross-sectional descriptive study was conducted among undergraduate medical students at Dr. SCGMC, Nanded. A validated questionnaire was administered through Google link among medical students. Results: A total of 225 students has participated. Around 130 (58%) students are from first year and 96(43.2%) students opined that learning AETCOM skills are necessary and around 125(55.8%) students opined that there should be sometime for sports activities during week days also and 107(48.2%) students stated that early clinical exposure in the first year is beneficial. Conclusion: The CBME curriculum focuses on learning the competencies needed in clinical practice and provides standards and framework for measuring performance. The thrust of the new curriculum attempts to make medical education in India more outcomes oriented.

A<sc>BSTRACT</sc>Background:The introduction of competency-based medical education (CBME) by the National Medical Commission (NMC) in India marked a pivotal transformation in undergraduate medical training. While this framework aims to produce skilled, ethical, and lifelong learners, its implementation, especially during the preclinical years, has presented both opportunities and challenges.Objective:To synthesize current evidence on student perceptions, teaching–learning strategies, early clinical exposure, AETCOM modules, self-directed learning, assessment practices, and institutional variability in CBME implementation across Indian medical colleges.Methods:A structured narrative review was conducted using literature from PubMed, Scopus, ERIC, and Google Scholar. Studies published between January 2019 and May 2025 that focused on undergraduate MBBS CBME in India were included. Thematic analysis was performed across domains, such as teaching–learning methods, student feedback, faculty preparedness, and institutional support.Results:Evidence indicates strong student preference for interactive and integrated learning modalities. Early clinical exposure (ECE) and AETCOM modules were well received but suffered from inconsistencies in delivery. Self-directed learning (SDL) showed variable readiness among the students. Key challenges include faculty training gaps, infrastructural disparities, assessment overload, and heightened student anxiety. Institutional variation, particularly between government and private colleges, impacts curriculum fidelity.Conclusion:While CBME is a promising step toward modernizing Indian medical education, its effectiveness depends on continuous faculty development, contextual curriculum refinement, and integrated student support systems. Harmonizing implementation strategies across institutions is crucial for achieving equitable educational outcomes.

INTRODUCTION:Medical education in India is experiencing a paradigm shift from traditional curriculum to competency-based medical education (CBME). It de-emphasizes time-based training and promises greater accountability, flexibility, and learner centeredness. Faculty development is integral in the context of CBME. Considering faculty perceptions toward the new CBME and addressing the difficulties will play a vital role in successful implementation.MATERIALS AND METHODS:A cross-sectional study was carried out among 297 teaching faculty in 91 medical colleges across 20 states all over India between February and July 2020. A structured validated questionnaire on CBME was used to collect the responses through Google forms and was exported and analyzed in Microsoft Excel.RESULTS:More than 80% opined that Faculty members in departments are not adequate for successful CBME implementation. Reflective learning, early clinical exposure, and elective posting were accepted by 60.2%, 70.4%, and 45.5% of the faculty, respectively. Around 81.8% welcomed horizontal integration, whereas only 54.2% favored vertical integration during the Phase I MBBS.CONCLUSION:Few reforms such as curtailing the duration of foundation course, sensitization of all medical teachers through faculty development programs, better synchronized vertical integration, increasing the strength of faculty in each department, and adequate infrastructure for skills laboratory can be undertaken as per faculty suggestions.

Competency-based medical education (CBME) aims to bring about the sequential acquisition of competencies required for practice. Although it is being adopted in centers of medical education around the globe, there is little evidence concerning whether, in comparison with traditional methods, CBME produces physicians who are better prepared for the practice environment and contributes to improved patient outcomes. Consequently, the authors, an international group of collaborators, wrote this article to provide guidance regarding the evaluation of CBME programs.CBME is a complex service intervention consisting of multiple activities that contribute to the achievement of a variety of outcomes over time. For this reason, it is difficult to apply traditional methods of program evaluation, which require conditions of control and predictability, to CBME. To address this challenge, the authors describe an approach that makes explicit the multiple potential linkages between program activities and outcomes. Referred to as contribution analysis (CA), this theory-based approach to program evaluation provides a systematic way to make credible causal claims under conditions of complexity. Although CA has yet to be applied to medical education, the authors describe how a six-step model and a postulated theory of change could be used to examine the link between CBME, physicians' preparation for practice, and patient care outcomes.The authors argue that adopting the methods of CA, particularly the rigor in thinking required to link program activities, outcomes, and theory, will serve to strengthen understanding of the impact of CBME over time.

The ultimate goal of medical education is to train and prepare aspiring physicians to respond to the health needs of the general population. At present, the medical education system in India relies on a curriculum that is teacher centered and time oriented. Unfortunately, this approach has led to a decline in the competence in recent medical school graduates. A more promising alternative is competency-based medical education (CBME). The implementation of CBME in India could dramatically improve the medical education system and ultimately improve patient outcomes. This article discusses the steps necessary to successfully plan and implement CBME in Indian medical colleges.

Medical education is a systematic process wherein interested and eligible individuals are trained to become physicians/surgeons. It is assumed that a person who completes the Bachelor of Science and Bachelor of Medicine (MBBS) degree will be competent enough to perform the duties of a physician of first contact. However, it is not the case with graduates from India. Most MBBS graduates prefer to pursue a postgraduate degree and become unavailable to people or governments. The doctor-to-patient ratio in India (1:1,655) does not currently satisfy the World Health Organization’s prescribed ratio (1:1,000). The Government of India, therefore, has been taking initiatives to increase the number of MBBS graduates. Moreover, there are several doubts over the quality of medical education and the competency of medical students. In addition, the National Medical Commission, the epic body that regulates the medical education and practice in India, has recently been conducting medical education technology workshops to improve teachers and has devised a new curriculum to elevate the standards of medical education in India. This editorial attempts to provide readers with the current status of medical education and research in India.

Competency-based medical education (CBME) is a method of medical training that focuses on developing learners' competencies rather than simply assessing their knowledge and skills. Attitude, ethics, and communication (AETCOM) are important components of CBME, and the use of artificial intelligence (AI) tools such as ChatGPT for CBME has not been studied. Hence, we aimed to assess the capability of ChatGPT in solving AETCOM case scenarios used for CBME in India. A total of 11 case scenarios were developed based on the AETCOM competencies. The scenarios were presented to ChatGPT, and the responses generated by ChatGPT were evaluated by three independent experts by awarding score ranging from 0 to 5. The scores were compared with a predefined score of 2.5 (50% accuracy) and 4 (80% accuracy) of a one-sample median test. Scores among the three raters were compared by the Kruskal-Wallis H test. The inter-rater reliability of the evaluations was assessed using the intraclass correlation coefficient (ICC). The mean score of solution provided by ChatGPT was 3.88 ± 0.47 (out of 5), indicating an accuracy of approximately 78%. The responses evaluated by three raters were similar (Kruskal-Wallis H P value 0.51), and the ICC value was 0.796, which indicates a relatively high level of agreement among the raters. ChatGPT shows moderate capability in solving AETCOM case scenarios used for CBME in India. The inter-rater reliability of the evaluations suggests that ChatGPT's responses were consistent and reliable. Further studies are needed to explore the potential of ChatGPT and other AI tools in CBME and to determine the optimal use of these tools in medical education.

Medical education in India is confronting a charismatic transformation from traditional curriculum to competency-based medical education (CBME). It is more clinically oriented; skill-based and claims to produce competent Indian medical graduates. CBME has divided subjects into competencies and related topics are scattered over different competencies. The intention behind teaching should not be merely students' learning, but contemplation should be towards concept building, imagination, creativity, self-motivated thinking, and the rightful application of knowledge in day-to-day life. Hence a well-formulated, organized, effective, and practically assessable design and an efficient approach are essential not only to link these spread-over pieces of the topic but to teach that topic in a certain flow and rhythm to a medical student also. Therefore, a stepwise approach has been proposed to teach a CBME-driven curriculum to medical students.

The Competency based Medical Education (CBME) had been introduced by Medical Council of India as an adaptive measure in 2019 curriculum to provide much relief to the stagnant medical education system. The advent of novel corona pandemic had played a devastating role in disrupting the planned system and had put few question marks on our preparedness and pointed the lacunae in our system. The authors had tried to bring about the structural changes and practical challenges which we shall be facing from a medical teacher point of view.

BACKGROUND:The healthcare needs of the general population are on the rise and to meet these demands, the healthcare professionals, especially doctors have to acquire a large number of skills. In the Indian settings, as of now, conventional system of education is being followed in medical colleges and this is despite the fact that it has many flaws associated with it.AIMS AND OBJECTIVES:The objective of the article is to explore the utility and the need of Competency Based Medical Education (CBME) in Indian settings.MATERIALS AND METHODS:It is a brief review of pertaining to the transition of delivery of medical education in India and is well-supported by the studies from different nations.RESULTS:CBME is a thoughtful approach to develop physicians in their future practice and encourages better accountability and flexibility. However, if so many things are good with CBME, then the question arises why it has not been implemented yet across all the medical colleges in India? This is because of the various challenges which have been identified in the planning and implementation phase of the program.CONCLUSION:In conclusion, CBME remains the ultimate solution for the problems persisting in the conventional system of medical education. However, a systemic plan and better involvement of the stakeholders in the preparedness phase will significantly enhance the chances of the success of the program.

Competency-based medical education (CBME) has emerged as one of the modes of the curriculum which is built around a framework of competencies and plays an important role in the making of a healthcare professional who is competent enough to meet the health care needs of the society. The purpose of the current review was to explore the role of e-learning in enhancing learning in different domains of learning and identify the various e-learning resources. An extensive search of all materials related to the topic was carried out on the PubMed search engine and a total of 35 articles were selected based upon the suitability with the current review objectives and analyzed. The search was carried out for a period of one month and all articles published between 2003 to 2021 were included. As only one search engine was used, there were no duplications. Keywords used in the search include e-learning and medical education in the title alone only. E-learning has been acknowledged as one of the significant curricular reforms, which has the potential to bring about a paradigm shift in medical education in India. The basic rationale for the utility of e-learning in the medical curriculum originates from the fact that the syllabus is extremely vast and students have to study many subjects in a fully-packed schedule, and that cannot happen only within the classroom hours. E-learning can play an important role in the augmentation of cognitive, psychomotor, and attitudinal/communication skills through the optimal use of e-learning resources. To conclude, e-learning has emerged as an important approach to strengthen the process of implementation of competency-based medical education in Indian settings. The need of the hour is to acknowledge the merits of e-learning and plan strategies for the successful integration so that the overall process of CBME implementation can be strengthened and streamlined.

Postgraduate medical education is an essential societal enterprise that prepares highly skilled physicians for the health workforce. In recent years, PGME systems have been criticized worldwide for problems with variable graduate abilities, concerns about patient safety, and issues with teaching and assessment methods. In response, competency based medical education approaches, with an emphasis on graduate outcomes, have been proposed as the direction for 21st century health profession education. However, there are few published models of large-scale implementation of these approaches. We describe the rationale and design for a national, time-variable competency-based multi-specialty system for postgraduate medical education called Competence by Design. Fourteen innovations were bundled to create this new system, using the Van Melle Core Components of competency based medical education as the basis for the transformation. The successful execution of this transformational training system shows competency based medical education can be implemented at scale. The lessons learned in the early implementation of Competence by Design can inform competency based medical education innovation efforts across professions worldwide.