In a healthcare landscape that’s more collaborative than ever, it’s crucial to ensure that future medical professionals are truly prepared to meet real-world challenges before they graduate. Traditional educational models, which often emphasize lecture-based classes, may not always guarantee that graduates have the clinical reasoning and patient skills they need.
This is where competency-based medical education (CBME) comes in. CBME is a transformative approach to instruction and assessment that’s gaining traction in healthcare education around the globe. A 2024 review of CBME practices in BioMed Central Medical Education found that it is being used in nearly every region of the world, including China, Canada, Turkey, and in multiple West African nations.
CBME is an outcomes-based instructional approach. It focuses on measuring whether a learner has achieved specific, predefined competencies rather than just completing a set amount of coursework or training hours. In this model, students progress by demonstrating mastery of skills, knowledge, and attitudes that are essential for professional practice.
Competencies are often defined by accrediting bodies or professional organizations and can include technical skills (like performing a physical exam), clinical reasoning, communication, professionalism, and teamwork. The goal of CBME is for all learners to reach a high standard of performance on specific skills that show what they can do and be, rather than facts they have memorized.
Medical schools have been experimenting with CBME because new physicians are not always ready to perform effectively when they enter the workforce. According to a 2025 paper on CBME in the New England Journal of Medicine, “current evidence suggests that [traditional medical education] has not been effectively preparing learners and that we are at a crisis point that requires a paradigm change.”
CBME aims to ensure that new doctors not only have strong clinical skills, but are well-equipped to work in multidisciplinary teams, handle and analyze information, and more. CBME has the potential to drive better outcomes not just in the classroom, but in the clinic and at the population level. There is also a possibility that CBME could contribute to reduced burnout among physicians: better-prepared, more capable clinicians may feel less overwhelmed in their roles.
The first step of CBME is defining the competencies students need to know and describing the acceptable standards for performing those skills. Many medical schools work to align their curricula with competencies outlined by bodies like the AAMC or, in Canada, the CanMEDS framework. Standards often include entrustable professional activities, or EPAs. EPAs, according to Stanford University, are the “every day” tasks that healthcare providers should be able to perform without supervision once competent. For instance, one EPA might be “initiating management for a patient with chest pain.”
The next step involves designing assessments. One option is OSCEs (Objective Structured Clinical Examinations). OSCEs are simulated scenarios which allow students to demonstrate competencies in a controlled setting. OSCEs can use patient mannequins or actors and are often structured as a series of stations presented in a timed circuit. These simulations test critical skills like patient communication, decision-making, and emergency response.
Finally, student performance must be tracked and analyzed. Many programs use e-portfolios to track a learner’s progress through milestones. These tools allow for personalized learning trajectories and help identify areas where additional support or practice is needed. In the Tiber Health MSMS curriculum, for example, we deploy a predictive analytics-powered dashboard that shows students and instructors exactly where students stand on specific USMLE topics.
CBME’s main advantage is that it puts students in the center of the learning process and focuses on helping them develop their skills to a high level of quality, rather than in presenting a certain amount of material within a certain amount of time. However, it is difficult to implement CBME well.
This difficulty isn’t the result of a lack of will to use CBME. It’s the fact that adopting it requires a cultural shift in how faculty teach and assess, significant faculty development, and robust systems for tracking and documenting learner progress. These are all heavy lifts for even well-resourced universities.
However, as the authors of the New England Journal of Medicine article note, “maintaining a physician education system that fails to consistently produce competent physicians because change is hard reflects fundamentally flawed logic.”
Competency-based medical education is a paradigm shift that can ensure learners become truly competent professionals. If you want your institution to take its first steps toward CBME, start by becoming a Tiber Health MSMS university partner.
Our innovative curriculum mirrors the first year of pre-clinical medical education in a competency-based, predictive analytics-powered learning format that empowers students and faculty to succeed. Learn more here.
