Fairness: the hidden challenge for competency-based postgraduate medical education programs.

Area of Science:

• Medical Education
• Competency-Based Education
• Systems Thinking

Background:

• Competency-based medical education (CBME) individualizes learning but must ensure fairness.
• Learner probation or dismissal due to unmet competencies can lead to legal challenges.
• Existing literature lacks in-depth examination of fairness in CBME.

Purpose of the Study:

• To examine fairness within postgraduate medical education using a systems lens.
• To identify potential threats to fairness in educational opportunities, assessment, and decision-making.
• To explore legal implications and environmental factors affecting fairness.

Main Methods:

• Literature search for studies on fairness in medical education.
• Systems analysis of fairness in postgraduate training.
• Examination of legal and environmental aspects of fairness.

Main Results:

• No prior in-depth examination of fairness in CBME was found.
• Fairness issues can arise in educational opportunities, assessments, and decision-making processes.
• Concerns about fairness are universal in competency-based medical education frameworks.

Conclusions:

• Assessment oversight and program evaluations can reveal hidden fairness threats.
• Recognizing potential fairness issues is the first step toward addressing them.
• Proactive discussions are needed to ensure fairness in all medical education programs.