Exploring Competency-Based Medical Education Through the Lens of the UME-GME Transition: A Qualitative Study

Area of Science:

• Medical Education
• Health Professions Education
• Competency-Based Medical Education

Background:

• Competency-based medical education (CBME) is a paradigm shift focusing on learner outcomes and competence assessment.
• The transition from undergraduate medical education (UME) to graduate medical education (GME) is evolving, impacting CBME implementation.

Purpose of the Study:

• To explore medical educators' experiences with CBME assessments during the UME-GME transition.
• To identify challenges and perspectives on implementing CBME across the UME-GME continuum.

Main Methods:

• Qualitative methodology using constructivist principles.
• In-depth, semistructured interviews with UME and GME leaders in CBME (February 2019-January 2020).
• Thematic analysis of interview transcripts to identify patterns.

Main Results:

• Four overarching themes emerged: mistrust between UME and GME, misaligned goals in residency selection, inadequate communication regarding competence, and inflexible training timeframes.
• Mistrust, misaligned goals, poor communication, and rigid timeframes impede CBME implementation.
• Interviewees represented UME and GME leadership, primarily with internal medicine backgrounds.

Conclusions:

• Despite commitment to CBME, identified challenges hinder successful implementation across the UME-GME continuum.
• Addressing mistrust, misaligned goals, communication gaps, and timeframes is crucial for effective CBME adoption.
• Improving the UME-GME transition requires acknowledging and resolving these identified themes for educators.