Remediation in health professions education: a scoping review of reviews

Becoming a physician requires navigating a deliberately rigorous pathway designed to ensure the development of competent physicians. Although most trainees complete training without difficulty, 2% to 30% require remediation. Remediation is a resource-intensive and emotionally charged process that often falls outside graduate medical education's (GME's) cultural norms, leading to negative personal and societal implications. This scoping review examines reviews on remediation in medical education with a focus on GME.

The authors searched Ovid MEDLINE, Embase, PsycINFO, and Web of Science for knowledge syntheses published from database inception to October 2025 discussing remediation in medical education, with a GME focus. The searches were initially run in December 2023 and updated in May and October 2025. Search terms included remediation, underperforming student, struggling learner, medical education, and review. Narrative and perspective reviews were excluded. A seven-stage remediation framework was used to organize the findings.

Fourteen reviews were analyzed, with most being systematic (7 [50.0%]) or scoping (4 [28.6%]) reviews. Included reviews were published between 2009 and 2025, with most (78.5%) published between 2020 and 2025. Definitions of struggling learner and remediation varied across the literature or were undefined, illustrating an absence of shared clarity in their meanings. Reviews commonly reported on the identification and diagnosis of competency deficiencies and interventions to address them but did not discuss how to communicate and involve learners in remediation planning or on high-impact outcomes to evaluate remediation efficacy.

Clear definitions of remediation in medical education have yet to be agreed on. Furthermore, gaps still exist in our collective knowledge surrounding learner involvement with remediation efforts and in determining impactful outcomes that measure the success of remediation, the struggling learner's reintegration into the health profession after remediation, and, ultimately, improvements in patient care.