Implementation of Competency-Based Medical Education in a Family Medicine Residency

Competency-based medical education (CBME) provides a paradigm shift in graduate medical education focusing on predefined competencies rather than time. This approach emphasizes frequent assessment along with resident-driven learning plans to promote continuous growth. We assessed how implementation of CBME was perceived by residents, affected resident knowledge, and impacted assessment data.

This was a single-institution, observational study conducted from July 2024 to June 2025. The curricular change included using a direct observation evaluation form, creation of individualized learning plans, and training faculty to be coaches. Perception of CBME implementation was evaluated through a survey sent to all residents. Pre- and postexposure data were collected on in-training exam scores, milestone subcompetency scores, and total evaluations completed. We used descriptive statistics and a one-sided Welch's t test for analysis.

Resident survey data showed residents agreed that implementing CBME, direct observations evaluations, and coaching were positive changes. Accreditation Council for Graduate Medical Education survey data showed an increase in satisfaction with faculty feedback from 3.7/5.0 to 4.0/5.0 postexposure. In-Training Examination scores increased after the exposure across all postgraduate years (P<.00005). The number of total evaluations increased from 646 pre-exposure to 1,173 postexposure. Milestone subcompetency scores did not increase postexposure.

Residents found implementation of CBME within a family medicine residency program to be generally positive. There was a dramatic increase in the number of evaluations completed and satisfaction with faculty feedback. Elements of CBME can be successfully implemented and improve evaluation processes used in family medicine residencies.