Orthopedic Residency Training Reform in Iran: A Competency-Based Approach

Area of Science:

• Medical Education
• Orthopedic Surgery Training
• Curriculum Development

Background:

• The traditional time-based apprenticeship model in Iranian orthopedic residency training requires evaluation.
• Trainee burnout and dissatisfaction are significant issues within current orthopedic residency programs.

Purpose of the Study:

• To critically evaluate the existing time-based orthopedic residency model in Iran.
• To design a competency-based curriculum for the initial two years of orthopedic residency.
• To align training with modern subspecialized practice and address trainee well-being.

Main Methods:

• Narrative appraisal of Iranian training standards and synthesis of resident-reported challenges.
• Review of international competency-based frameworks (North America, Europe, Australasia).
• Development and expert panel refinement of explicit milestones and assessment tools.

Main Results:

• A curriculum with 42 competencies across five domains, replacing seniority-based progression with milestone-triggered advancement.
• Integration of simulation laboratories, structured feedback, and wellness sessions.
• Pilot implementation showed increased resident satisfaction and a 30% reduction in burnout symptoms.

Conclusions:

• A competency-based, well-supported curriculum enhances orthopedic resident preparedness and well-being.
• Recommended for nationwide implementation to align with contemporary clinical practice standards.