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The Implementation of Competency-Based Medical Education in Surgical Training: A Scoping Review
Joon Soo Kim1, Sophie Yu2, Margaret B Mitchell3
1Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
Journal of Surgical Education
|June 26, 2026
Summary
Competency-based medical education (CBME) in surgical residencies shows varied implementation globally. Many programs integrate CBME components into existing structures, highlighting a need for systemic reform for effective surgical training.
Area of Science:
- Medical Education
- Surgical Training
- Competency-Based Education
Background:
- Implementation of competency-based medical education (CBME) in postgraduate surgical training varies significantly worldwide.
- Inconsistent definitions of CBME in practice contribute to this variability.
- This review uses Van Melle et al.'s 2019 framework to analyze CBME implementation in surgical residency programs.
Purpose of the Study:
- To characterize the global implementation of CBME in surgical residency programs.
- To evaluate how different programs align with the core components of CBME.
- To identify patterns and challenges in CBME adoption within surgical education.
Main Methods:
- A scoping review of English-language articles from Embase, PubMed, MedEdPortal, and ERIC (2001-2023).
- Studies describing active CBME implementation in surgical residencies were included; isolated workshops or supplements were excluded.
- Implementations were classified, and studies were evaluated against 5 core CBME components: outcome competencies, sequenced progression, tailored learning, competency-focused instruction, and programmatic assessment.
Main Results:
- Seventy studies from North America and Europe were included.
- Outcome competencies were consistently defined, but sequenced progression, competency-focused instruction, and programmatic assessment were variably implemented, particularly in Canadian and European programs.
- Local innovations and assessment instruments showed feasibility, but full alignment with all 5 core CBME components was rare.
Conclusions:
- CBME implementation in surgical residency is heterogeneous, with many programs adopting a piecemeal approach.
- Greater emphasis on systemic educational reform is needed to support more effective CBME implementation in surgical training.
- Addressing the variability in core component integration is crucial for advancing CBME in surgical residencies.
