Twelve Tips for Implementing Competency-Based Medical Education (CBME) in Resource-Limited Educational Settings

This experience-informed perspective article presents twelve practical tips for implementing Competency-Based Medical Education (CBME) in resource-limited educational settings (RLS). CBME has gained global traction as a framework aligning medical training with patient care outcomes, yet its implementation in RLS remains challenging due to constraints in infrastructure, faculty capacity, and system readiness. The tips emerged from the collective lived implementation experience of the authorship team-medical educators and researchers with direct CBME experience in RLS-triangulated with a targeted narrative review of the literature, and were finalized through iterative consensus. The twelve tips are: (1) Secure formal institutional commitment to drive change; (2) Adapt the CBME framework to reflect local contextual needs; (3) Map competencies to the existing curriculum for strategic integration; (4) Engage learners as co-creators of the CBME experience; (5) Use Entrustable Professional Activities (EPAs) to translate competencies into clinical action; (6) Prioritize low-cost, high-impact assessment methods; (7) Develop local assessment champions to lead sustainable change; (8) Leverage educational technologies and low-fidelity simulation for scalable CBME delivery; (9) Build peer learning networks and communities of practice; (10) Implement a phased rollout to build readiness and sustainability; (11) Invest in faculty development to foster a CBME-aligned mindset; and (12) Assess and build systems readiness for sustainable CBME implementation. This practical guidance aims to support educators, curriculum leaders, and administrators in low- and middle-income countries (LMICs) seeking to adapt and implement CBME in a sustainable, contextually appropriate manner.