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Foundational Competencies for Undergraduate Medical Education

Foundational Competencies for Undergraduate Medical Education

Through an inclusive and iterative process, the AAMC, AACOM, and the ACGME co-sponsored the creation of a common set of national foundational competencies for use in undergraduate medical education programs in the U.S. that align horizontally among UME programs and vertically across the continuum of medical education. 

  • First co-constructed CBE framework across UME, GME, MD & DO communities
  • Most inclusive process to develop a framework - intentionally included learner, patient and clinical leaders’ perspectives
  • Collaborative efforts are underway to operationalize this competency framework

Overview

Medical Professionals Practicing on Medical Supplies

Foundational Competencies for Undergraduate Medical Education

The Association of American Medical Colleges (AAMC), the American Association of Colleges of Osteopathic Medicine (AACOM), and the Accreditation Council for Graduate Medical Education (ACGME) are co-sponsoring an initiative to create a common set of foundational competencies for use in undergraduate medical education programs in the United States.

This initiative aligns with recommendations outlined in the Undergraduate Medical Education-Graduate Medical Education Review Committee (UGRC) report and is part of a comprehensive effort by all three organizations to improve the transition to residency.

An initial draft of undergraduate medical education competencies was developed by a diverse working group and circulated in January, 2024. Following feedback received from the community on the initial draft, a revised second and third draft were developed. The second draft of the competencies was circulated in April 2024 and community input was collected through May 10, 2024. A third draft was reviewed by the Advisory Committee, Reactor Panels and others before final publication in December 2024.

The co-sponsors are actively engaged in creating additional resources and offerings to support the use of the competencies in local practice. This includes a new learning community for Competency Based Medical Education (CBME) in UME, instructional guides, and a new faculty development train-the-trainer course. As these become available in 2025, details will be added to this website and shared broadly. Please direct questions or concerns to CBME@aamc.org.

Upcoming Events

Developing Faculty Skills in Competency-Based Medical Education (CBME) Agenda

Developing Faculty Skills in Competency-Based Medical Education (CBME)

September 10–12 & December 3-5 | Chicago, IL

The course, tailored specifically for those faculty members working in undergraduate medical education (UME) and based on the new Foundational Competencies for UME, begins with a review and exploration of key principles and concepts of competency-based medical education (CBME), and then drills deeper into more specific assessment methods, skills, and approaches throughout the week. The course is highly interactive, and uses multiple learning approaches combined with systems thinking to help participants build effective competency-based educational programs, including those with robust systems of assessment.
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Learn Serve Lead: CBME Learning Community for UME Session

November 1 | San Antonio, TX

The CBME Learning Community for UME is designed to accelerate the development of and transition to CBME in undergraduate medical education (UME) in the United States. Modeled after a similar community by the ABMS and ACGME for specialty pathways in GME, this forum will serve to recognize the five essential core components of CBME as well as barriers and facilitators to addressing them in UME. Join us to learn from experts in CBME, share practices, and lessons learned. Open to all engaged in medical education, faculty development, and assessment of medical students. A full agenda to be shared closer to the event by emailing CBME@aamc.org.
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Frequently Asked Questions

Having a shared set of competencies will help ensure that medical schools are providing a similar foundation for their graduates, and it will help promote a shared language about these outcomes. It will also aid in teaching and learning across the continuum of medical education. Considering the UME-GME transition specifically, one of the recommendations of the Coalition for Physician Accountability’s Undergraduate Medical Education-Graduate Medical Education Review Committee (UGRC), was to “jointly define and implement a common framework and set of outcomes (competencies) to apply to learners across the UME-GME transition.” Residency training selection may be aided if similar language about expected outcomes is used and shared.1

Yes, but not without systematic review by local faculty and formal consideration through the school’s curriculum governance process. Schools may choose to use the Foundational Competencies – or a subset of the subcompetencies - verbatim, if after reviewing/vetting, they determine that they fully align with their medical school education program’s intended outcomes. No set of externally developed competencies, including the New Foundational Competencies for UME, should be used without careful and formal faculty review. According to the LCME co-secretaries, this way of adopting and utilizing the competencies is consistent with LCME expectations. For example, as part of the ongoing and systematic monitoring, review, and revision of a medical school’s EPOs, the Curriculum Dean could invite the medical school curriculum committee (or subcommittee) to consider how the Foundational Competencies in UME align or map with the local EPOs. This process may reveal additional outcomes beyond the Foundational Competencies for UME are needed to reflect the local mission and vision of the medical school’s educational program.

The AAMC PCRS served an important need at the time it was developed and released in 2013. However, medical education and healthcare have changed significantly since that time. The foundational competencies will replace the PCRS. In addition, the Foundational Competencies are being developed differently and in a more collaborative and inclusive manner. For example, they are being jointly sponsored by AAMC, AACOM, and ACGME and have received broad input from many individuals who have a stake in their use (the public, medical students, faculty, health system leaders, staff and more).2

As the name implies, the Foundational Competencies are designed to reflect common outcomes for foundational abilities of medical students. They are not intended to be exhaustive of everything a student may be expected to achieve during their undergraduate medical training. Additionally, schools will likely want to build upon these competencies and add outcomes that are reflective of their own mission, principles, and community.

Medicine is a diverse field, with training differentiated at various steps along the continuum. The purpose of the foundational competencies will be to describe the outcomes expected for all graduates of U.S. medical schools, both DO and MD degree-granting schools, before they enter specialty-based residency training. Importantly, these competencies may not address the entirety of what is necessary for a graduate who pursues training in a particular specialty. Medical schools or specialty societies may choose to identify additional competencies related to a given specialty or career path. Starting with a basic foundation for all students, then expanding individually based on specialty choice, will promote continuity across the medical education continuum.

A detailed description of our methods can be found on page 6 of the Foundational Competencies Report. In short, an advisory committee, representing 24 stakeholder organizations, was convened for 20 months to guide and inform the process. The competencies (and subcompetencies) were developed by a working group representing 21 individuals, including MD and DO medical school course/clerkship directors, assistant/associate deans, residency program directors, and learners. This group began drafting competencies after reviewing the literature and early input from 100s of individuals during an exploratory phase of the project. Additionally, two reactor groups – patient/caregiver and DO/MD medical student – were formed to provide ongoing feedback to the working group. After public release of two drafts, thousands of individuals have provided valuable feedback, which is being incorporated into the final version. We intend to revisit and update the competencies every 5-8 years.

The project sponsors and advisors are currently working on plans for supporting schools in using the Foundational Competencies. This includes supporting the medical education community as they align educational activities, teaching and assessment methods, consider additional assessment tools, transform data management tools, share implementation strategies and case studies to help move all schools further towards competency-based education. Stay tuned for more and share your own ideas and practices by emailing CBME@aamc.org or completing the form below.

The Liaison Committee on Medical Education (LCME) is recognized by the U.S. Department of Education to serve as the accreditation body for US medical school programs awarding the MD degree. The AAMC and the American Medical Association co-sponsor the LCME; neither sponsor has a role in setting accreditation standards or requirements, in making accreditation decisions, or in designing and implementing accreditation processes. Although the LCME accepts and considers input from others, it makes decisions about accreditation standards independently. Thus, the LCME will be informed of, but not directly involved in, this work, and adoption of the resulting competencies will not be a specific requirement for accreditation.

The Commission on Osteopathic College Accreditation (COCA) of the American Osteopathic Association (AOA) is recognized by the U.S. Department of Education as the accreditor of colleges of osteopathic medicine. COCA accreditation signifies that a college has met or exceeded the Commission's standards for educational quality. COCA is independent of AACOM. The COCA will be informed of the work of the competencies revision and will be represented in the process as a part of the AOA.

1. Undergraduate Medical Education-Graduate Medical Education Review Committee. Recommendations for Comprehensive Improvement of the UME-GME Transition. Coalition for Physician Accountability; 2021. Accessed July 11, 2024.
https://physicianaccountability.org/wp-content/uploads/2021/08/UGRC-Coalition-Report-FINAL.pdf

2. Physician Competency Reference Set (PCRS) links to schools’ program objectives. Association of American Medical Colleges. Accessed July 11, 2024.
https://www.aamc.org/data-reports/curriculum-reports/data/physician-competency-reference-set-pcrs-links-schools-program-objectives

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