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.
The three sponsoring organizations plan for the competency initiative and convene the advisory committee.
Early feedback is gathered from more than 1,000 medical professionals, learners, patients, and caregivers about foundational competencies and the implications of adopting common outcomes across undergraduate medical education. The selection of a diverse working group follows a national call for applicants.
The working group develops foundational competencies for undergraduate medical education. Iterative drafts are shared for public review and feedback.
Foundational competencies are distributed broadly, and the community is invited to engage in collaborative efforts to actualize competency-based medical education.
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
Dr. Edgar is the ACGME’s Senior Vice President, Competencies, Milestones, and Faculty Development. She provides leadership for the oversight, development, innovation, and maintenance of domestic and international competencies, the Milestones, and faculty development. She serves as an ACGME ambassador to and collaborator with stakeholders both internal (ACGME International, ACGME Global Services, Department of Education, Review Committees) and external (program director groups, certification boards, medical specialty groups) to advance the implementation of competencies, Milestones, faculty development, and other ACGME strategic initiatives.
Dr. Holmboe is the Chief Executive Officer at ECFMG/Intealth. He is also Adjunct Professor at Yale University, the Uniformed Services University of the Health Sciences, and the Northwestern University Feinberg School of Medicine. His research interests include interventions to improve quality of care and methods in the evaluation of clinical competence.
Dr. Howley is Senior Director for Transforming Medical Education at the Association of American Medical Colleges. She is an educational psychologist specializing in medical and health professions education and joined the AAMC in 2016 to advance the continuum of medical education, support experiential learning, competency based education, and lead curricular transformation across its member institutions and their clinical partners. She is also an adjunct associate professor at the University of North Carolina Chapel at Hill School of Medicine.
Dr. Kirk is the Chief Accreditation and Recognition Officer at the ACGME and Professor Emeritus of Internal Medicine at University of Texas (UT) Southwestern Medical Center in Dallas. She has served successively as Associate Dean for Medical Education, Director in the Office of Medical Education, Associate Dean of Undergraduate Medical Education, and Clinical Sciences Director at UT Southwestern.
Dr. Speicher, as senior vice president of learning, research and innovation, is responsible for overall organizational improvement, including leadership development, Competency-Based Medical Education, and osteopathic medical education systems development. He also leads AACOM’s efforts to identify and develop new projects that advance osteopathic medical education, generate new revenue and/or address related challenges.
Professor and Senior Associate Dean, Office of Innovation in Health Professions Education
Associate Dean for Medical Education; Professor of Medicine, Division of Hospital Medicine
Associate Vice Chair for Justice, Equity, Diversity, and Inclusion
Clerkship Director and Associate Program Director
Assistant Dean of Medical Education for Curriculum and Instructional Design
Instructor of Medical Education
Assistant Professor of Medical Education, Director of Clinical Clerkships, Medical Director of Simulation, Associate Program Director - General Surgery Residency
Clerkship Director; Associate Professor
Academic Hospitalist; School of Medicine Acting Internship Director; Associate Professor, Department of Internal Medicine
Associate Dean, Competency Assessment and Professional Standards; Professor of Medicine
Clerkship Director; Associate Professor of Family Medicine
Professor of Physiology and Pharmacology, Division of Anatomy and Molecular Medicine
Education Fellow
Associate Dean for Assessment and Educational Development
Assistant Dean of Assessment, Evaluation and QI; Interim Assistant Dean of Curriculum; Clinical Professor of Internal Medicine and Learning Health Sciences
Medical Student
Faculty Director of Simulation; Assistant Professor, Department of Clinical Science
Assistant Dean, Medical Student Assessment
MetroHealth, Department of Internal Medicine; Assistant Dean for Longitudinal Clinical Education; Associate Professor, Center for Medical Education
Interim Dean of Academic Affairs; Professor
Senior Associate Dean, Medical Education; Associate Professor, OB/GYN
Senior Vice Dean, Vice Dean of Medical Education, and Professor of Ophthalmology at the Wayne State University School of Medicine
Senior Vice President, Certifying Board Services
General surgery resident at Northwell Health
Dean; Senior Vice President for Health Affairs; and Professor of Surgery, Herbert Wertheim College of Medicine, Florida International University
Clinical Assistant Professor of Obstetrics and Gynecology and Clerkship Director for obstetrics and gynecology at Texas A&M School of Medicine
Associate Professor of Pediatrics in the Division of Pediatric Critical Care Medicine at Vanderbilt University School of Medicine
Faculty, Mercer School of Medicine; President of the International Association of Medical Science Educators
Assistant Dean for Clerkship Education, Michigan State University College of Osteopathic Medicine
Associate Vice President for Competency-Based Assessment at National Board of Medical Examiners
Senior Education Specialist
Curriculum Assessment Program Evaluation (CAPE)
Mayo Clinic Alix School of Medicine
Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Residency Program Director of Obstetrics and Gynecology, North Shore University Hospital
Professor of Integrative Physiology and co-director of the Graduate Program in Integrative Medicine & Health Sciences at Georgetown University Medical Center
Vice President of Undergraduate Medical Education Innovations at the American Medical Association
Professor of clinical medicine and Senior Associate Dean for GME and Faculty Affairs at the Miller School of Medicine, University of Miami
Associate Dean of Clinical Competencies and an Associate Professor of Pediatrics at SUNY Downstate Health Sciences University College of Medicine
Chief Executive Officer of Intealth
President of the Educational Commission for Foreign Medical Graduates (ECFMG)
Board Chair of the Foundation for Advancement of International Medical Education and Research (FAIMER), ECFMG’s nonprofit foundation
Professor Emerita of Medical Education and Psychiatry at Wright State University Boonshoft School of Medicine
Pediatrician and Associate Professor of Pediatrics at the University of Colorado Anschutz Medical Center
Vice President for Professional Development Initiatives and Communications, National Board of Osteopathic Medical Examiners
Third-year osteopathic medical student at Philadelphia College of Osteopathic Medicine –South Georgia campus
Vice Chair for Education and Academic Affairs, and Director of Residency Training at The University of Chicago
Chief Internal Medicine resident and Captain in the U.S. Army at the Western Michigan University Homer Stryker M.D. SOM
Dean of New York Institute of Technology College of Osteopathic Medicine
Professor of Medicine in the Division of Gastroenterology at NYU Grossman School of Medicine
Please share your questions, ideas, suggestions, and concerns. All feedback received will be reviewed and if you would like a response, please include your email address. If you would like to submit anonymous input, please leave the optional identifying fields blank. Note: maximum 4,000 characters.
|
