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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 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.

Learning Community

Group of Doctors Around Laptop

Learning Community for Competency-Based Medical Education (CBME) in Undergraduate Medical Education (UME)

The Learning Community for CBME in UME is a new initiative designed to accelerate the implementation of CBME in UME in the United States. Modeled after a similar community for specialty pathways in GME, the Learning Community will support medical educators, institutions, and organizations in the transition toward CBME by fostering collaboration and learning to scale promising practices, align with graduate medical education (GME) and lifelong practice, and support meaningful change.

The Learning Community will focus on the five core components of CBME and include opportunities to:

  • Share innovations in teaching and assessment related to the 2025 Foundational Competencies for UME.
  • Engage in faculty development to support competency-based teaching and assessment.
  • Explore policy and structural needs to enable CBME adoption.
  • Collaborate on strategies for individualized learning plans and developmental progression.
  • Connect with national organizations and peers working toward aligned CBME models across UME, GME, and continuing practice.

The Learning Community will convene 3-4 times annually through a mix of in-person events (typically aligned with national conferences) and virtual discussions.

Overhead view of medical professionals huddling together

Upcoming Learning Community Event

Programmatic Assessment in CBME: Demystifying Principles, Purpose, and Practical First Steps
Webinar | February 24, 2026, Noon-1 p.m.

This webinar will demystify programmatic assessment (PA) in competency-based medical education (CBME) and help UME faculty understand where to begin. Participants will learn what PA is — a coordinated system that gathers multiple low-stakes, competency-aligned data points over time to support meaningful feedback and informed decisions — and what it is not — simply adding more assessments or relying on a single high-stakes exam. The session will introduce core PA principles, including alignment with competencies, triangulation of evidence, rich feedback, and longitudinal coaching. Participants will learn practical first steps for schools beginning this work, offering a realistic roadmap for launching PA in a way that strengthens learning, supports equity, and improves readiness for residency.

By the end of this session, participants will be able to:

  • Define PA and explain how it differs from traditional assessment approaches.
  • Identify the core principles underlying PA.
  • Describe initial steps their medical school can take to implement PA.


Register Now

Trainings

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

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

Save the Dates for 2026
Part I: July 22-24, 2026
Part II: Oct. 14-16, 2026

Tailored specifically for faculty members working in undergraduate medical education (UME) and based on the new Foundational Competencies for UME, this two-part course 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. 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.

Review the Fall 2025 course agenda (registration closed). Email CBME@aamc.org to be notified when registration opens for the 2026 course and to be added to our mailing list for other learning opportunities.

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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