Issues impeding satisfactory outcomes with the competency-based medical education program for undergraduates, and some possible solutions

The announcement of the competency-based medical education (CBME) curriculum for undergraduates by the National Medical Commission (NMC) in India in 2019, and its consequent implementation by all medical colleges has, by and large, been unsatisfactory because of many difficulties experienced by colleges in its implementation. The program has over 2800 listed competencies for the students to be trained in, over 800 listed skills, and over 100 skills for mandatory certification before the summative examination. The greatest reason for failure, however, is no major change in the assessment process with CBME. Workplace-based assessment methods on a continuous basis are well known and applied widely in other countries. However, these are yet to be widely accepted and notified by the regulatory agency for the Indian undergraduate medical student. We focus on the reasons for the unsatisfactory state of affairs in CBME assessment that have led to deficiencies in the intended outcome. Major policy changes in assessment such as revision of the list of competencies and skills, along with adoption of a combined formative-summative assessment process based on learning place-based assessment methods could ensure creation of an adequately trained Indian medical graduate.