Updated Review of Customized Onboarding Strategies for Faculty in Competency-based Medical Education: Emerging Principles and Challenges

Competency-based medical education (CBME) marks a paradigm shift in medical training by prioritizing outcomes over time-based progression and focusing on clearly defined competencies aligned with societal needs. Faculty serve as critical agents of this transformation, but the success of CBME implementation depends significantly on effective and sustained faculty onboarding. This narrative review examines customized onboarding strategies in CBME and explores emerging principles and challenges. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar using keywords such as CBME, faculty development, onboarding, and competency-based assessment. Articles published between 2019 and 2025 were included based on relevance, empirical content, and English language. Data from selected studies were thematically analyzed and validated through expert consultation. Findings highlight persistent challenges in onboarding, such as resistance to change, time constraints, inadequate institutional support, and variable CBME familiarity. The review outlines a phased onboarding model—from preonboarding to continuous support—emphasizing the use of online learning platforms, simulation tools, and peer mentoring to improve faculty readiness. Success metrics include faculty engagement, learner performance, and longitudinal faculty development. While evidence supports CBME’s effectiveness in improving learner outcomes, further empirical validation is warranted to evaluate the impact of tailored onboarding on faculty performance. The review underscores the need for sustainable, context-sensitive, and tech-enabled onboarding frameworks to foster institutional capacity for CBME.