Enhancing curricular alignment: a dual-review crosswalk of educational program objectives to the national undergraduate medical education foundational competencies

The 2024 Undergraduate Medical Education (UME) Foundational Competencies establish a unified national framework specifying 45 MD/DO-common sub-competencies across six domains. Institutions will need to determine whether existing educational program objectives (EPOs) explicitly reflect these competencies, a challenge that is particularly nuanced for mission-driven schools whose curricula emphasize community engagement, primary care, and population health. This study evaluated alignment between institutional EPOs and the new national framework at a community-based MD-granting medical school. A five-member faculty workgroup conducted a structured dual-review crosswalk to map 34 institutional EPOs against the 45 UME sub-competencies. Matrix sections were assigned according to each reviewer’s phase expertise: Phase 1 sub-competencies to two basic science course directors with primary expertise in Phase 1 foundational science education, and Phase 2 and 3 clinical sub-competencies to two physician-educators with curriculum development and direct clinical teaching experience. A fifth member, the Associate Dean for Medical Student Education, provided cross-phase oversight and led drafting of proposed EPO revisions. The workgroup convened multiple times to compare classifications and reach consensus. Each sub-competency was classified as Well Mapped, Partially Mapped, or Not Mapped, based on the strongest EPO relationship identified. Of the 45 sub-competencies, 39 (86.7%) were classified as Well Mapped and 6 (13.3%) as Partially Mapped; none were Not Mapped. Partially Mapped sub-competencies spanned four domains: Professionalism (2); Patient Care and Procedural Skills (2); Medical Knowledge (1); and Interpersonal and Communication Skills (1). Targeted EPO revisions addressed all six gaps through the addition of six new objectives (three in Personal and Professional Development, two in Critical Thinking, and one in Clinical Skills), together with revisions to the language of nine existing EPOs. Following revision, all 45 sub-competencies achieved Well Mapped status, and the institutional EPO set expanded from 34 to 40 objectives. The revised EPO set was approved by the institution’s Medical Curriculum Committee in October 2025. This dual-review crosswalk demonstrated that a mission-driven curriculum can align strongly with a national competency framework while revealing discrete opportunities for explicit language refinement. The process offers a practical, low-resource model for institutions seeking to systematically align institutional program objectives with the 2024 UME Foundational Competencies.