CBME, by the ICBME Collaborators, Competency-based medical education
by ICE Blog Admin

1 + 1 + 1 = 1

By: Dorothy Andriole MD, Laura Edgar EdD CAE, Lisa Howley PhD MEd, and Mark R. Speicher, PhD, MHA

In the sometimes siloed and discontinuous world of U.S. medical education, three national organizations developed a unique collaboration to co-sponsor the development of a single set of foundational competencies for undergraduate medical education in the United States…here’s the story of the WHY, HOW, and WHAT’S NEXT about this unique collaboration in advancing competency based medical education (CBME) in the U.S.

WHY?

The year 2020 marked the end of two separate accreditation systems for graduate medical education (GME)  in the U.S. with the  completion of a 5-year process of  integration of the osteopathic educational tradition into the Accreditation Council for Graduate Medical Education  (ACGME) accreditation system and the phasing out of the American Osteopathic Association (AOA)  process of accreditation.1  Since  2020, all GME programs in the U.S. are  accredited by a  single body, the ACGME, and all medical schools in the U.S.  – both MD-granting (allopathic) and DO-granting (osteopathic) – prepare their students to enter the same ACGME-accredited GME system after graduation.

Also in 2020, the Coalition for Physician Accountability (CoPA),2  a consortium of organizations in the U.S.  that represent the continuum of medical education through assessment, accreditation, licensure, and certification activities, charged a committee of experts and stakeholders in undergraduate medical education (UME) and GME to develop a set of recommendation to improve the transition to residency.  This Undergraduate-Graduate Review Committee (UGRC) produced a  report with 34 recommendations to improve the transition to residency which the CoPA accepted and released in 2021.3 The term,  “competencies” appears over 100 times in the report,  underscoring a fundamental  focus on competency based education in the transition to residency; recommendation #9 states  that, “ UME and GME educators, along with representatives of the full educational continuum, should jointly define and implement a common framework and set of outcomes (competencies) to apply to learners across the UME-GME transition.” 3  Concurrently, strategic prioritization at the Association of American Medical Colleges (AAMC) to advance CBME across the continuum  supported the development of a common set of foundational competencies for undergraduate medical education.4

HOW?

Shortly after release of the UGRC Report, the executive leadership of three key organizations – ACGME,American Association of Colleges of Osteopathic Medicine (AACOM) and AAMC – jointly decided to co-sponsor an initiative to create a common set of foundational competencies for UME in the U.S., utilizing a framework of 6 competencies that fully aligned with the framework employed by the ACGME for GME programs throughout the U.S.  This initiative represented a collaborative approach for these three organizations. Over the three years, engaging the medical education community at large, a 20-member working group developed the Foundational Competencies for Undergraduate Medical Education. Their work was supported by an advisory committee of members representing key organizations in U.S. medical education across the continuum, as well as reactor panels of medical students and of patients and caregivers. In 2024, the three organizations jointly published the Foundational Competencies for Undergraduate Medical Education . 5

WHAT’S NEXT?

Developing the Foundational Competencies for Undergraduate Medical Education is only the first step in fully implementing competency based education in UME programs throughout the U.S. utilizing a framework fully aligned with that utilized in GME in the U.S. There is much work to be done in the years ahead.

The AAMC, AACOM and ACGME jointly chose to publish the  Foundational Competencies for Undergraduate Medical Education as an  open access publication. While the competencies were developed explicitly for use by U.S. medical schools, medical educators globally may find this set of competencies a useful, free, open-access resource to review, adapt for their local needs in whole or in part, and share widely.   In the U.S., the three sponsoring organizations have launched a learning community for CBME in UME which includes a new faculty development course, guidebooks, workshops, and webinars. Learn more about all that’s up ahead at  Foundational Competencies for Undergraduate Medical Education.sn’t constrain your work at all—it just makes it stronger.

About the Author:

Dorothy Andriole MD is Senior Director, Medical Education Research at the AAMC.

Laura Edgar EdD CAE is Senior Vice President, Competencies, Milestones, and Faculty Development at the ACGME and project team co-lead for the Foundational Competencies for Undergraduate Medical Education

Lisa Howley PhD MEd is Senior Director, Transforming Medical Education at the AAMC and project team co-lead for the Foundational Competencies for Undergraduate Medical Education

Mark R. Speicher, PhD, MA is Senior Vice President of Research, Learning and Innovation at the AACOM and project team co-lead for the Foundational Competencies for Undergraduate Medical Education. Acknowledgements: The authors gratefully acknowledge the contributions of Eric Holmboe MD, past Chief Research, Milestone Development, and Evaluation Officer at ACGME and Lynne M Kirk MD, MACP, past Chief Accreditation and Recognition Officer, ACGME as project co-leads at the ACGME

References

  1. Accreditation Council for Graduate Medical Education. History of the Transition to a Single GME Accreditation System. Available at:
  2.  https://www.acgme.org/about/transition-to-a-single-gme-accreditation-system-history/ . Accessed August 12, 2025.
  3. Coalition for Physician Accountability. Available at: https://physicianaccountability.org/  Accessed August 12, 2025.
  4. Coalition for Physician Accountability, Undergraduate medical education-graduate medical education review committee (UGRC). Recommendations for comprehensive improvements of the UME-GME transition. Available at https://physicianaccountability.org/wp-content/uploads/2021/08/UGRC-Coalition-Report-FINAL.pdf   . Accessed August 12, 2025.
  5. Association of American Medical Colleges. A Healthier Future for All: The AAMC Strategic Plan. Available at https://www.aamc.org/about-us/strategic-plan/healthier-future-all-aamc-strategic-plan  . Accessed August 12, 2025.
  6. Foundational Competencies for Undergraduate Medical Education. Available at UME Competencies AAMC | AACOM | ACGME . Accessed August 12, 2025.

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