Health and Development Journal

Health and Development Journal

Implementation and Challenges of Competency-Based Medical Education: Evidence from Mashhad University of Medical Sciences

Document Type : Original Article

Authors
Seyyed Mahdi Hoseinifard 1
Effat Saghi 2
Yasin Roudsarabi 1
Zahra Movaffaghi 3
Mahdieh Naderi 4
Sara Sabouri 3
Fatemeh Roudi 2
1 Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Education Development (EDO) Employment, Mashhad University of Medical Sciences, Mashhad, Iran
4 Faculty of Engineering Science, Islamic Azad University, Mashhad, Iran
10.34172/jhad.1214
Abstract
Background: Competency-based medical education (CBME) is an approach focused on training and evaluating medical professionals. The introduction of CBME frameworks has significantly transformed medical education. This research represents the first attempt to evaluate the acquisition of essential competencies within the general medicine program at Mashhad University of Medical Sciences (MUMS), utilizing feedback from graduates and medical interns.
Methods: This cross-sectional study was conducted at MUMS in 2023 and 2024, involving medical graduates and interns from the previous two years at the Faculty of Medicine. Participants were selected using convenience sampling. A researcher-designed questionnaire, developed from a literature review and incorporating elements of the Association of American Medical Colleges (AAMC) questionnaire, was used. The questionnaire’s validity was established through content validity, and its reliability was assessed using Cronbach’s alpha.
Results: The questionnaire return rate was 97%. A study of 367 medical graduates and interns at MUMS revealed an overall mean self-reported competence of 79.02%. Additionally, 62% of graduates felt adequately prepared for independent practice. However, there were notable weaknesses in areas such as information technology, rational drug prescribing, and general procedures. Graduates perceived the relevance of basic science content to general practice as low, with physiology and pharmacology rated highest and genetics and medical physics lowest.
Conclusion: This study showed that the medical education program in Mashhad is not based on CBME and strongly advocates a systemic revision of the medical curriculum at MUMS to align with a CBME framework, thereby strengthening medical students’ capabilities.
Keywords
Competency-based education
Curriculum
Education
Medical students
Subjects
  1. Vasquez JA, Marcotte K, Gruppen LD. The parallel evolution of competency-based education in medical and higher education. The Journal of Competency-Based Education. 2021;6(2):e1234. doi:1002/cbe2.1234
  2. Alharbi NS. Evaluating competency-based medical education: a systematized review of current practices. BMC Med Educ. 2024;24(1):612. doi:1186/s12909-024-05609-6
  3. Giancola SP. Program evaluation: Embedding evaluation into program design and development: Sage Publications; 2025.
  4. Van Melle E, Frank JR, Holmboe ES, Dagnone D, Stockley D, Sherbino J. A Core Components Framework for Evaluating Implementation of Competency-Based Medical Education Programs. Acad Med. 2019;94(7):1002–9. doi:1097/acm.0000000000002743
  5. Bhattacharya S. Competency-based medical education: An overview. Annals of Medical Science & Research. 2023;2(3):132-8. doi:4103/amsr.amsr_27_23
  6. Frank JR, Danoff D. The CanMEDS initiative: implementing an outcomes-based framework of physician competencies. Med Teach. 2007;29(7):642–7. doi:1080/01421590701746983
  7. Simpson JG, Furnace J, Crosby J, Cumming AD, Evans PA, Friedman Ben David M, et al. The Scottish doctor--learning outcomes for the medical undergraduate in Scotland: a foundation for competent and reflective practitioners. Med Teach. 2002;24(2):136–43. doi:1080/01421590220120713
  8. Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach. 2007;29(7):648–54. doi:1080/01421590701392903
  9. Zaini RG, Bin Abdulrahman KA, Al-Khotani AA, Al-Hayani AM, Al-Alwan IA, Jastaniah SD. Saudi Meds: a competence specification for Saudi medical graduates. Med Teach. 2011;33(7):582–4. doi:3109/0142159x.2011.578180
  10. Chaney KP, Hodgson JL. Using the Five Core Components of Competency-Based Medical Education to Support Implementation of CBVE. Front Vet Sci. 2021;8:689356. doi:3389/fvets.2021.689356
  11. Kiguli S, Mubuuke R, Baingana R, Kijjambu S, Maling S, Waako P, et al. A consortium approach to competency-based undergraduate medical education in Uganda: process, opportunities and challenges. Educ Health (Abingdon). 2014;27(2):163–9. doi:4103/1357-6283.143774
  12. McKenzie-White J, Mubuuke AG, Westergaard S, Munabi IG, Bollinger RC, Opoka R, et al. Evaluation of a competency based medical curriculum in a Sub-Saharan African medical school. BMC Med Educ. 2022;22(1):724. doi:1186/s12909-022-03781-1
  13. Soundariya K, Nishanthi A, Mahendran R, Vimal M. Evaluation of Competency-Based Medical Education (CBME) curriculum implementation for Phase II Medical undergraduates: A qualitative study. J Adv Med Educ Prof. 2025;13(1):36–48. doi:30476/jamp.2024.104312.2052
  14. Niroumand E, Sepahi V, Khazaei MR, Vaziri S, Khazaei M. The state of ambulatory education from the viewpoint of externs and interns students at Kermanshah University of Medical Sciences. Educational Development of Judishapur. 2016;7(4):286–97.
  15. Mostafazadeh-Bora M, Rafati Rahimzadeh M, Moghadamnia AA. The Effect of an Early Exposure Training Course on Pharmacology Principles and Prescription Writing on the Satisfaction and Knowledge Level of Pre-clerkship Students. Babol-Jbums. 2025;27(0):e4. doi:22088/JBUMS.27.SUPPLEMENT_1,_MEDICAL_EDUCATION,_.4
  16. Amini M, Ghanavati S, Sagheb M-M, Kojuri J, Dehghani M-R, Nabeiei P, et al. Evaluation of general medicine course from graduated medical students’point of view based on AAMC. Educational Development of Judishapur. 2016;7(3):240–6.
  17. Mirmohammadi S, Mehrparvar A, Bahaloo M, Davari M. Satisfaction of Shahid Sadoughi University of Medical Sciences’ alumni about the quality of medical education. The Journal of Medical Education and Development. 2013;8(2):36-46.
  18. Sargolzaie N, Sarhadi S, Moulaei N, Nikbakht J. Investigating the quality of clinical teaching in major wards of educational hospitals from the perspectives of faculty members and students. Future of Medical Education Journal. 2023;13(4):21–5. doi:22038/fmej.2023.72888.1544
  19. Zamanzad B, Mazi M, Shirzad H. Rate of satisfaction and evaluation of medical students (interns and externs) from the quality of clinical education in the Shahre-kord university of medical sciences-2005. koomesh. 2007;9(1):13-20.
  20. Chan WP, Wu TY, Hsieh MS, Chou TY, Wong CS, Fang JT, et al. Students’ view upon graduation: a survey of medical education in Taiwan. BMC Med Educ. 2012;12:127. doi:1186/1472-6920-12-127
  21. Sherer R, Dong H, Yu F, Fan J, Li J, Jiang I, et al. A survey of graduates’ perceptions on a Chinese medical school’s traditional and reform curricula. Perspect Med Educ. 2016;5(4):244–52. doi:1007/s40037-016-0282-4
  22. Ramazanzade K, Ahmadi Darmian M, Farrokhfall K. An Evaluation of the Quality of Curriculum Implementation of Basic Medical Sciences from the View of Students at Birjand University of Medical Sciences. IJME. 2024;24(0):90-9. doi:48305/24.0.90
  23. Shahidi F, Saqeb MM, Amini M, Avand A, Dowlatkhah HR. Qualitative Evaluation of General Practitioner Training Program as Viewed by Graduates from Shiraz, Fasa and Jahrom Medical Universities. J Adv Med Educ Prof. 2015;3(3):142–9.
Health and Development Journal
Volume 14, Issue 1
Spring 2025
Pages 1-7

  • Receive Date 27 October 2025
  • Revise Date 10 November 2025
  • Accept Date 17 December 2025