De-emphasizing time-based training in the delivery of competency-based medical education for undergraduates in India: Justification, challenges, and potential solutions

In the conventional medical curriculum in India, the duration of medical graduation is 4.5 years, excluding internship. The limitation of time-based advancement can be understood in two ways, either a student is sent to next professional year without attainment of the desired course outcomes or that students spend unnecessary time in a specific professional even after gaining the required outcomes. Acknowledging these limitations and also after realizing the multiple benefits attributed to Competency Based Medical Education (CBME), the same has been implemented in the Indian set-up for undergraduate courses from 2019 batch onwards. In general, CBME advocates against time-based training, especially because not every student can learn at an identical pace. However, adoption of the same strategy (time-variable) in imparting medical education has its own challenges. In India, even though, in principle, we have adopted all principles of CBME, except the time-variability of the course. However, now the same question arises, if all students learn at varying pace, how can we ensure that within a specified time duration, all the students will attain the desired outcomes? Even though, the task at hand is difficult, it can be accomplished, if we all work together in a planned and coordinated manner. In the mission to produce a competent medical graduate within a defined time interval, there is an immense need for better planning, support from administration, active participation of faculty members, involvement of the students, and better collaboration between departments.