Competency-Based Time-Variable Graduate Medical Education: Considerations for Trainees, Programs, Clinical Competency Committees, and Boards

Competency-based medical education (CBME) is increasingly used as a framework for graduate medical education (GME). “Promotion in Place” (PIP) is a specific competency-based time-variable CBTV-GME model, where each trainee graduates into a period of “sheltered independent” practice when they achieve competency. While there is growing interest in piloting CBTV-GME and evidence that supports favorable outcomes, GME programs and boards considering a pilot may have questions about challenges and opportunities.

In this session we will address key considerations for trainees, programs, clinical competency committees (CCCs), and Boards. We will draw on examples and lessons learned from the development and implementation of the PIP pilot, now in year 5 at Mass General Brigham (MGB). A brief update on additional specialties considering and/or actively planning to pilot the PIP CBTV-GME model will be presented.

A series of customizable guides will be shared including process maps, common assessment commitments, a CCC simulation guide for competency-based determination of readiness for independent practice, and an FAQ. We aim to engage participants in a discussion of how other programs and specialties have adapted and customized these guides and templates while considering and/or implementing a CBTV-GME pilot. This interactive session will invite questions and discussion about key considerations, challenges, and opportunities for programs, specialties, and Boards considering a PIP CBTV-GME pilot.