title: Defining a competency framework: the first step toward competency-based medical education.
abstract: Despite the existence of a large variety of competency frameworks for medical graduates, there is no agreement on a single set of outcomes. Different countries have attempted to define their own set of competencies to respond to their local situations. This article reports the process of developing medical graduates' competency framework as the first step in the curriculum reform in Tehran University of Medical Sciences (TUMS). A participatory approach was applied to develop a competency framework in Tehran University of Medical Sciences (TUMS). Following literature review, nominal group meetings with students and faculty members were held to generate the initial list of expectations, and 9 domains was proposed. Then, domains were reviewed, and one of the domains was removed. The competency framework was sent to Curriculum Reform Committee for consideration and approval, where it was decided to distribute electronic and paper forms among all faculty members and ask them for their comments. Following incorporating some of the modifications, the document was approved by the committee. The TUMS competency framework consists of 8 domains: Clinical skills; Communication skills; Patient management; Health promotion and disease prevention; Personal development; Professionalism, medical ethics and law; Decision making, reasoning and problem-solving; and Health system and the corresponding role of physicians. Development of a competency framework through a participatory approach was the first step towards curriculum reform in TUMS, aligned with local needs and conditions. The lessons learned through the process may be useful for similar projects in the future.
authors.affiliation: Department of Internal Medicine, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran. mirzazad@tums.ac.ir.
authors.forename: Azim
authors.initials: A
authors.lastname: Mirzazadeh
authors.affiliation: Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. sa_mortazhejri@razi.tums.ac.ir.
authors.forename: Sara
authors.initials: S
authors.lastname: Mortaz Hejri
authors.affiliation: Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Emergency Medicine, Clinical Skill Center, Tehran University of Medical Sciences, Tehran, Iran. mjalili@tums.ac.ir.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jalili
authors.affiliation: Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. fasghari@tums.ac.ir.
authors.forename: Fariba
authors.initials: F
authors.lastname: Asghari
authors.affiliation: Department of Emergency Medicine, Clinical Skill Center, Tehran University of Medical Sciences, Tehran, Iran. alabaf@tums.ac.ir.
authors.forename: Ali
authors.initials: A
authors.lastname: Labaf
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. sedaghat@tums.ac.ir.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Sedaghat Siyahkal
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. ali_afshari@tums.ac.ir.
authors.forename: Ali
authors.initials: A
authors.lastname: Afshari
authors.affiliation: Educational Development Office, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. narsis_saleh@yahoo.com.
authors.forename: Narges
authors.initials: N
authors.lastname: Saleh
mesh_terms: D002983:Clinical Competence; D003162:Competency-Based Education / Q000379:methods*; D003479:Curriculum; D004501:Education, Medical / Q000458:organization & administration*; D006801:Humans; D007492:Iran; D013337:Students, Medical