title: When traditional model meets competencies in Singapore: beyond conflict resolution.
abstract: BACKGROUND
  The implementation of competency-based internal medicine (IM) residency programme that focused on the assurance of a set of 6 Accreditation Council for Graduate Medical Education (ACGME) core competencies in Singapore marked a dramatic departure from the traditional process-based curriculum. The transition ignited debates within the local IM community about the relative merits of the traditional versus competency-based models of medical education, as well as the feasibility of locally implementing a training structure that originated from a very different healthcare landscape. At the same time, it provided a setting for a natural experiment on how a rapid integration of 2 different training models could be achieved.
  
  
  METHODS
  Our department reconciled the conflicts by systematically examining the existing training structure and critically evaluating the 2 educational models to develop a new training curriculum aligned with institutional mission values, national healthcare priorities and ACGME-International (ACGME-I) requirements.
  
  
  RESULTS
  Graduate outcomes were conceptualised as competencies that were grouped into 3 broad areas: personal attributes, interaction with practice environment, and integration. These became the blueprint to guide curricular design and achieve alignment between outcomes, learning activities and assessments. The result was a novel competency-based IM residency programme that retained the strengths of the traditional training model and integrated the competencies with institutional values and the unique local practice environment.
  
  
  CONCLUSIONS
  We had learned from this unique experience that when 2 very different models of medical education clashed, the outcome may not be mere conflict resolution but also effective consolidation and transformation.
authors.affiliation: Internal Medicine Residency Programme, National University Health System, Singapore.
authors.forename: See Meng
authors.initials: SM
authors.lastname: Khoo
authors.forename: Manjari
authors.initials: M
authors.lastname: Lahiri
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Huggan
authors.forename: Sophia
authors.initials: S
authors.lastname: Archuleta
authors.forename: Dariusz P
authors.initials: DP
authors.lastname: Olszyna
authors.forename: Wei Ping
authors.initials: WP
authors.lastname: Goh
authors.forename: Gerald S W
authors.initials: GS
authors.lastname: Chua
authors.forename: Khek Yu
authors.initials: KY
authors.lastname: Ho
mesh_terms: D000068:Accreditation; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D017145:Models, Educational; D017008:Negotiating; D012846:Singapore