Transforming Surgical Training through Competency-Based Progression
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Abstract
The traditional Halstedian model of surgical education, built on fixed training periods and apprenticeship-style learning, is increasingly insufficient for modern surgical practice. As techniques such as laparoscopy, robotics, and Artificial Intelligence (AI)-assisted procedures advance, rigid time-based training often fails to produce uniformly competent surgeons, raising concerns about patient safety and workforce readiness. Competency-Based Medical Education (CBME) offers a more effective framework by focusing on demonstrated mastery rather than time spent in training. Using structured assessment tools, such as Entrustable Professional Activities (EPA) and Objective Structured Assessment of Technical Skills (OSATS), CBME establishes clear, objective performance standards. Simulation-based training further supports skill development in a controlled environment, reinforcing outcome-driven learning. By prioritising competence, CBME enables individualised progression, more reliable assessment, and greater global alignment in surgical education. This modern approach is poised to improve patient outcomes, trainee satisfaction, and system efficiency.
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