Competency-Based Medical Education in Preclinical Training: Reframing Transformations in the Post-Pandemic Era — a Systematic Review

Competency-Based Medical Education (CBME) has evolved over decades, prioritizing real-world proficiency over traditional, time-based training. While its application has been well established in clinical education, its integration into the preclinical phase is gaining traction, particularly in response to the challenges highlighted by the COVID-19 pandemic. The shift to digital learning formats disrupted hands-on training, peer interaction, and professional identity formation, underscoring the need for structured competency development early in medical education. This systematic review explores how CBME principles are being incorporated into preclinical education, examining diverse teaching methodologies and their role in bridging the gap between foundational knowledge and clinical application. By employing a structured analysis of competency frameworks, we identified recurring patterns in the alignment of educational strategies with targeted learning outcomes. Our findings reveal that certain competency domains frequently co-occur in more elaborate instructional designs, suggesting inherent synergies that may support both knowledge retention and transferability. While these developments mark progress, the field still lacks a comprehensive, empirically validated framework for CBME implementation in preclinical education. More systematic research is needed to refine best practices, optimize instructional approaches, and harness the potential synergy between competencies. Strengthening the evidence base will be essential for guiding the future integration of CBME, ensuring that competency-driven education begins early and effectively prepares students for the evolving demands of medical practice.