Programmatic Evaluation, the end of “all or nothing” in medical education.
Abstract
Programmatic evaluation occupies an increasingly central place in contemporary medical education, especially in institutions that have adopted competency-based training models. While not yet a universal standard, it has established itself as one of the most influential and discussed approaches in the field of clinical assessment. Over the past two decades, medical education has shifted from content-centered curricula to integrated professional competency frameworks. International organizations such as the Accreditation Council for Graduate Medical Education (ACGME), the CanMEDS of the Royal College of Physicians and Surgeons of Canada, and the General Medical Council (GMC) have promoted frameworks that describe physicians not only as clinical experts but also as communicators, collaborators, professionals, and lifelong learners. This shift has necessitated a profound rethinking of assessment systems. In this context, programmatic evaluation stands out as the most coherent methodological response to competency-based education. Its role is not simply to be "another technique," but rather a structural framework that organizes all assessments within a training program. In many medical schools and residency programs, assessment is no longer conceived as a set of isolated exams, but rather as a longitudinal system for collecting and integrating evidence. Its influence is also felt in the educational culture. Frequent feedback, individualized monitoring, and collegial deliberation on student progress are gaining ground as quality standards. Furthermore, the scientific literature in medical education recognizes Programmatic Assessment as a model with high conceptual validity for evaluating complex competencies in real-world clinical settings.
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References
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