Challenges in Implementing the Competency-Based Medical Education Curriculum in Pharmacology: Impact of Shortened Duration and Reduced Teaching Hours

Background The Competency-Based Medical Education (CBME) curriculum was introduced by the Medical Council of India in 2019 to enhance the quality of Indian medical graduates (IMGs). Its goal is to produce IMGs who possess the knowledge, skills, attitudes, and values needed to serve as competent community physicians while remaining globally relevant. The curriculum incorporates new elements and refined assessment methods. However, the duration of the second-year MBBS course was reduced from 18 months to 12 months, and pharmacology teaching hours were cut from 300 to 230. These changes have raised concerns about the challenges of implementation and the adequacy of training. This study seeks to identify the obstacles faced by pharmacology faculty in implementing the CBME curriculum, particularly focusing on the effects of the shortened course duration, reduced teaching hours, and faculty-related challenges while proposing actionable solutions for effective implementation. Materials and methods This nationwide cross-sectional study, conducted between September and October 2023, surveyed 52 pharmacology faculty members from eight states and one union territory in India. Following Institutional Ethics Committee (IEC) approval number IEC-43/2022, data were collected using a structured questionnaire designed to capture faculty experiences and opinions on the CBME curriculum. Key areas of focus included course duration, teaching hours, new curriculum elements, faculty adequacy, and training status. The questionnaire, validated by internal and external experts, underwent a pilot study prior to its distribution via Google Forms (Google LLC, Menlo Park, California, USA) for purposive sampling. Responses, comprising closed-ended and Likert scale items, were analyzed using Microsoft Excel (Microsoft Corporation, Redmond, Washington, USA), with the chi-square test applied for significance. An open-ended section was included to gather additional insights for enhancing CBME implementation. Results Thirteen (25%) of the study participants had not undergone the Curriculum Implementation Support Program (CISP) even three years after the CBME curriculum was introduced. A majority, 37 (71.2%), felt that the reduction of the second-year MBBS duration from 18 months to 12 months and the decrease in theory hours from 100 to 80 were insufficient for effective syllabus completion. However, nearly the same percentage of faculty expressed satisfaction with the allocation of 150 practical hours, compared to the 200 hours in the pre-CBME curriculum. Notably, 45 (87%) of the faculty reported significant challenges in conducting self-directed learning, small group discussions, seminars, tutorials, and similar activities. Furthermore, all participants unanimously agreed that the inability to appoint additional assistant professors in a department, as restricted by the National Medical Commission (NMC) guidelines, to compensate for the shortage of tutors had negatively impacted the implementation of the CBME curriculum. Conclusions The CBME curriculum marks a significant breakthrough in the Indian medical education system. However, it is crucial to identify and assess the barriers to its effective implementation and establish a systematic feedback mechanism to ensure that the CBME curriculum, as outlined in the NMC document, is successfully put into practice.