It has been 4.5 years since the Accreditation Council for Graduate Medical Education (ACGME-I) accredited competency-based emergency medicine residency programmes were started in July 2010 in Singapore. The transit from a time-based curriculum to a competency-based curriculum, which centres on the 6 ACGME-I core competencies of ‘medical knowledge’, ‘patient care’, ‘professionalism’, ‘interpersonal and communication skills’, ‘systems-based practice’, and ‘practice-based learning and improvement’, has led to a significant change in the curriculum and evaluation. In addition to passing high stake summative professional exams (medical knowledge) and being competent in patient care, residents are taught the principles of patient safety and cost-effectiveness in the context of the entire healthcare delivery (systems-based practice) and they are involved in quality improvement projects (practice-based learning and improvement) with emphasis on evidence-based practice. Not only does the resident demonstrate his engagement in self-improvement through reflective logs, he is also taught how to facilitate the learning of others as teachers to junior learners (practice-based learning and improvement)
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