# GeNext MedEd Foundation — Fellowship Competency Framework

Status: Master institutional template
Use: Adapt to each approved programme by defining programme-specific competencies, expected level and acceptable evidence.

## Competency domains
### 1. Knowledge
Understands the relevant anatomy, pathology, diagnostics, treatment principles, indications, contraindications, complications and evidence base appropriate to the programme.

### 2. Clinical reasoning
Synthesises history, examination, investigations and context into a reasoned differential diagnosis, management plan and follow-up strategy.

### 3. Diagnostic pathway
Selects, interprets and contextualises relevant investigations and recognises their limitations.

### 4. Procedural / technical competence where applicable
Demonstrates safe preparation, procedural understanding, technical steps, anticipation of complications and supervised performance at the level permitted by the programme and host centre.

### 5. Peri-procedural / operative planning
Understands patient selection, preparation, consent, equipment, team requirements, contingency planning, postoperative care and complication management.

### 6. Communication
Communicates clearly with patients, families, colleagues and multidisciplinary teams, appropriate to the learner role and local clinical-governance rules.

### 7. Professionalism
Demonstrates punctuality, reliability, respect, ethical conduct, accountability, appropriate boundaries and responsiveness to feedback.

### 8. Patient safety
Recognises risk, respects supervision boundaries, follows consent and confidentiality standards, escalates concerns appropriately and does not allow educational goals to override patient welfare.

### 9. Teamwork and multidisciplinary care
Participates constructively in team-based care and understands the roles of relevant disciplines.

### 10. Documentation
Produces appropriate educational and clinical documentation within the permissions of the programme and host institution, and maintains a compliant learning record.

### 11. Academic practice
Engages in case presentation, critical appraisal, journal club, teaching, audit, research or other academic activities defined by the programme.

### 12. Reflective learning
Identifies strengths, gaps and next learning goals, incorporates feedback and documents meaningful reflection.

## Suggested progression scale
- Level 0 — Not yet exposed
- Level 1 — Observes / describes with guidance
- Level 2 — Discusses / contributes with supervision
- Level 3 — Performs selected elements under direct supervision where permitted
- Level 4 — Performs or leads at the programme-defined supervised level where permitted
- Level 5 — Demonstrates consistent programme-level competence; this does not itself confer independent privileges

Not every competency should progress to Level 5. Observerships may intentionally remain at Levels 1–2 for clinical activities.

## Evidence sources
- direct observation;
- case-based discussion;
- procedural assessment;
- logbook pattern;
- presentation / seminar;
- written or oral assessment;
- mentor review;
- portfolio / assignment;
- audit or research activity;
- faculty global assessment.

## Programme adaptation table
For each competency record:
- Competency ID:
- Domain:
- Statement:
- Expected final level:
- Permitted learner role:
- Evidence required:
- Assessment method:
- Reviewer / assessor:
- Milestone timing:

## Principle
Case numbers may support evidence of exposure but should not be used alone as proof of competence. Competency decisions should combine context, observed performance, reasoning, professionalism and programme-specific evidence.