Fellowship Competency Framework

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.