Table 3.

Challenges in implementing CMBE in psychiatry and the way forward

Challenges	Way forward
Administrative blocks	Upgrading medical education department of the medical schools.
-Lack of trained professionals or medical educators	Training, peer-support, and mentoring teachers to effectively implement CBME.
	Effective utilization of human resources.
-Resource constraints	Training and supporting teachers in effective utilization of time and resources for UG training.
-Overburdened teachers or consultants	Collaborating with organizations like IToP (Indian teachers of Psychiatry, departments of education and technology, etc.) to enhance the skills of teachers in training.
Attitudinal block or old teaching culture	Orienting college administrators, HODs other disciplines and teachers about the significance of psychiatry training in implementing CBME.
	Supporting them in acquiring teaching skills.
	Priming students about the scope of psychiatry.
Lack of trained psychiatry teachers (High student teacher’s ratio)	Forward feeding of the student’s information concerning their level of competencies from UG to PG and working on the weak areas.
	Effective utilization of human resources (teachers, psychiatry residents, tutors, student-leaders, etc.) in planning and implementing CBME.
	Utilizing national knowledge network and digital India platform to integrate expertise across institutions.
Lack of robust assessment methods	Developing locally relevant evidence-based assessment tools.
	Collaborating with the education and technology departments, etc.
	Feedback from students on the assessment methods and required changes.
	Developing entrustable professional activities (EPAs) to assess skills.
	Greater emphasis on work-based assessment, mid-term rotation assessment.
	Utilizing novel and multifaceted assessment models.
The negative attitude of medical students towards psychiatry	Early exposure to psychiatry or behavioral sciences.
	Incorporating psychiatry in the foundation course.
	Short enrichment or orientation program.
	Promoting integrative teaching: integrating psychiatry with other disciplines of medicine as well as training psychiatry in the non-psychiatry block.
	Multidisciplinary teaching: taking on boards consultants of other departments.
Lack of innovation	Utilizing digital technology in training and assessment.
	Utilizing low and high touch activities and allocating resources accordingly.
	Blended learning approach to bridge the gap of high student/teacher ratio.
	Training of teachers (workshops, seminars, etc.) in novel methods of teaching and assessment.
Financial and human resource implications for implementing CBME	Collaborating with the funding agencies and education department.
	Infusing funds in upgrading the medical education deparment of medical colleges.
	Funding enrichment programs or activities.
	Encouraging research on developing or adapting existing training modules that are locally relevant.
Lack of leadership from psychiatric teachers	Psychiatric teachers must take a leadership role in strengthening psychiatry training and its integration.
	Highlighting the positive impact of competencies learned during psychiatry training in other disciplines of medicine.
	Advocating for psychiatry as a major subject or a subject which is to be mandatorily passed.
	Taking leadership in organizing, conducting, and collaborating with others for various enrichment activities.

CBME: Competency-based medical education, HODs: Heads of departments, PG: Postgraduation, UG: Undergraduate, IToP: Indian Teachers of Psychiatry