Rethinking Training in Emergency Medicine: Time-based or Competency-Based Lens?

Authors

  • Fatimah Lateef Senior Consultant, Dept of Emergency Medicine, Singapore General Hospital, Core Faculty, Emergency Medicine Residency, Sing Health, Professor, Duke NUS Graduate Medical School, Yong Loo Lin School of Medicine, National University of Singapore and Lee Kong Chian Medical School, Nanyang Technological University, Director, Sing Health Duke NUS Institute of Medical Simulation (SIMS), Faculty, Duke NUS Global Health Institute, Singapore.  Author
  • Wee Choon Peng Jeremy Senior Consultant Dept of Emergency Medicine, Singapore General Hospital Programme Director, Graduate Medical Education, Singhealth Emergency Medicine Residency Program; Clinical Assistant Professor, Duke NUS Graduate Medical School, Singapore Author

DOI:

https://doi.org/10.47363/JCCEM/2026(5)201

Keywords:

Emergency Medicine, Competency-Based Training, Entrustable Professional Activities, Assessment

Abstract

Time-based training requires Emergency Medicine residents to complete the required number of years in an accredited programme, without triggering the threshold for formal remediation. This will graduate them for independent practice. This is administratively clean, operationally predictable, and grounded in the reasonable assumption that clinical experience accumulates over time. Competency-based Emergency Medicine education, on the other hand, utilizes a structured framework of defined competencies, assessed through multiple methods over the course of training, with progression contingent on demonstrated achievement rather than elapsed time. It de-emphasizes time-based training and allows for greater accountability, flexibility and learner-centredness.


Against the evolving medical educational landscape and the critical need to future-proof Emergency Medicine residents for the rapidly progressive and
disruptive practice, the question to consider is: which is the best model? In this paper, the author shares the argumentative logic for competency-based training, as well as the counter-argument supporting time-based training. This is followed by the suggestion for a hybrid model of training, in Emergency medicine residency.

Author Biographies

  • Fatimah Lateef, Senior Consultant, Dept of Emergency Medicine, Singapore General Hospital, Core Faculty, Emergency Medicine Residency, Sing Health, Professor, Duke NUS Graduate Medical School, Yong Loo Lin School of Medicine, National University of Singapore and Lee Kong Chian Medical School, Nanyang Technological University, Director, Sing Health Duke NUS Institute of Medical Simulation (SIMS), Faculty, Duke NUS Global Health Institute, Singapore. 

    Fatimah Lateef, Senior Consultant, Dept of Emergency Medicine, Singapore General Hospital, Core Faculty, Emergency Medicine Residency, Sing Health, Professor, Duke NUS Graduate Medical School, Yong Loo Lin School of Medicine, National University of Singapore and Lee Kong Chian Medical School, Nanyang Technological University, Director, Sing Health Duke NUS Institute of Medical Simulation (SIMS), Faculty, Duke NUS Global Health Institute, Singapore. 

  • Wee Choon Peng Jeremy, Senior Consultant Dept of Emergency Medicine, Singapore General Hospital Programme Director, Graduate Medical Education, Singhealth Emergency Medicine Residency Program; Clinical Assistant Professor, Duke NUS Graduate Medical School, Singapore

    Senior Consultant Dept of Emergency Medicine, Singapore General Hospital Programme Director, Graduate Medical Education, Singhealth Emergency Medicine Residency Program; Clinical Assistant Professor, Duke NUS Graduate Medical School, Singapore

Downloads

Published

2026-09-15

Issue

Vol. 5 No. 9 (2026): Volume 5 Issue 9

Section

Articles