Rethinking medical education in India: A review of student-reported outcomes in the preclinical CBME era.

Background: The introduction of competency-based medical education (CBME) by the National Medical Commission (NMC) in India marked a pivotal transformation in undergraduate medical training. While this framework aims to produce skilled, ethical, and lifelong learners, its implementation, especially during the preclinical years, has presented both opportunities and challenges. Objective: To synthesize current evidence on student perceptions, teaching-learning strategies, early clinical exposure, AETCOM modules, self-directed learning, assessment practices, and institutional variability in CBME implementation across Indian medical colleges. Methods: A structured narrative review was conducted using literature from PubMed, Scopus, ERIC, and Google Scholar. Studies published between January 2019 and May 2025 that focused on undergraduate MBBS CBME in India were included. Thematic analysis was performed across domains, such as teaching-learning methods, student feedback, faculty preparedness, and institutional support. Results: Evidence indicates strong student preference for interactive and integrated learning modalities. Early clinical exposure (ECE) and AETCOM modules were well received but suffered from inconsistencies in delivery. Self-directed learning (SDL) showed variable readiness among the students. Key challenges include faculty training gaps, infrastructural disparities, assessment overload, and heightened student anxiety. Institutional variation, particularly between government and private colleges, impacts curriculum fidelity. Conclusion: While CBME is a promising step toward modernizing Indian medical education, its effectiveness depends on continuous faculty development, contextual curriculum refinement, and integrated student support systems. Harmonizing implementation strategies across institutions is crucial for achieving equitable educational outcomes.