Egyptian graduates report mixed views of competency-based medical curriculum

A nationwide survey of 7,264 recent graduates from 27 Egyptian medical schools found moderate satisfaction with the country’s competency-based undergraduate medical program. Respondents identified the integration of basic and clinical sciences, varied learning opportunities, early clinical exposure, emphasis on critical thinking and self-directed learning, and faculty support as notable strengths. Heavy workloads, frequent assessments and difficulty adapting to the new curriculum were also reported.

The descriptive cross-sectional study evaluated graduates’ perceptions and experiences of a reform introduced in 2018. The national program follows a five-year medical course followed by a two-year internship and is aligned with the National Academic Reference Standards for Medicine. Its aim was to organize training around essential competencies for evolving healthcare demands, while the survey focused on how graduates experienced the redesigned curriculum.

Researchers distributed an online questionnaire between December 2023 and December 2024 and received 7,264 responses, corresponding to a response rate of 40.7%. The convenience sample covered 27 Egyptian medical schools. The questionnaire contained 45 Likert-scale items examining different program dimensions, together with three open-ended questions asking participants about their most and least favorable aspects of the program and possible improvements.

The researchers assessed the questionnaire through expert review and exploratory factor analysis. Four factors emerged from the factor analysis, accounting for 64.53% of the total variance, and the instrument produced a Cronbach’s alpha of 0.98, indicating high internal consistency in this sample. The analysis included descriptive statistics, independent-samples t-tests and one-way analysis of variance, with p < 0.05 used as the significance threshold. Cohen’s d and eta-squared were calculated for statistically significant group comparisons to describe their practical magnitude.

Mean satisfaction scores ranged from 2.71 to 3.41 across the program dimensions examined, which the authors characterized as moderate overall satisfaction. The highest-scoring areas were not presented as uniformly strong endorsements across every measure. Instead, graduates’ responses highlighted several elements they valued, including integrated teaching of basic and clinical sciences, diverse learning opportunities, early exposure to clinical settings, attention to critical thinking and self-directed learning, and faculty support.

Some groups reported slightly higher satisfaction, including male students, high achievers, graduates with stronger English proficiency and those who had lived in university housing. Although the study found statistically significant differences among some subgroups, the reported effect sizes were small. These observational associations do not establish why the groups differed, and the survey design does not show that any personal or academic characteristic caused greater satisfaction with the curriculum.

The survey also documented reported difficulties with the program. Graduates cited heavy workload, frequent assessments and difficulty adjusting to the new curriculum. The study’s quantitative content analysis of open-ended responses categorized favorable comments, unfavorable comments and suggested improvements, then counted the frequency of the resulting themes. These descriptive themes were consistent with the patterns in the quantitative survey results, providing additional detail about graduates’ experiences without establishing cause-and-effect relationships.

Because the participants were recent graduates recruited through convenience sampling, the results may not represent every graduate or medical school in Egypt with equal precision. The 40.7% response rate also leaves the potential for selection bias. As a cross-sectional assessment based on retrospective reports, the study did not track changes in satisfaction over time or directly compare students under the new curriculum with students educated under the previous system. Its national coverage across 27 institutions nevertheless provides a broad snapshot of graduate experiences with the reform.

The research evaluated perceptions rather than measured clinical competence, patient outcomes or later performance in medical practice. It therefore cannot determine whether the new curriculum caused improvements in those outcomes or whether it improved graduates’ readiness for independent clinical work. Taken together, the findings describe a curriculum that graduates valued for its integrated content, varied learning experiences, early clinical exposure and support for autonomous learning, alongside reported difficulties involving workload, assessment frequency and curriculum adjustment.

Subject of Research: Graduate perceptions of Egypt’s competency-based undergraduate medical curriculum

Article Title: Evaluation of the new Egyptian undergraduate medical program from students’ perspectives: a nationwide cross-sectional study

Article References: Hosny, S., Atwa, H., Ghaly, M. S., Makhlouf, A. M., Radi, S., Said, Z. N. A., Salah, H., Shoulah, A., & Abdelnasser, A. (2026). Evaluation of the new Egyptian undergraduate medical program from students’ perspectives: a nationwide cross-sectional study. BMC Medical Education, 26(1), Article 1446. https://doi.org/10.1186/s12909-026-10200-2

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10200-2

Keywords: medical education, competency-based learning, Egypt, medical curriculum, graduate survey, student satisfaction, clinical exposure, curriculum reform, Evaluation, Egyptian, undergraduate, medical