AETCOM to Humanistic Competence: Strengthening the Affective Core of Indian Medical Education

Abstract

Background: India’s Competency-Based Medical Education (CBME) framework, introduced through GMER 2019, includes the longitudinal Attitude, Ethics and Communication (AETCOM) module to strengthen the affective domain. However, humanism—encompassing compassion, empathy, cultural humility, reflective practice, and relationship-centred care—remains largely implicit rather than explicitly articulated within this structure.
Summary: This Viewpoint critically examines the evolution and achievements of AETCOM while highlighting gaps in current
implementation, including limited experiential depth, suboptimal assessment of humanistic behaviours, and the erosive influence of
the hidden curriculum. Drawing on global scholarship (e.g., Epstein & Hundert, Branch) and Indian policy documents, it argues that
humanism constitutes an essential missing dimension that should be deliberately integrated into AETCOM and the broader CBME
framework to produce more compassionate and resilient Indian Medical Graduates.
Recommendations: Practical strategies include explicit mapping of humanistic competencies, incorporation of narrative medicine
and reflective portfolios, reformed assessment using multi-source humanistic rubrics, and targeted faculty development. A conceptual
model and comparative table illustrate the proposed integration.
Conclusion: Explicit recognition and embedding of humanism within AETCOM will enhance the humanistic core of Indian medical
education, ultimately improving patient care, professional fulfilment, and equity in diverse clinical contexts.