Competency-based medical education (CBME) addresses the accountability of postgraduate training programmes to graduate specialists capable of independent practice.

We undertook a systematic review and narrative synthesis of the published CBME literature in anaesthesia training programmes to identify current practices and areas requiring further exploration.

We grouped the 23 studies that met our inclusion criteria into the following categories: demonstrating outcomes of CBME, developing a consensus on an achievable CBME curriculum, CBME curriculum framework, design and implementation of workplace-based assessment (WBA) tools, trainee self-assessment, perceptions of trainees and supervisors on WBA tools, and technological solutions for assessment and feedback.

Included studies reported variable success in reaching consensus in competency outcome frameworks for sequenced progression and limited research on approaches to curriculum delivery, whilst the majority of studies focused on workplace assessment.