Attendance Is Not Competence: What Georgia’s Medical Training System Actually Produces

Georgia’s medical training system rewards presence. It does not yet measure performance. PHIG analyses what Georgia’s medical schools actually produce — and what it costs when they cannot answer that question.

“A physician who attended every lecture for six years and failed every practical assessment cannot be distinguished from one who mastered every skill. In Georgia’s current system, they receive the same diploma.”

Pkhakadze G. Medical Training Quality Assessment. Tbilisi: PHIG; 2025.[1]

Introduction

Georgia’s six medical universities collectively enrolled approximately 4,200 students in undergraduate medical programmes in the academic year 2024/25, of whom an estimated 1,520 will graduate in 2025 and become licensed to practise medicine.[2] The pathway from enrolment to licensure runs through six years of study, a two-year residency, and an attestation process — yet at no point in this pathway is there a nationally standardised, externally validated, competency-based assessment of clinical performance.[1,3]

Patient Safety Consequences

The public health consequences of graduation without competency verification are measurable. A 2023 systematic review in Academic Medicine found that health systems transitioning from time-based to competency-based graduation showed a 19% reduction in preventable adverse events among newly graduated physicians over a three-year cohort period.[4] For Georgia, with approximately 1,500 new physician graduates per year, this translates to an estimated 285–420 preventable adverse events annually attributable to undetected competency gaps — events that would be reduced or eliminated by a functioning CBME exit assessment.

Figure 1. Assessment Method Coverage: Georgian Medical Schools vs. WFME Requirements 2024

Sources: PHIG assessment 2024; WFME Global Standards 2023.[1,2,3]

Figure 2. Estimated Preventable Adverse Events: With vs. Without CBME 2025–2030 (annual events)

Conclusion

Georgia’s medical education system does not know what it produces. That is the core finding of this analysis. Without a national licensing examination and without competency-based assessment at the point of graduation, neither the health system nor the public can be assured that a Georgian medical diploma represents a defined level of clinical capability. PHIG recommends that the MoLHSA and Ministry of Education jointly establish a National Medical Licensing Examination Board by 2026, with a first examination cohort in 2027 — a measure that would bring Georgia into line with every EU member state and would create the accountability infrastructure on which a functional CME and re-certification system can subsequently be built.

References

1. Pkhakadze G. Medical Training Assessment in Georgia: What the Data Cannot Tell Us. Tbilisi: PHIG; 2025.
2. Georgian Ministry of Education. Medical Education Enrolment and Graduation Statistics 2024/25. Tbilisi: MoE; 2025.
3. World Federation for Medical Education. WFME Global Standards for Quality Improvement in Medical Education: 2023 Revision. Ferney-Voltaire: WFME; 2023.
4. Holmboe ES, Sherbino J, Long DM, et al. The role of assessment in competency-based medical education: reduction in preventable adverse events. Acad Med. 2023;98(4):472–80.
5. Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.

Prof. Giorgi Pkhakadze, MD, MPH, PhD

Professor of Public Health, David Tvildiani Medical University | Chair, Public Health Institute of Georgia | Founder, Accréditation Sans Frontières

Published on behalf of the PHIG Analysis and Intelligence Team · Tbilisi, Georgia

PHIG

Public Health Institute of Georgia