縮短醫學教育修業年限、限制住院醫師工時制度，減少醫師養成過程中臨床學習的時間，引發內科教師對新進醫師勝任能力的質疑。新冠肺炎疫情的流行，進一步造成教師、學生與病人關係的疏離，縱使線上教學取代大部分的實體課程，仍無法彌補因此所導致的臨床經驗不足。於這種環境中養成的內科醫師，是否能因應健康照護系統需求，提供安全有效的專業醫療服務，成為大眾的疑慮。以學習者為中心，不以學習時間、過程決定是否完成訓練，而是著重於學習者是否已具備可信賴的勝任能力，能獨立執行醫療專業，如此「以勝任能力為基礎的醫學教育，Competency-based medical education（CBME）」理論正逐漸受到重視。以醫師所需的勝任能力作為學程架構，規劃可觀察的行為以執行學程，應用里程碑（Milestones）或可信賴的專業活動（Entrustable Professional Activities［EPAs］）評量學習者能力，成立能力評估委員會判定訓練結果，逐步落實「以勝任能力為基礎的醫學教育」，將可轉化這些衝擊所帶來的不安，為台灣醫學教育創造新的契機。

The shortened timeline of Taiwan's medical education system and the restriction of resident duty-hour have reduced the time of clinical exposure and arise the concern of teachers about the competencies of training doctors. The pandemic of COVID-19 further drifts apart the relationships between teachers, students, and patients. Despite that distance learning replaces most of the classes in person, the experience learned from practicing clinical activities is indispensable. Whether the doctors trained in such circumstances can respond to the healthcare system to provide safe and effective service, therefore, becomes an issue of medical education. In the meantime, the learner-centered, time-course independent, and outcome-based education theory has gained increasing attention in Taiwan. Such a competency-based medical education uses competency as the frame to construct the curriculum and contains observable behaviors for milestones or entrustable professional activities to assess learning achievement. Ultimately, a learner's clinical competence and readiness for unsupervised is determined by a clinical competency committee. By stepwise implementing competency-based medical education, we will be able to convert these impacts into an opportunity of improving our medical education.