Development of a curriculum for community-based medical leadership education

Background Leadership is increasingly essential in community-based medicine, where physicians must collaborate with various stakeholders and address complex health needs with limited resources. Despite its importance, leadership education in Japan’s undergraduate medical curricula remains inconsistently implemented, lacking standardized competencies and practical training opportunities. This study aimed to identify essential leadership competencies in community-based medicine and develop a structured educational curriculum based on those competencies. Methods We adopted Kern’s six-step approach to curriculum development. A literature review was conducted to extract preliminary competencies. A two-round Delphi study was then implemented with 61 community-based physician leaders in rural and remote areas of Kagoshima Prefecture, Japan. In Round 1, 26 competencies were evaluated on necessity, difficulty of acquisition before graduation, and timing of acquisition using a four-point Likert-type scale. Items were refined using quantitative criteria including Cronbach’s a, McDonald’s w, and the content validity ratio (CVR). In Round 2, 14 revised competencies were confirmed using dichotomous agreement and the same values. Based on the results, a short elective course was designed with lectures and case-based group work for medical students. Results All 26 initial competencies were rated necessary, but only four met the criteria for both difficulty and timing. These, along with qualitative feedback, informed the creation of 14 revised competencies. In Round 2, internal consistency remained high (a = 0.97; w = 0.97), and all competencies surpassed the critical CVR threshold. The final curriculum emphasized attainable competencies and included practical scenarios aligned with Miller’s pyramid framework. Conclusions This study identified and validated leadership competencies specific to community-based medicine and developed a corresponding curriculum. The phased, evidence-informed approach addressed local needs and enabled structured educational implementation. While limited to one region, this framework may inform broader efforts to integrate leadership training into undergraduate medical education.