Clinical excellence is the ability to provide rigorous, evidence-based,
and rewarding care to the right patients. The BALM (brilliance,
attitude, leadership, and materials) framework is a novel model for
adjudicating clinical excellence. There are a few models and frameworks
for evaluating clinical excellence, but each has its flaws and does not
consider the peculiarities of economically-challenged regions such as
sub-Saharan Africa. Coincidentally, such low-resource areas have an
urgent need for a framework to assess clinical excellence because of
their low health-related indices. The five-step mode of professional
excellence is a well-recognised tool and was the model upon which the
BALM framework was built. So, the BALM framework determines to what
extent, using the five-step stages of novice, advanced beginner,
competent, proficient, and expert, a clinician has achieved in each of
the four critical domains, namely brilliance, attitude, leadership and
materials. Therefore, a clinician, who strives for excellence, aims to
be an “expert” in each of the domains of the BALM framework. The
framework is concise, practical, easy to use, and multidimensional,
although it still needs to be applied widely to assess its
reproducibility.