It is crucial to conduct competency based and outcome based training. We need to assess the gaps between training curriculum and clinical competence. Performing needs analysis is important to design optimal training curriculum for each professional. There are several teaching methods to teach knowledge and technical skills. One teaching method could not be used for every objective. Hybrid curriculum is invented to conduct integrated training by using lecture, hands-on practice workshop, medical simulation, etc. We advocate to design the outcome based training curriculum by considering the resources and needs analysis. There are four steps in designing the integrated training curriculum: selecting the training curriculum, setting up objectives, dividing each objective or technique into several steps, selecting or inventing teaching method or material for each step.