Learning in practiceCompetency based medical training: reviewCommentary: The baby is thrown out with the bathwater

The origins and development of the competency approach are explored, its current role in medical training is evaluated, and its strengths and limitations are discussed.

Abstract

The competency approach has become prominent at most stages of undergraduate and postgraduate medical training in many countries.In the United Kingdom, for example, it forms part of the performance procedures of the General Medical Council (GMC), 1 underpins objectively structured clinical examinations (OSCEs) and records of in-training assessment (RITA), and has been advocated for the selection of registrars in general practice and interviews. 2 3 It has become central to the professional lives of all doctors and is treated as if it were a panacea-but there is little consensus among trainees, trainers, and committees on what this approach entails.I aim to explore the origins and development of the competency approach, evaluate its current role in medical training, and discuss its strengths and limitations.