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Recent developments in medical education reflect a burgeoning movement towards competencybased education. 1 Curricular documents and training programmes, pregnant with terms such as ÔcompetenceÕ and ÔcompetenciesÕ; competency-based education and assessment, are becoming the norm. Although the impetus for this seems very straightforward and obvious at first sight (who would ever aim for incompetence?), the competency movement has given rise to a great deal of confusion and controversies. Both medical professionals and educationalists discuss added values, opportunities and threats of competency-based approaches to medical education. 2–4 A lot of confusion seems to originate from the fact that there is no consensus over what the term means. Many different definitions of competence (competency) exist, depending on the (geographical, political, social) context of professional practice …