Entrustability of professional activities and competency-based training.

The idea of competency-based training (CBT) seems to have entered medical education with a speed and impact that has outperformed problem-based learning in the 1980s and 1990s. Within less than 10 years, the CanMEDS competencies in Canada, the ACGME competencies in the United States and similar frameworks in other countries have been introduced for postgraduate medical training countrywide, and examples of competency-based undergraduate medical training have now begun to emerge. The growing number and impact of medical education journals and medical education conferences have helped in the spread of what could almost be called a ‘competencies hype’. It is likely that 2000–10 will be remembered as the decade of CBT in medical education. Competencybased training could remain in our memories as a lasting change that really advanced medical training. However, if we do not want to end up 10 years from now with the conclusion that a ‘competency’ was essentially nothing but a label, replacing what we conveniently used to call ‘educational objective’, it will now be necessary to specify its definition and translate it into daily practice. Signs of confusion about the concept of competency are already visible in the literature from fields other than medical education. The way in which we succeed in defining competencies, implement competency-based education and – most crucially ) assess competencies will be critical.