BACKGROUND: Graduate medical education in the UK is in danger of being subsumed in a minimalist discourse of competency. ARGUMENT: While accepting that competence in a doctor is a sine qua non, the author criticises the construction of a graduate and specialist medical education based solely upon a competency model. Many competency models follow the concepts of either academic competence or operational competence, both of which have lately been subject to criticism. CONCLUSION: The author discusses the need for replacing such criterion-referenced models in favour of a model that engages the higher order competence, performance and understanding which represent professional practice at its best.
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Martin Talbot (2004) studied this question.
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