Monkey see, monkey do: a critique of the competency model in graduate medical education


Dr Martin Talbot, MA Ed, MEd, FRCP, Director of Undergraduate Medical Education, Sheffield Teaching Hospitals, Medical Education, 8 Beech Hill Road, Sheffield S10 2SB, UK. Tel: 00 44 (0)114 271 3553; Fax: 00 44 (0)114 271 3408; E-mail:


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.