Skill or Competency: What Should we be Assessing?

India introduced competency-based medical education (CBME) in the year 2019. There is often confusion between terms like ability, skill, and competency. The provided curriculum encourages teaching and assessing skills rather than competencies. Though competency includes skill, it is more than a mere skill, and ignoring the other aspects like communication, ethics, and professionalism can compromise the teaching of competencies as well as their intended benefits to the patient and the society. The focus on skills also undermines the assessment of relevant knowledge. This paper clarifies the differences between ability, skill, and competency, and re-emphasizes the role of relevant knowledge and its assessment throughout clinical training. It is also emphasized that competency assessment is not a one-shot process; rather, it must be a longitudinal process where the assessment should bring out the achievement level of the student. Many of the components of competencies are not assessable by purely objective methods and there is a need to use expert subjective judgments, especially for the formative and classroom assessments. A mentor adds to the success of a competency-based curriculum.