On outcomes and humility.

The competency movement in medical education asserts itself in every corner of students' experiences from matriculation through residency. Such a focus on making sure trainees achieve desired levels of skills, knowledge, and technique is highly desired by the patients they will be servicing, but educators' need to turn nearly every dimension of medical education into a competency is an ill-advised leap that transforms a complex educational mission into a bottom-line venture. This commentary provides a critical examination of the wholesale use of competency measures in academic medicine, using the concurrent articles by Murray-García and García about multiculturalism and by Kumagai about narrative medicine as thoughtful examples of educational efforts that turn away from this narrow orientation, focusing instead on the ongoing reflective processes and humility that mark the lifelong development of skilled, empathic physicianhood.