The Future of Veterinary Education: Part 3. Competency-Based Education (#655)

The Promise and the Pitfalls

Veterinary education loves competencies.

In fact, modern education may love them a little too much.

If Part 1 of this series explored how we assess veterinary students, and Part 2 examined the importance of mentorship, Part 3 asks a different question:

Can professional competence be reduced to a series of measurable tasks?

The answer, like most things in medicine, is complicated.

The Rise of Competency-Based Education

For much of the twentieth century, veterinary education was largely time-based.

Students spent four years in veterinary school.

Residents completed three or four years of specialty training.

The assumption was straightforward:

If sufficient time was spent in training, competence would emerge.

Sometimes it did. Sometimes it didn't.

Educational leaders began asking an uncomfortable question:

How do we know that a graduate is actually competent?

Not merely knowledgeable.

Not merely experienced.

Competent.

The result was the rise of competency-based education.

Rather than measuring time spent in training, educators increasingly sought to measure what students could actually do.

At first glance, this seemed entirely reasonable.

And in many ways, it was.

The Appeal of Competencies

Competencies provide clarity.

Students know what is expected.

Faculty know what must be taught.

Accreditation bodies know what should be assessed.

Employers know what graduates should be capable of doing.

Competencies promote accountability.

Competencies help ensure that essential skills are not overlooked.

Competencies establish minimum standards.

Competencies make educational outcomes more transparent.

Who could argue against that?

Certainly not me.

The profession has a responsibility to ensure that graduates possess the knowledge and skills necessary to care for animals safely and effectively.

Competencies help achieve that goal.

The Checklist Revolution

But over time, something interesting happened.

Competencies multiplied.

Then they multiplied again.

Soon there were competencies. Sub-competencies. Milestones. Entrustable Professional Activities. Assessment rubrics. Behavioral indicators. Documentation systems. Tracking systems. Evaluation systems.

Educational frameworks began to resemble aircraft maintenance manuals.

Everything was measured. Everything was documented. Everything was recorded.

The assumption seemed to be that if we could measure enough things, we could fully describe professional competence.

But could we?

The Problem with Checklists

Imagine two veterinary students.

Both can perform a neurological examination. Both can interpret laboratory results. Both can formulate differential diagnoses. Both can complete every required competency.

Yet one becomes an extraordinary veterinarian.

The other becomes merely adequate.

Why?

The answer is that competence and excellence are not the same thing.

Competencies can identify minimum standards.

Competencies are less effective at identifying greatness.

The veterinarian whom clients trust implicitly. The clinician who remains calm during a crisis. The surgeon whose judgment consistently guides difficult decisions. The mentor who inspires future generations. The colleague everyone seeks for advice.

These qualities often exist beyond the boundaries of formal competencies.

The Things We Cannot Easily Measure

Consider some of the characteristics that define exceptional veterinarians:

Judgment. Humility. Curiosity. Integrity. Compassion. Resilience. Wisdom.

Can these qualities be measured?

Perhaps partially.

Can they be reduced to a checklist?

That is less clear.

A student may demonstrate empathy during an observed interaction. But does that observation truly capture their character?

A resident may successfully complete a communication assessment. Does that guarantee they can guide a grieving family through euthanasia five years later?

Some aspects of professionalism resist measurement.

Not because they are unimportant.

Because they are profoundly important.

Goodhart's Law Comes to Veterinary Education

Economists have a phrase:

When a measure becomes a target, it ceases to be a good measure.

Educational systems are not immune.

Once competencies become targets, students naturally focus on satisfying competencies. Faculty naturally focus on documenting competencies. Programs naturally focus on reporting competencies.

The danger is that the measurement system begins to define the educational experience itself.

The checklist becomes the curriculum. The form becomes more important than the substance. The documentation becomes more important than the conversation. The process becomes more important than the person.

The Administrative Temptation

Competency-based education also appeals to administrators.

Competencies generate data.

Data can be counted. Reported. Compared. Audited. Displayed in dashboards. Presented during accreditation reviews.

There is comfort in measurable outcomes.

They create an appearance of certainty.

But education is not manufacturing.

Students are not products moving through an assembly line.

Professional formation is inherently messy.

Human development rarely follows a spreadsheet.

The Best Teachers Know the Difference

The finest educators I have known understood something important.

Competencies matter.

But competencies are only the beginning.

The goal is not simply producing graduates who can perform required tasks.

The goal is producing professionals who know when, why, and whether those tasks should be performed.

A competency can teach a student how to perform a spinal tap. Wisdom teaches when not to perform one.

A competency can teach communication techniques. Experience teaches when silence is more powerful than words.

A competency can measure technical proficiency. Character determines how that proficiency is used.

A Better Question

Perhaps the question is not whether competency-based education is good or bad.

That is too simplistic.

Competencies have unquestionably improved many aspects of professional education.

The better question is this:

What lies beyond competence?

Because no client has ever walked into a veterinary hospital hoping to find a minimally competent veterinarian.

They are looking for something more:

Judgment. Trust. Compassion. Experience. Wisdom.

The challenge facing veterinary education is ensuring that our pursuit of measurable competencies does not distract us from the immeasurable qualities that define exceptional professionals.

Looking Ahead

Competency-based education is likely here to stay.

Nor should it disappear.

The profession needs standards.

Students need clarity.

Accreditation requires accountability.

But we must remember that not everything that matters can be measured.

And not everything that can be measured matters equally.

The future of veterinary education will depend not only on how well we define competence, but on whether we preserve the humanity that lies beyond it.

Because the ultimate goal is not to produce veterinarians who simply satisfy competencies.

It is to produce veterinarians worthy of the trust society places in them.

Coming Next

Part 4. Bigger Classes, Smaller Connections: The Economics of Veterinary Education

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