[From contents to competency. Educational strategies for the physicians of the 3rd millennium].

Italy, as well as many other countries, is facing the problem to adapt medical education to the challenges of a rapidly changing, globalised world. One main concern is the mismatch of competencies to patient and population needs, which calls for an orientation to a competency-based medical education. Competency is defined as the ability to use knowledge, skills and attitudes in a professional context. Addressing to competency the educational design implies to overcome the boundaries of disciplines to consider mainly the final outcome. A number of international initiatives have defined systems of competency, such as TUNING Medicine or CanMeds, which can form a sound base for the development of a national system. An overall picture of professional competencies allows also to design a continuum between pre- and post-graduate training, up to the continuous professional development. A second essential issue is the adoption of the point of view of complexity in considering the educational system, as well as to focus on reflective thinking as a meta-competency. The National Conference of the Directors of Medical Curricula is running a set of initiatives to support this process of change.