Competency is the ability to use a structured set of knowledge, skills, and attitudes in a specific professional context, or in professional training. Over the past 10 years there has been an acceleration of the trend towards a competency-based design of the education of healthcare professionals, rather than just defining learning objectives or relying on the content of disciplinary programs. The choice for a competency-based curriculum is not only the result of a changed pedagogical vision, but also an answer to the request of accountability toward society about how are the professionals trained and also to allow comparability between universities and nations. In recent years, many international initiatives have defined competency models for medicine and more specifically for public health. This article summarizes these initiatives, putting them in the context of the evolving Italian legislation.