It has been more than a decade since the Royal College of Physicians and Surgeons of Canada implemented the Canadian Medical Education Directives for Specialists (CanMEDS) project. Despite frequent and widespread correspondence to Canadian practitioners and educators, the adoption of the 7 core competencies espoused by CanMEDS has been slow. Barriers to the teaching and acquisition of these skills include a lack of understanding of what they actually represent, a paucity of tools to teach them and an inability to quantify performance. It is essential to translate the goals of the CanMEDS project into clinically relevant concepts. We define the current status of the CanMEDS competencies with respect to urological training and provide some context to what has been, until now, a poorly defined and abstract educational construct.