Dr. Strangelove, or how I learned to stop worrying and love the core competencies.

Swallow hard. If you are a neurology residency program director, plan to be one, or spend considerable amounts of time around one, you may feel that you are in for a rough ride over the next couple of years. New work hours restrictions imposed by the Accreditation Council on Graduate Medical Education (ACGME) have created significant strains on our system of providing neurologic education, leading to a fair amount of debate in the graduate medical education community. New ACGME requirements regarding teaching and evaluating core competencies provide another burden and challenge. The core competencies, moreover, are relevant not just to residency education, but to practicing neurologists, as they are to be incorporated into continuing medical education, board certification, and credentialing. But while the core competencies initially struck me as abstruse and burdensome, the difficulties they engender are, on reflection, readily surmountable. In my case, a helpful approach to the competencies began with the recognition that we were already doing most of the things the ACGME asked for, though we may not have labeled them as such.