Paul Hager and I worked on a large number of research projects and publications throughout the 1990s. The focus of this work was on developing a competency-based approach to professional education and assessment. I review this work and its impact over the years. Notwithstanding the fact that most professional associations today have a competency framework and that most university courses use them in their courses for initial professional education, they still have a relatively naïve view of the relationship between theory and practice. The second part of the article outlines how this might be theorized in health education.