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BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7183.3 (Published 27 February 1999) Cite this as: BMJ 1999;318:S3-7183Is competence comparable to pornography? An editorial in the Journal of the American College of Surgeons (1999:188;55-6) claims it is, paraphrasing the Supreme Court Justice who said, “I can't define pornography, but I know it when I see it.” Most surgeons would agree with a statement that substituted the word competence for pornography. The editorial attempts to grapple with the fact that though the college does “sophisticated and psychometrically valid assessments of cognitive knowledge” most of its members believe that these bear little relationship to day to day competence.