Competency-Based Education (CBE) programs have developed differently within higher education and medical education systems, yet both systems face challenges when bridging the gap between theory and practice. Both medicine and higher education face the challenge of adapting CBE programs for learners who begin the program with different configurations of knowledge and skillsets and learn at different rates. Additional challenges include, but are not limited to standard setting, time variability within programs for student learning, defining competencies, and training faculty to develop and assess CBE programs. This article argues there is much higher education programs can learn about defining competencies, assessing performance, and curriculum design by understanding how CBE is implemented in medical education. We also provide an overview of how CBE in medical education (CBE-ME) has evolved compared to CBE in higher education (CBE-HE), including examples of how medical education has addressed defining competency issues, assessing competence, and standard setting.