Traditional surgical training, based on apprenticeship, no longer meets contemporary requirements. The Competency-Based Postgraduate Medical Education approach and Entrustable Professional Activities (EPAs) offer a structured framework for assessing competencies. This review examines the effectiveness of these concepts and their implementation in urology. International data confirm that EPAs allow for the standardized progression of surgical competencies. In urology, frameworks of 16 to 32 EPAs have been validated. A pilot study demonstrated the feasibility of this approach in Switzerland. Challenges include the imbalance between technical and non-technical competencies, as well as the need to adapt frameworks to the Swiss context. Successful implementation requires training supervisors and identifying motivated team leaders.