It is commonly argued that maintaining competence in procedural medicine requires the continuing practice of minimum numbers of procedures. While these continuing practice requirements may pose few problems for doctors working in city or regional hospitals, they may be impossible to meet in rural general practice. The authors review the literature relating to psychomotor skills in procedural medicine and argue that there is little or no evidence to justify the judging of competency by numbers of procedures performed. Instead it appears that with appropriate initial training, doctors can be expected to retain their psychomotor skills even after lengthy periods without practice.