Background: Clinical competency committees (CCCs) are now an Accreditation Council on Graduate Medical Education (ACGME) requirement for plastic surgery training programs. They serve to monitor resident progress and make formal recommendations to program directors on promotion, remediation, and dismissal, based on resident progress toward the curricular milestones. Methods: Here, we present an overview on building, conducting, and improving a CCC, reviewing the literature available regarding best practices regarding this novel assessment system, with attention to the particular requirements for plastic surgery training. Results: We present the results of the Duke University CAQCC as a case study in the efficacy of a well-executed group in terms of improved resident outcomes, particularly regarding In-service Examination scores as an objective measure. Conclusions: Rather than simply serving as a necessary ACGME dictum, the CCC has the opportunity to demonstrably improve resident education. This article is valuable for department leaders, program directors, faculty, and residents toward understanding the purpose and design of their CCC.