There has been a call to include empathy as a selection criterion in medical training. Empathy is a complex construct currently assessed by self-rating and observational scales, which may be complicated by the subjectivity of such measurements. Neuroscientific research into disorders of empathy such as autism should be encouraged to help further refine the evolving construct of empathy. Empathy may be more common in females, and selection for higher empathy may discriminate against males unless sex-specific adjustments are included in selection criteria. Physician empathy may lead to greater patient satisfaction and confidence in physicians, but more evidence is needed to support links to physician competence. In contrast, academic performance and conscientiousness have been clearly linked to physician competence. Competence and empathy may be independent qualities developed by different aspects of medical training. Provision of better work conditions and environments for physicians may forestall erosion of empathy, reducing the need to predict and enhance its development. Empathy should be valued in medical students and doctors, but more research is needed into the nature, assessment, and correlates of empathy before its adoption as a selection criterion for medical students.