Over the course of the last decade since the LCME mandate, cultural competence has become a core component of medical education in the United States and Canada. However, the approach varies a great deal between schools, and there is limited evidence to guide the creation of effective curricula. This chapter seeks to present a critique of the competence-centered approach to cross-cultural education, and the potential pitfalls of such an approach, with particular emphasis on Islamophobia. An alternative approach, focused on self-reflection and the idea of literacy, will also be presented.