This paper presents the results of an empirical descriptive and contrastive study designed to assess how closely postgraduate translation programmes fit the reality of professional practice. Focusing on medical translation, the case study analyses the convergences and divergences between the competences that professional medical translators deploy in their work and highlight as being essential and those that students are expected to acquire in postgraduate courses in which medical translation is taught.Two empirical studies were conducted. The first study focused on a socio-professional perspective: 167 English-to-Spanish medical translators were surveyed to obtain information about their profiles and their opinions on the competences needed for medical translation. The second study focused on an academic perspective: the syllabuses of postgraduate courses in which medical translation is taught in Spain were analysed to determine the competences students are expected to acquire. The results of these two studies, which are analysed, compared and discussed, show that there are a significant number of convergences, but also some divergences, between the university courses and the professional practice. These raise interesting questions which need to be taken into account when designing, planning and improving existing and new postgraduate courses.