(D): Ok, this is saying the schooling for a specialist (like a psychiatrist) is usually ENOUGH to make you competent. The problem is the word usually. What about the fringe cases? This would mean there are some people who get through med school who are totally incompetent. This isn't the underlying assumption.
(E): This is simply the opposite of D. This is saying the schooling to become a psychiatrist (let's keep the same example) is REQUIRED for someone to be competent. Meaning they can't be competent unless they took this course. This gives us no knowledge about how many are actually competent.
An example might help here:
Jimmy works really hard in school. Therefore Jimmy is going to be a millionaire.
What is the underlying assumption?
(C): Working hard = millionaire (D): Working hard usually = millionaire (E): Working hard is one of the things you need to be a millionaire.