Abstract

When they stopped secrecy, the consultants of an internationally-famous postgraduate teaching centre in psychiatry--not a designated teaching hospital--discovered that they had one-tenth the national average of distinction awards. Subsequent investigation of the whole system suggests that this is not an isolated case. Moreover, official figures are scanty and misleading. This paper explores the difficulties in understanding, investigating, and influencing the system. The composition of the committees involved, the de facto quota system, the method of collecting information, and the convention of secrecy are examined and critized.