Born of necessity, developed with remarkable consensus, and piloted successfully for a year, the United Kingdom's new foundation programme for medical graduates has been launched.1 The programme aims to ensure that all entrants to formal postgraduate specialist training have met the standards required to progress to that particular phase of lifelong learning.2 Opinions vary about the role of these reforms and their impact on the medical education system and workforce.

The programme focuses on performance in the workplace, rather than only knowledge and skills, largely in response to recent scandals that highlighted problems with clinical governance, professional teamwork, and practitioners' honesty. The core competencies required to complete the programme match those laid down by the General Medical Council in Good Medical Practice and reflect reasonable expectations of the ability of junior medical practitioners.3 Although the UK may be the first to formalise such a system, similar moves are being discussed in other places with similar systems of medical education and career progress.

The introduction of such programmes should not imply …