Briefing

Quality control in postgraduate training

EDITOR - Sharif and Afnan(1) suggest pass rates at membership and fellowship examinations as a method of assessing the quality of postgraduate specialist training. Whilst pass rate data would be easy to collect, the information would be of limited value in assessing training programmes and could even be detrimental. I am not aware of any research linking a candidate's ability to regurgitate facts in an examination to their ability to practice as a successful specialist. Whilst it is important that trainees pass examinations, the purpose of training should be to prepare doctors for a successful specialist career rather than to be good at taking examinations. Qualities such as leadership, communication skills, teaching ability and surgical skills are poorly assessed in postgraduate examinations. If the benchmark were to become examination pass rates, programmes might not address these general needs.

Overseas graduates tend to achieve lower pass rates, so there would be a real danger that overseas graduates might be discriminated against when applying for training posts.

In many specialities the membership examination is an entrance examination, with many candidates gaining their membership before entering a specialist registrar programme, or during the first year of structured training.

Perhaps the annual evaluation forms already completed by trainees in some specialties could be used by postgraduate deans to obtain meaningful objective data, such as a log of the number of hours of formal teaching, supervised training in clinics, wards and in theatre, both during the day and out of hours.

If the purpose of training is to prepare a doctor for a specialist career, one measure of the success of a programme might be the time taken from completion of training to obtaining a consultant post. After all, the aim of an appointment committee is to look for all of the qualities desirable in a consultant, and to appoint the most suitable candidate.