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ABSTRACT - Quality assurance (QA) of medical training is a growing concern. There have been few studies comparing different methods. A window of opportunity occurred when a Royal College of Physicians (RCP) visit was followed soon after by a pilot of a web-based questionnaire in a deanery which already had a welldeveloped QA system in geriatric medicine. The different methods of RCP visit, deanery visit and web-based survey were compared. Surveys are easily administered and repeated but may be hindered by poor response rates and lack of corroborating information. Negative aspects can be exaggerated and positive ones overlooked. Trainers' views tend to be underused. Visits consume more time and resources but give a better overview. Each method format was found to have advantages and disadvantages and no one method alone would have picked up all the information. This paper recommends a robust deanery mechanism as a continuous QA mechanism backed up by periodic focused external visits.
KEY WORDS: general medicine, geriatric medicine, monitoring visits, postgraduate medical training, quality assurance, trainee surveys, triangulation
Introduction
Any trainee will tell you that they learn more from some jobs than others. Unless poor training is identified and remedies put in place, matters are unlikely to improve. Even placement at university teaching institutions does not assure better training than at district hospitals.1 It is not surprising, therefore, that medical education commissioners wish to be assured of the quality of the training they are purchasing. Rigorous and validated accreditation systems are critical in demonstrating professional competence and accountability.
The certificate of completion of training (CCT) is awarded by the Postgraduate Medical Education and Training Board (PMETB) upon completion of specialist training, allowing access to the specialist register of the General Medical Council and therefore the ability to practice as a specialist in the UK. PMETB has a regulatory role in approving medical training, but also aspires to promote higher standards of education and training for the profession.2 PMETB proposes to assure the quality of postgraduate medical training by moving to a system that places great weight on deanery-based quality control processes.3
Quality control must be effective, but there is currently little evidence to show how this can best be achieved or even whether attempts to assure the quality of...