COMPREHENSIVE EVALUATION OF SPECIALIST TRAINING - AN ALTERNATIVE TO BOARD EXAMINATIONS IN EUROPE

Demands for specialist examinations grow in a new Europe with open bor ders for labour force, including medical doctors. Significant mechanis ms stimulating this development are outlined. In the light of an analy sis of the purpose of evaluation of postgraduate medical education, a warning is expressed against. simplistic approaches and solutions. The measurement of clinical competence is complex and requires clarificat ion of concepts, unveiling of needs, understanding of methodology, acc eptance of consequences, and consideration of resource aspects of the different types of evaluation available. In order to emphasize the edu cational purpose of specialist training, a comprehensive formative eva luation process is suggested as an alternative to specialist examinati ons. This should involve both the trainee and the institution. Europe should not automatically imitate North America, and a supernational ex amination system with its many pedagogical, methodological, legal, and resource problems may not be the right approach to the assurance of q uality in postgraduate medical education in Europe.