The Accreditation Council for Graduate Medical Education in the United
States has recently required institutions with residency and fellowsh
ip training programmes to develop an Institutional Policy Review Docum
ent outlining how the educational quality of these programmes is monit
ored. Whereas departments may have assumed this responsibility in the
past, this is clearly a function of the institution. The purpose of th
is paper is to describe a long-standing, effective, internal peer revi
ew process to assure quality education in an institution.