Monitoring standards of training

In postgraduate medical education there will always be a tension between de livering the service and ensuring time for reflection and learning. The bal ance requires monitoring to ensure national implementation of standards and to provide an external review for hospitals. However, the current system i n the United Kingdom of visiting by many different agencies is disruptive t o hospitals and wasteful of resources. The North Western Deanery has worked with medical royal colleges to develop a co-ordinated system of visiting and reporting which is designed to share information and expertise while reducing the pressure on hospitals. Setting and maintaining standards Clear standards are published and hospita ls are encouraged to measure their own performance against these so that th ey are able to address identified problems. The effectiveness of the visits depends on collection and collation of data, especially face-to-face inter views with trainees and consultants. At the end of the visit a structured v erbal feedback is given to senior managers and clinicians in the hospital a nd is followed by a written report. Improving the quality of training Systematic review of training placements by the postgraduate dean's team has resulted in a steady increase in the qu ality of training placements and a structured approach has given trusts a f ramework to review the quality of training between visits. The future must lie in greater investment of responsibility in postgraduate deans for routi ne monitoring of training placements to consistent standards, which would a llow the newly emerging Medical Education Standards Board (MESB) to review deaneries rather than individual placements.