Graduate or postgraduate education is the period of formal specialization in a doctor’s life leading to issuance of a specialist diploma when successfully completed. From an educational point of view postgraduate education has often been perceived as a rather simple part of a doctor’s professional career and has attracted less research interest than undergraduate and continuing education. This is about to change as training objectives and curricula are being developed and working contracts are being improved, reduction of excessive working hours being one of the main goals.

Although the type of bodies responsible for postgraduate education and its organization differ from one country to another, service-based training and theoretical courses are core elements in most countries. The structure and process of the training have been much more focused during the last decade. Accreditation criteria have been developed and evaluation procedures of training sites have been systematized and improved. Increased emphasis has been placed on the learning environment (climate); and the processes of feedback, appraisal, supervision and mentoring are being studied and acknowledged as indispensable for quality training. Systematically used formative assessment has been slow to develop in most countries. A satisfactory final assessment (specialist examination) is a prerequisite for obtaining a specialist diploma in some countries, but not in others. The European Union represents the highest number of nations with mutual recognition of specialist diplomas, although the training varies considerably from one member state to another.

The competencies needed for successful training in the new millennium are being debated. The United States Accreditation Council for Graduate Medical Education (ACGME) has made the most radical move so far by endorsing general competencies in the areas of patient care; medical knowledge, interpersonal and communication skills; professionalism; practice-based learning and improvement; and system-based practice.

Numerous research questions need to be addressed in postgraduate education as health care undergoes significant reorganization and as the knowledge base for every specialty grows with unprecedented speed, while at the same time working hours decrease and the length ofspecialist training is already perceived as long. Postgraduate education needs more attention, being a crucial period ofa doctor’s continuous professionaldevelopment.


Sleep Deprivation Junior Doctor Academic Medicine Postgraduate Training Postgraduate Education 
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Copyright information

© Springer Science+Business Media Dordrecht 2002

Authors and Affiliations

  • Hans Asbjørn Holm
    • 1
  1. 1.Norwegian Medical AssociationNorway

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