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Lessons learned in developing new postgraduate medical specialist training programs for Australia and New Zealand

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What can be learned from the process of introducing major postgraduate medical education reform?

Considerable changes in the processes of medical student education have been occurring for the past 20 years. Such changes began with the recognition that the curriculum was becoming increasingly full, leading to fatigue and loss of enthusiasm for the craft of medicine in medical students just as they were entering the medical workforce.1 Changes in medical student education have included limitations on curriculum content; new ways of learning, such as inquiry-driven learning using problem-based learning principles; formative assessments; more feedback on student performance; emphases on ethics, communication and clinical reasoning; and greater integration of preclinical and clinical learning opportunities.24

Have these changes been mirrored in postgraduate medical training? In a general sense, changes in postgraduate training for graduates of these new medical courses have been limited.5 It could be argued that, as postgraduate trainees are already “trained” and have commenced work, such reforms are not really necessary. However, the changing health care environments in which trainees work have placed the traditional apprenticeship model under severe duress. Erosion…