A comparison of three different quality assurance systems for higher medical training

Quality assurance (QA) of medical training is a growing concern. There have been few studies comparing different methods. A window of opportunity occurred when a Royal College of Physicians (RCP) visit was followed soon after by a pilot of a web-based questionnaire in a deanery which already had a well-developed QA system in geriatric medicine. The different methods of RCP visit, deanery visit and web-based survey were compared. Surveys are easily administered and repeated but may be hindered by poor response rates and lack of corroborating information. Negative aspects can be exaggerated and positive ones overlooked. Trainers' views tend to be underused. Visits consume more time and resources but give a better overview. Each method format was found to have advantages and disadvantages and no one method alone would have picked up all the information. This paper recommends a robust deanery mechanism as a continuous QA mechanism backed up by periodic focused external visits.