Postgraduate Medical Education – an increasingly important focus of study and innovation

Graduating medical students often feel relieved that the strenuous learning during undergraduatemedical education has ended when they eventually hold the license to practice medicine in their hands – just to discover that learning has only just begun when they enter postgraduate training. For many graduates the transition from the final year of undergraduate education to the first year of postgraduate training is rough and demanding with its sudden and unfamiliar burden of professional responsibility. Undergraduate final year medical students participating in a 360-degree realistic full day assessment, simulating a busy first postgraduate working day in hospital [1], [2] reported that patient management and responsibility felt overwhelming at times, even though it was a simulation exercise. They had never truly experienced this merge of required knowledge, skills, and attitudes before. Yet, managing patients and taking up professional responsibilities during postgraduate training are core to every physician’s daily work regardless of specialty. For many decades, postgraduate medical education in Germany has not been regarded as a training period. Defined learning objectives, structured training programs and validated assessment concepts were missing. Training was based on assumed “learning by doing”, often unsupervised, and completing a set ofmostly quantitative requirements, such as numbers of operations, endoscopies, ultrasounds, and other “collectibles”. In other countries, sophisticated admission processes [3], [4] and educational frameworks [5], [6], [7], [8] have been developed for postgraduate medical training programs aiming at preparing residents for their increasingly complex professional roles in delivering health care [9]. The current trend in organizing postgraduate educationmoves towards competency based training [10] which focuses on individual decisions of entrustment and fading supervision for comprehensive professional tasks depending on the individual learner’s competencies rather than merely counting solitary procedures [11], [12]. To ease the transition from undergraduate to postgraduate training the German National Competence-based Learning Objectives Catalogue (NKLM) has been developed for undergraduate medical education [13]. It is strongly based-on the CanMEDS framework designed for postgraduate medical training and provides a transfer of the framework to undergraduate medical education [13]. Furthermore, the German Medical Association (BÄK) is currently revising theModel Specialty Training Regulations (MWBO) with an emphasis on competences and compe-