The practice of postgraduate medical education could be said to be as old as the practice of medicine itself, but the formal organisation of postgraduate medical education in this country dates back to the turn of the century. With the growth in the knowledge-base of medicine and also the expansion of the British Empire, postgraduate education became at last a necessity for every doctor. During the last seventy years several reports have dealt with this issue and have made many recommendations and suggestions, few of which have been assimilated into practice. In the West of Scotland, the innovations have been ahead of the country as a whole which places the region in a strong position today. However, several issues appear problematic at both local and national level. These issues may be divided into three major areas, management; education; and special issues. In the management area problems relate to the specification of aims, the question of roles, the increasing problems of finance and the problems of conflict. With education problems relate to the curriculum, to assessment and to evaluation. Finally, special issues which encompass all these problems are particularly related to the pre-registration year, to continuing medical education and to teaching skills. There are no simple solutions to these problems. However, dialogue, discussion and further research could alleviate the situation. What is important is to recognise that the problems of postgraduate medical education are not unique. Many of the debates now occurring in the field of postgraduate medical education have already taken place, or are on-going in other educational areas. Postgraduate medical education can both learn from and contribute to these debates.
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The Development of Postgraduate Medical Education, with Particular Reference to the West of Scotland