In 2002 Unfinished Business, a report and consultation paper by Sir Liam Donaldson, Chief Medical Officer for England, put forward proposals for the reform of the senior house officer (SHO) grade, including the formation of the new early years foundation posts (Donaldson, 2002). In 2004 Modernising Medical Careers – The Next Steps (Department of Health, 2004) outlined specialty and general practitioner (GP) training programmes building on the foundation programme. As a result all medical training will be changing to a competency-based model from August 2007. This will encompass run-through training from specialist training years 1 (ST1) to 6 (ST6). Some regions and specialties have been chosen as pilot sites for specialist training year 1 commencing August 2006.
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