Recent surveys have highlighted widespread criticisms of the use of workplace-based assessments (WPBAs) in psychiatric training. We describe our systematic review of psychiatric WPBAs, including a ‘surgical dissection’ of their format and process. From our review, we identified seven overarching WPBA themes, and have drawn on these to make further recommendations to strengthen the wider acceptability of WPBAs in psychiatric settings. We hope this will encourage further debate on ways of improving these tools, rather than them becoming side-lined as ‘top-down’ tick-box exercises.

In line with Modernising Medical Careers (Department of Health, 2003), the foundation year programme aims to bridge the gap between undergraduate and specialist training. Psychiatry posts have been incorporated into the second year of this programme, with satisfactory progress of doctors being monitored via a range of workplace-based assessment tools. Learning that occurs in the context of the daily workplace is more likely to be relevant and reinforced, leading to better practice (Davis et al, 1995).

After many years of hard work and training, the transition from trainee to consultant is potentially challenging. Having successfully negotiated the hurdles of preregistration training, the MRCPsych examination and the specialist registrar (SpR) interview, trainees have to pass one final signpost to mark the end of their formal training – securing their first substantive consultant psychiatrist post. Despite overall vacancy rates of about 12% for consultant psychiatrists in the UK (Royal College of Psychiatrists, 2002), competition can be intense for some posts.

This paper aims to help trainees successfully negotiate the important ‘step up’ from senior house officer or equivalent grade to specialist registrar. It outlines the current structure of higher specialist training programmes in psychiatry, stresses the importance of early planning during basic specialist training and provides a guide to success in the shortlisting and interview stages.

In line with the Royal College of Psychiatrists' commitment to improve its professional examinations based on the best current evidence, Spring 2003 has seen the introduction of the objective structured clinical examination (OSCE). This has replaced the individual patient assessment (IPA) in the MRCPsych Part I clinical examination. An OSCE consists of a series of time-limited clinical tasks that candidates have to perform in a consecutive series of ‘stations' or booths. They have the advantage of being able to test clinical competence using a number of different scenarios via a standardised format (Katona et al, 2000). Their use has become widespread over recent years, particularly in undergraduate psychiatry exams (Brewin & Cantwell, 1997), as they have good reliability and validity (Hodges et al, 1998). This was confirmed by the College's initial pilot OSCE, which had a κ score of around 0.8 for the examination as a whole (Oyebode, 2002).

The MRCPsych Part II examination remains an important milestone (or barrier) for those wishing to pursue higher specialist training in psychiatry. There have been significant changes to the structure of this complex exam, with modification of the multiple choice question (MCQ) and essay papers and the introduction of the critical review paper. With pass rates varying from 39–49% over recent years, it clearly represents a significant hurdle for psychiatric trainees. This article aims to provide specific advice on how best to approach and tackle each of the components of the exam.