Gersten Jonker

Certification decisions in anesthesiology training   151 7 DISCUSSION So, although decision-makers were satisfied with the competence level of most trainees they had certified, many indicated to have certified trainees they would not entrust with the unsupervised care of their loved ones. Such “false positive” certification decisions – certified, but not truly competent – are an alarming finding and suggest flawed assessment systems that fail to consider all facets of competence. Failure to take aspects such as professionalism into account may jeopardize professional collaboration and patient safety [5]. A limitation of our qualitative research approach is that we are not able to quantify the incidence of such “false positive” certifications, nor can we pinpoint the problem to countries or curricular systems. Nevertheless, it is concerning that this experience appears to be common among anesthetists certifying trainees across Europe. Another limitation is that we have not specifically investigated individual or local tendencies to entrust residents at completion of training with care for loved ones. Furthermore, our interview study was in anesthesia only, but we suspect that this finding will resonate with colleagues responsible for certification in both surgical and non-surgical specialties. Finally, although we did apply researcher triangulation, we did not triangulate with data from other sources. A future study could build on our findings with data from surveys or focus groups. To fulfil the profession’s promise of societal accountability, the assessment and certification processes should be optimized, to ensure adequate competence of all trainees at the time of certification. All patients, including our own loved ones, deserve to justifiably trust every new medical specialists that our training programs deliver.