Context: A national reform of the postgraduate medical education in Denmark introduced (1) Outcome-based education, (2) The CanMEDS framework of competence related to seven roles of the doctor, and (3) In-training assessment. Objectives: The purpose of the study was to evaluate the process of developing new curricula for 38 specialist training programmes. The research question was: which conditions promote and which conditions impede the process? Methods: Evaluation of the process was conducted among 76 contact-persons, who were chairing the curriculum development process within the specialties. Quantitative and qualitative data from a questionnaire survey and telephone interviews were triangulated for data analysis. Results: The response rate of the questionnaire survey was 83% (63/76). Twenty-six telephone interviews were conducted. Identified promoting factors included positive attitude and motivation in faculty and support from written guidelines and seminars. Identified impeding factors included insufficient pedagogical support, poor introduction to the task, changing and inconsistent information from authorities, replacement of advisors, and stressful deadlines. Conclusions: This study identified promoting and impeding factors in a national postgraduate curriculum development process. Surprisingly the study indicates that pedagogical support provided throughout a process in some aspects might not be useful. General suggestions regarding curriculum reform processes are formulated.