Background: changing socio-political context Over the last decade the socio-political world within which medicine exists has changed significantly. The expectations of medicine as a profession, and doctors as its constituent members, have morphed drastically and the role of the physician has transformed from an autocratic decision-maker to a collaborative facilitator for patients in supporting them to make complex healthcare decisions. National and international high-profile healthcare scandals have also meant that governments, and through them the public, now expect greater transparency in the standards to which doctors are trained and demand evidence that trained doctors have actually met these standards before they are allowed into independent practice. Additionally, there are public and professional expectations that fully trained doctors are evaluated at regular intervals to ensure that they are up to date with the latest developments and have maintained the professional skills that enable them to practise medicine. Moreover, all this is happening when, on the one hand, quite appropriately, an emphasis on patient safety has necessitated a reduction in the working hours of trainees around the world and, on the other hand, many healthcare training systems are being encouraged to shorten the length of training, to meet healthcare workforce needs and to reduce the overall cost of training. Therefore, one can no longer rely on the traditional apprenticeship model where trainees were expected to spend long hours over a number of years in training with the hope that they would have enough experience and would have learnt sufficiently by osmosis to enable them to practise independently. Instead, training has had to become more structured, efficient and outcome-orientated, to ensure that trainees engage in educationally valuable activities to attain competencies that have been defined in a curriculum that is 'fit for the purpose' to prepare the needs of their professional 1 Workplace-Based Assessments in Psychiatric Training, ed. Dinesh Bhugra and Amit Malik.