START – introducing a novel assessment of consultant readiness in Paediatrics: the entry not the exit

This article was migrated. The article was marked as recommended. The Royal College of Paediatrics and Child Health (RCPCH) developed a new end-of-training assessment held for the first time in 2012, known as START, the Specialty Trainee Assessment of Readiness for Tenure as a consultant. It is a novel, formative, multi-scenario, OSCE-style, out-of-workplace assessment using unseen scenarios with generic, external assessors undertaken in the trainees’ penultimate training year. This paper describes the introduction and structure of this formative assessment. While many other colleges have summative exit exams the inception of this assessment was designed to be formative, providing feedback on consultant-readiness skills, and not a high-stakes hurdle towards the end of training, It was developed from the College’s examinations question-setting group and following two pilots in 2009 and 2010, the assessment evolved and the first live diet was held in November 2012.