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Abstract
Higher Specialist Training (HST) has been radically reformed in the last decade, and specialties have been urged to conduct further reform. This paper reports on an explorative investigation into curriculum provision and assessment within four specialties in the West Midlands. Methods include analysis of curriculum documents; observation of the RITA process; and interviews with consultants (4), specialist registrars (5) and members of the regional higher specialist training management team (3). Three major themes identified within the interviews are discussed: the content and use of the curriculum; the impact of service-based learning; and issues around assessment.