This paper outlines the principles of good assessment, including the importance of defining the purpose of assessment as well as what should be assessed. It then considers how SpR assessment should be undertaken, including possible tools for assessment such as peer ratings, patient assessment mini-CEX, and portfolios. It concludes with a brief discussion of how to draw together the various aspects discussed and some advice on remediation.

There is a requirement for annual assessment of all specialist registrars (SpRs).¹ However, this is undertaken on an ad hoc basis with wide variation in practice both between and within specialties. Little of the assessment undertaken to date has been sufficiently robust to withstand legal challenge. Annual assessment for SpRs is soon to be extended to SHOs through Modernising Medical Careers (MMC) and public, political, and professional pressure to show that adequate self regulation has been important in driving revalidation forward. A priority for the newly established Postgraduate Education Training and Standards Board (PMETB) has been to provide a principles and standards framework for assessment within postgraduate medical training² (box 1). Annual assessment for trainees will be used to show continuing fitness to practice within the revalidation framework. Assessment therefore is increasingly recognised as a priority; what remains unclear is how this should be done—how will we measure success?