title: Audits show that specialist paediatric training programmes are sensitive to medical, staffing and economic changes.
abstract: OBJECTIVE
  In Finland, specialist paediatrics training is led by university hospitals, but half of it is carried out in regional central hospitals. We audited the training provided by four regional central hospitals in the tertiary care area covered by Tampere University Hospital, in 2003, 2008 and 2015.
  
  
  METHODS
  The audits comprised hospital visits and discussions with the chief doctor of the paediatric clinic, the trainees and the specialists who trained them. A modified version of the European Union of Medical Specialists 1997 protocol was used, and the key areas that performed poorly in the audits were followed up.
  
  
  RESULTS
  In 2008 and 2015, most of the key follow-up issues had improved, but two main areas in need of further development were identified in 2015. These were that educational objectives should be clarified, and their implementation systemically followed up, and that trainees should spend more time working in outpatient settings.
  
  
  CONCLUSIONS
  Since 2003, a marked improvement had taken place in the paediatric training provided by regional central hospitals, partly because of the increase in paediatric specialist resources. This study underlines the importance of repeat audits and the need for co-opera-tion between the university hospital and regional hospitals, including regular visits.
authors.affiliation: Tampere Center for Child Health Research, Tampere University Hospital, University of Tampere, Tampere, Finland.
authors.forename: Olli
authors.initials: O
authors.lastname: Lohi
authors.affiliation: Tampere Center for Child Health Research, Tampere University Hospital, University of Tampere, Tampere, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Helminen
authors.affiliation: Tampere Center for Child Health Research, Tampere University Hospital, University of Tampere, Tampere, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Korppi
mesh_terms: D007396:Internship and Residency / Q000592:standards*; D008485:Medical Audit; D010372:Pediatrics / Q000193:education*; D058996:Quality Improvement
keywords: Auditing; Central hospital; Medical training; Paediatrics; Specialisation