The quality of Finland’s postgraduate medical education: a national perspective from programme directors

In Finland, postgraduate medical education (PGME) is coordinated by five medical schools and delivered in training units. Following a national reform from time-based to competency-based medical education in 2020, all programme directors (PDs) collaboratively developed unified specialty-specific curricula. This study aimed to evaluate the national quality of PGME from the perspective of PDs. A survey including 36 Likert-scale and 12 open-ended questions was constructed using the World Federation for Medical Education (WFME) standards as a framework. The national electronic survey was conducted with REDCap in 2024 and e-mailed to all 253 PDs. The response rate (n = 82) was 35%, covering 90% of specialties. Results showed broad alignment with WFME standards, particularly regarding mission clarity and competency-based structures. Variation existed in pedagogical training, mentoring resources, and assessment practices across universities. Most PDs reported having structured feedback practices and supervisory support, although structures for workplace supervision quality and trainee support varied. Only a few specialties had established clinical competency committees. From the PDs’ perspective, the national implementation of competency-based PGME has progressed as expected, yet notable variation remains at the grassroot level between specialties. The study reveals areas for further development, especially in harmonizing assessment practices and strengthening supervisory structures nationally, and further research is needed from the perspectives of trainees and clinical supervisors.