Table 5 Theme 4

4.1 Adjustments to the residency

... I think at this early-stage flexibility is really important. In five or 10 years’ time, you can start lifting the quality but I think, at the moment, if some sites don’t have the capacity to do all of these things for all of their people that want to be residents, I think they should recognise that they are trying too quickly to make it high quality without getting buy in from the base. E8, FG2

We have kind of tailored our frequency right from the start. And SHPA was happy with that. We did need to tweak a few things. E12, FG4

4.2 Program design

… Some of it (residency activities and tasks) is not being built really thinking about curriculum and learning needs and all that sort of stuff. Some of it is being built to fix the department’s problems rather than development of the residents… E8, FG2

So we have been trying to turn it around so that we actually focus on them attending seminars that target their learning needs and their gaps which they can identify themselves through all the feedback and assessments that we do. E10, FG2

4.3 Concern about flexibility leading to inconsistencies

… it was super-flexible at the start because no-one knew what they were doing. E8, FG2

We have got such a mixed implementation of our residencies through the different sites. It means something different per site on what it looks like with regards to permanency, temporary positions, what you get at the end, if you get anything at the end... E5, FG1

I was thinking about consistency between sites: Is this resident from the “Hospital A” the same as “Hospital B”, the same as “Hospital C”? I don’t think we have really established that yet. So accreditation for five versus 3 years, well, your program might change after that, yet these guys are still doing it. How can you for employment say that this resident matches this resident? … E9, FG2