Appraisal and reassessment of the specialist in anaesthesia

Appraisal and reassessment of the physician is an integral part of ensuring that 'quality of care' provided by the health care system is the best possible within the constraint of resources. Assessment tools used for initial certification at completion of medical school as a general physician and for initial certification as an anaesthesiologist are discussed. The expansion of core or general physician competencies to include behavioural, communication and evidence-based resource management skills in addition to knowledge and clinical skills is reviewed. With global workforce market expansion into the health care sector, equitable application of valid, reliable assessments of the physician will be increasingly important as international anaesthesiologists seek clinical licensure. Standards of care can be defined at several levels, including hospital, court, licensing body and government. Examples of each level are given. Re-certification of anaesthesiologists currently occurs in two distinct ways: by examination and through continuing medical education. Details of each approach are included.