Evaluation of residents and residency programs is an important but time-consuming exercise for busy residency program directors. Its purpose is to improve and thereby enhance the skills of medical specialists.1 Achievement of this goal requires the assessment of the residents' progressive acquisition of professional knowledge, skills, and attitudes, and the documentation of the extent to which the residency program promotes—or fails to promote—the acquisition of these competencies.2
A comprehensive evaluation system should focus on the program as well as the residents. Feedback from this formative evaluation system can be provided continuously to the resident, teacher, and program director, allowing the residents to evaluate their progress, teachers to evaluate their instruction, and program directors to evaluate their curriculum.2
The distinction made by most authors between formative and summative evaluation is an important one. Formative evaluation occurs on an ongoing basis and shapes day-to-day behavior with feedback; it resembles