Adapting to change: when training assessment reform meets clinical reality

SUMMARY

Recent changes to formative assessment in UK psychiatry training aim to strengthen clinical reasoning, autonomy and alignment with consultant practice. Presenting these reforms to trainers and resident doctors revealed a gap between policy intention and front-line experience. The article reflects on this, exploring what implementation of assessment reform reveals about learning, trust and professional identity, highlighting how successful change depends not only on assessment design but also on engagement with those expected to use it.