Background/introduction Award of a certificate of completion of training is dependent on registrars attaining 44 competences described in the 2010 Genitourinary Medicine Higher Specialty Training curriculum.

Aim(s)/objectives This study evaluates clinical opportunities of a 4-year modular training programme in a large teaching hospital to determine:

1. Whether opportunity cost of training to service delivery is justifiable.

2. Competences that are inadequately addressed by direct clinical opportunities alone.

Methods Curriculum competences-based evaluation was undertaken with local faculty and trainees quantitatively assessing the ‘usefulness’ of the modular programme to meet each curriculum competence.

A Quality-Cost Justification matrix determined whether opportunity costs to service provision could be justified for individual clinical opportunities. This considered whether the opportunity is a mandatory curriculum requirement as well as the quality of training determined by triangulating quantitative ‘usefulness’ ratings of the faculty with qualitative findings of the trainee survey.

Results While 100% (n = 6) of registrars were either satisfied or very satisfied with existing clinical opportunities, these were only sufficiently useful for attaining 23/44 competences. Additional formalised training by way of an academic programme, opportunities to design teaching programmes and research and management experience were required to meet 10/20 GUM, 5/18 HIV, 6/6 management competences.

For all sexual health and 2/6 HIV clinical opportunities, the high quality of training justified the opportunity cost to service provision.

Discussion/conclusion The curriculum competences-based approach to training evaluation offers a focused and objective approach to resolve conflict of training and service provision. Furthermore, it highlights and supports formalisation of non-clinical training opportunities.