Background Palliative care has been established for about 12 years in Singapore but is much less developed elsewhere in the Asia-Pacific region. The Department at the National Cancer Centre runs a busy hospital support service; seeing over 1400 new patients in 2010. It has always hosted a large number of visiting foreign doctors often returning to establish palliative care in their own countries. Local doctors also rotate through. No formal training programme or evaluation of the experience has been undertaken.

Aims Eighteen months ago, in an attempt to formalise and evaluate the training, a series of standard ‘core tutorials’ were developed on foundational palliative care topics. MCQs were written based on these using various guidelines. 20 doctors were tested with the same MCQ preposting and after the tutorial completion; the typical interval was 6–8 weeks. Findings: Overseas doctors (n=6): mean preposting 51.4% (+/-12.9); mean post-tutorials 75% (+/-5.3) mean improvement 45% Local MOs (core trainees) (n=9): mean preposting 65.2 (+/-14.9); mean post-tutorials 82.1% (+/-8.81); mean improvement 26% Local ASTs (spRs) (n=5): mean preposting 79.8 (+/-8); mean post-tutorials 82.5% (+/-8.81); mean improvement 3%.

Conclusion The results suggest all doctors benefited from the training but the overseas doctors improved most and results overall were more uniform. Clearly the tutorial learning was also supplemented by on-going clinical exposure. The learning points have been: MCQs were refined to eliminate ambiguity and to consider language difficulties for overseas doctors. Testing allowed struggling doctors to be identified and remedial support given. A more advanced MCQ has been added for end of posting testing. Progress is being made to use an IT system for online tutorials and MCQ testing to cut down on tutor time MCQs mainly test knowledge but they are helpful as part of a multifaceted evaluation to determine development during the posting.