Introduction A nationwide external quality evaluation aimed to identify strengths, good practices and areas in need of development.

Methods The enhancement-led four-phase evaluation process included a self-evaluation report by the universities; evaluation interviews and visits by the evaluators; an evaluation report; and a feedback seminar. The evaluation focused on the management and planning of education and the definition of learning outcomes and the learning philosophy; education resources and support and pedagogical training; the constructive alignment of education; and the continuous development of education.

Results Key strengths included good cooperation between units, pedagogical training of the trainers, investment in web-based learning and the use of previous evaluations in the development of education.

Changes in working life, the upcoming reform of specialist medical education and the continuity of funding were seen as external challenges.

Areas needing development included clarifying of the learning philosophy, broadening the learning outcomes to cover competences, achieving higher visibility, expanding and diversifying practices for learning assessment and feedback. Reflection practices were recommended to support interaction skills, professional growth and the promotion of development skills. Advancing pedagogical training of trainers was suggested. Genuinely interactive virtual learning was emphasised. Increasing the throughput of students and promoting interest in the specialty at the basic studies stage were recommended. The research-based and international approach in developing education was encouraged.

Discussion After the report the learning philosophy was clarified in the new curriculum, reflection was included in the logbook and a project to develop evaluation of the learning outcomes as competencies and entrustable professional activities started. A pedagogical web-based course and a pedagogical guide book for trainers were published. The specialty has worked vigorously on the external challenges, too.

High quality education is essential in occupational health care. An external evaluation of education may substantially help to meet the challenges of quality education.