Too much control diverts from the essence of learning and teaching

Learning is not only about acquiring knowledge and skills but, above all and especially in the workplace, it is about participating in practice and lending meaning to experiences with the aid of supervisors [4]. Workplaces are messy environments in which learners have to deal with whatever crops up. To determine in advance what should be taught and learned in practice is to ignore the unpredictability of the practice and the sudden presentation of new situations in which you are forced to find out by trial and error how best to behave professionally. It is in this context that learners should become professionals. What has to be learned, then, is context-dependent and personal; the outcome cannot be described in well-defined criteria but should instead be more reflective and process-oriented. By limiting medical education to narrowly defined content and outcome we ignore the very nature of medical practice which features uncertainty and ambiguity. This ambiguity and uncertainty is precisely what future doctors must learn to deal with [5]. In this letter I will express my dissent from this trend of detailing medical education content, based on my personal experiences and the literature. In 1981, I started my residency in general practice in the Netherlands. This residency had been launched a few years earlier without detailed descriptions of learning outcomes. Guiding principles of this training programme were The Basic Job Description of the General Practitioner, drawn up by the professional body, and educational insights, for instance about the importance of supervised workplacebased learning, time for reflection, formal learning, and meeting peers. I learned a lot, especially in the workplace, but also from the weekly peer meetings that were facilitated by a general practitioner and a social sciences teacher. Precisely because there was no programme detailing all the specifics, we felt encouraged to self-direct our learning. As a result, we engaged ourselves in searching for evidence, To the editor,