The goal of this program is to help each trainee objectively assess and improve the quality of care hey provide to their patients in the ambulatory setting. Common diseases with established and widely accepted evidence based practice guidelines have been selected. When in practice, various external agencies pass judgment on individual and group physician performance using such outcome data. In addition, the Accreditation Council, for Graduate Medical Education in the US, requires residency programs to promote, teach, and evaluate outcomes in each of the six competencies. Practice Based Learning being one of them. In many respects such analysis will also reflect the systems within which we practice, our knowledge base and our ability to communicate effectively with patients, their families and all members of the health care team.