The Approval exercise is an attempt to standardize psychiatric training in different hospitals, following the introduction of the Membership examination ten years ago. Very little, however, has been said about how standards are defined, who defines them, how reliable they are, or how valid in respect of the attributes required to become a consultant psychiatrist. The College is now directing its attention to these issues in considering a syllabus for the examination, a document setting out the aim of training in psychiatry and, of particular importance to this paper, the possibility that the Central Approval Panel should become more accountable to those whose interests it primarily represents—the trainees in the hospitals whose approval status it decides.