After 10 years certifying medical specialists Conacem is committed to evaluate the process focusing, among other aspects, on critical issues of postgraduate training programs. In this prospect, it has been important to look at the fact that there are several non university programs with a variety of contents, institutional sponsorship, curricula and faculty support. This constitutes a very inhomogenous source of knowledge and skills, even though many arise in the same area of academic influence of the most traditional Medical Schools. Available data disclose 316 specialty programs, alluded by 398 physicians, that were offered in about 40 institutions, referring to 28 different disciplines. This represents the 20.7% of all the specialists certified in this period with accomplished formal academic programs. At least 92.7% pertain to institutions academically related to the Medical Faculties and, among them, a 77% to the University of Chile. This information allows a critical review of proposals and to raise initiatives to put in order some scenarios of postgraduate education, that urgently need to be better managed from the standpoint of both the universities and the accreditation system.