Transcript The Royal College of Pathologists

Framework for
specialty training –
the Gold Guide
Professor Shelley Heard
Incoming Director of Training and Standards
RCPath
19th October 2007
The Gold Guide
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setting the context
describing the process
gaining consensus
key changes
process for amendment
the future
The Context (1)
August
2002
February
2003
July 2003
April 2004
The context (1)
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need to respond to policy change set out by
Modernising Medical Careers (2003)
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Orange Book needed up-dating and “modernising”
to reflect change from specialist training to specialty
training
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Orange Book described specialist training as set out
by STA and JCPTGP
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Gold Guide describes specialty training to approved
curricula, agreed by the Postgraduate Medical
Education and Training Board (PMEB)
The context (2)
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Four Health Departments
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Commissioned by UK Strategy Group (4 CMO Group)
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editor and 4 HD officials supported by stakeholder reference
group
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recognise transitional arrangements for those already in
SpR (specialist) training and those who would be entering
specialty (ST) training
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not about terms and conditions so no mention of pay,
extension of contracts (“period of grace”), study leave
arrangements
From the Orange Book to the
Gold Guide
Guide to Specialist Registrar
Training
The Orange Book
1998
Reference Group
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Academy of Medical
Royal Colleges
Academy Trainee’s
Doctors’ Group
BMA – JDC
COPMeD
COGPED
GMC
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NHS Employers
Patient representative
PMETB
Service stakeholders
from four devolved
administrations
Workforce Review
Team
The Process
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DH document
iterative with reference group and their stakeholders (at
least 3 iterations)
detailed responses from reference group –e.g. Academy,
COPMeD, PMETB, Academy trainees, JDC, NHS
Employers and others
expert input from PMETB, educationalists from 3 Royal
Colleges
workshop with health department officials from devolved
administrations – acceptable to DH
legal review
4 DH review
Ministerial sign-off
Gaining consensus –
was it successful?
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considerable task
hard to know in current climate
not always agreement amongst constituencies
a bit of who shouted loudest
stay within regulatory framework
political environment
Specialty training as a specialty
registrar (StR)
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Becoming a ST
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Progressing as a ST
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Being an ST and an employee
Becoming a StR
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recruitment issues being dealt with as 2008 and then
2009 and beyond
NTNs – for all those in run-through programmes, not
FTSTAs
flexible training arrangements – competitive entry; ad
personam programmes; achieve competences and
minimum time required
academic training in integrated programmes
taking time out of programme (OOP)
inter-deanery transfers
Out of programme
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Time out of programme for approved clinical
training (OOPT)
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Time out of programme for clinical
experience (OOPE)
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Time out of programme for research (OOPR)
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Time out of programme for career breaks
(OOPC)
Inter-deanery transfers
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process has evolved and has been agreed by
postgraduate deans
no automatic right
well-founded reasons
capacity in programme
significant change since appointment
may require an interview since will be
competition for available places
NTN from receiving deanery
Progressing as an StR
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underpinned by appraisal, Annual Review of Competence
Progression (ARCP), annual planning
progression defined through assessment strategy in
curriculum
assessment is a formal process which assesses progress
through the curriculum
measured using a range of defined/validated assessment
tools and triangulated judgments
formal process resulting in an Outcome
based on available written evidence, especially from
structured report from educational supervisor which
summarises assessment evidence
trainee should not normally attend unless problems
anticipated
Educational
Appraisal
1. Learning agreement:
aims & intended learning
outcomes
based on specialty curriculum
2. Advice on portfolio
3. Regular feedback (2 way)
4. Personal Development Plan
5. Trainer’s structured report
6. Workplace based (NHS) appraisal
Workplace
based (NHS)
appraisal
ARCP
A. Evidence
1. Assessment of performance e.g
workplace based assessments
and observational methods
eg mini-CEX, DOPS, video,CBD
examinations
structured report
2. Assessment of experience, e.g.
portfolio/log book
audit
research
critical incidents
Review of
Competence
Progression
B. Annual Competence Review
Appropriately constituted panel
considers evidence
Outcome
•Review of evidence of progress
•Outcome of review
•Educational Planning
Educational supervisor and/or TPD meet
with trainee to
review competence outcome
with trainee
plan next part of training
Outcome
Annual
Planning
Based on paper from PBETB workplace assessment group (2005)
The Annual Review of
Competence
Progression
Gold Guide, 2007
Purpose of ARCP
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provide a for recording the evidence of the trainee’s
progress within the training programme or in a FTSTA
provide a means whereby the evidence of the outcome of formal
assessment, through a variety of PMETB agreed in-work
assessment tools and other assessment strategies, including
examinations, are coordinated and recorded to provide a coherent
record of a trainee’s progress
provide a mechanism for the assessment of outofprogramme
clinically approved training
to make judgements about the competences acquired by a
specialty trainee and their suitability to progress to the next stage
of training if they are in a training programme, or to document the
competences achieved ay a trainee in a FTSTA
provide a final statement of the trainee's successful attainment of
the competences for the specialty and thereby the completion of
the training programme.
Annual Review of Competence
Progress (ARCP) - Outcomes
Satisfactory Progress
1. Achieving progress and the development of competences at the expected rate
Unsatisfactory or insufficient evidence – trainee required to meet with the
Panel (Outcomes 2, 3, 4)
2. Development of specific competences required – additional training time not required
3. Inadequate progress by the trainee – additional training time required
4. Released from training programme with or without specified competences
5. Incomplete evidence presented – additional training time may be required
Recommendation for completion of training
6. Gained all required competences; will be recommended as having completed the
training programme and for award of a CCT or CESR/CEGPR
Outcomes for trainees in FTSTAs, out of programme, or undertaking “top
up” training within a training Programme
7. Outcome
for Fixed-term Specialty Trainee (FTSTAs)
8. Out of programme for research, approved clinical training or a career break
9. Outcome for doctors undertaking top-up training in a training post
Being a Specialty Registrar and
an employee
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accountability as an employee as well as a trainee (Trust,
Assurance and Safety – the Regulation of Health Professionals in
the 21st Century)
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training always within the context of employment
employers must be aware of performance and progress
of postgraduate trainees
employers must ensure that mechanisms are in place to
support the training of trainees
transfer of information where there are on-going
needs/issues – trainee has right to know
workplace based (NHS) appraisal (for employers)
Protocol for changing the
Gold Guide
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The Gold Guide will be reviewed on annual basis.
Membership of the review group is be confined to officials from the four UK
Health Departments.
Individual country Programme Boards/Steering Groups are invited to submit
requests for changes/amendments to the review group, with reasons.
Comments regarding changes and/or amendments must be received by the
review group in April/May each year.
The Review group will meet, consider requests and write the relevant
changes, subject to testing of impact of any additions.
All changes/amendments will be published as supplements to the Guide
(with relevant date of implementation) in June of each year.
The Review group could be requested to consider urgent amendments on
an ad hoc basis.
A separate recruitment supplement will be issued each year.
The Future
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Tooke review
Consultation period
? back to Specialist Registrar (SpR)
training