Modernising Medical Careers for GPs

Education Supervision and Review of Progression

Modernising Medical Careers

The Principles of MMC

• Trainees enter run through training on completion of foundation programme

• Training throughout the programme to meet requirements of the curriculum

• Completion of the programme is competency based (though minimum time set)

• Certification of completion of training (CCT) awarded on completion

Principles of WPBA

• Longitudinal assessment of each trainee’s progress over 3 years

• Multiple sampling using workplace based assessment tools

• Tools look at developmental progression

• Links to RCGP Curriculum

• Learner led

• Competencies demonstrated when ready

Implementation of WPBA

• All learning and assessments recorded in e-portfolio

• Regular educational supervision– GP based

• Annual review of progression– Deanery panel

Workplace Based Assessment

• Externally and locally assessed components

• Assessed by clinical supervisor in hospital or general practice setting

• Demonstrate progression rather than pass or fail for individual assessments

Locally Assessed Components

• Case based discussion CbD

• Consultation observation tool COT

• Mini CEX (Clinical evaluation exercise)

• Directly observed procedure (DOPs)

Externally Assessed Components

• Multi-source feedback (MSF) – 2 domain questionnaire using both clinical and

non-clinical colleagues

• Patient satisfaction questionnaire (PSQ)– Empathy questionnaire (CARE)

– assessed components

Educational Supervision

• 6 monthly review– Done at end of posts 1 and 3 or mid ST3– WPB Assessments and results– Coverage of curriculum – Clinical supervisors report– Review PDP – Produce PDP for next 6 months– Complete report on e-portfolio

Educational Supervision

• Annual Review– For ST1&2 done at month 10 or 11 of year– Educational supervisor meeting and report as 6

month review– Annual NHS appraisal – documentation automatically

produced by e-portfolio– Put Trainee forward for Deanery Panel with

recommendation• Satisfactory progress• Panel review requested e.g. some ill defined concerns, • Unsatisfactory progress

Annual Review of Competency Progression

• Done by a panel convened by the Deanery

• 5 panel members with representatives of educators, employers, lay and RCGP

• Panel members not involved in trainees programme

• Quality management of assessment and review processes

Annual Review of Competency Progression

• For trainees progressing satisfactorily– Review of e-portfolio summary only

• For trainees with development needs– Full review of e-portfolio– Decision on further education plan– Interview with trainee

EducationalAppraisal

Annual Review of

Competence Progression

Outcome

Annual Planning

1. Learning agreement:aims & intended learning outcomesbased on specialty curriculum2. Advice on portfolio3. Regular feedback (2 way)4. Personal Development Plan5. Trainer’s structured report6. Workplace based (NHS) appraisal

Educational supervisor and/or TPD meet with trainee toreview competence outcome with trainee plan next part of training

Based on a paper from PMETB’s Workplace Assessment Group (2005)

Workplace based (NHS)

appraisalARCP

A. Evidence1. Assessment of performance e.g.workplace based assessments and observational methods E.g. mini-CEX, DOPS, video, CBDexaminationsstructured report2. Assessment of experience, e.g.portfolio/log bookauditresearchcritical incidentsB. Annual Competence Review Appropriately constituted panel considers evidence Outcome Review of evidence of progressOutcome of reviewEducational Planning

Completion of Training

• Demonstrate competency through WPBA.• Pass AKT and CSA• Experience prior to Aug 07 certified by

VTR forms• Deanery Panel recommends eligibility for

Certificate of Completion of Training (CCT)• Recommendation confirmed by RCGP

certification unit to PMETB• PMETB issues CCT

Certification

• Article 10 – Certificate of Completion of Training (CCT)

• Article 11 – Certificate of Eligibility for GP Registration (CEGPR)

– Posts not approved for GP training– More than 7 years prior to completion date– Overseas experience

The Principles of MMC

• Trainees enter run through training on completion of foundation programme

• Training throughout the programme to meet requirements of the curriculum

• Completion of the programme is competency based (though minimum time set)

• Certification of completion of training (CCT) awarded on completion

TerminologyOld

GP Registrar……….

SHO…………………

Course Organiser…

Scheme Organiser..

Day Release Course

GP Trainer………….

New

GP Specialty Registrar (GP StR3)

GP Specialty Registrar (GP StR1 or 2)

Primary care medical educator

Programme Director

Structured Teaching Programme

GP Trainer

Educational Supervisor

Clinical Supervisor

Implications for General Practice

• All trainees on 3 year programme

• Self construct schemes and stand-alone registrar posts ended July 2007

• GP training programmes have expanded and need to expand further by absorbing current posts

• Programmes approved by PMETB

Implications for General Practice

• 50% of trainees completing F2 will enter GP training

• Acquisition of hospital posts for GP programmes

• All trainees starting 2008 should have 18 months in GP– Integrated training posts (ITP)– Full GP posts

Projected numbersYear 2 yr

progs3 year progs

ST 1 & 2 posts

Trainers needed

2006-7 37 75 195 167

2007-8 73 197 343 200 ST3

24 ITP

2008-9 0 210 425 160 ST3

95 ST2

2009-10 0 250? 510 230 ST3

105 ST2

Summary

• GP Curriculum• GP Specialty training

in 3 year integrated programmes

• Ongoing assessment, appraisal and education supervision

• Expansion of numbers and time in GP