Counting experience prior to entry into a CCT training programme in Anaesthetics

This guidance supersedes training programme update no. 1/2020, ‘Completion of units of training outside the training programme’, dated 20 October 2020.

Please note that OOP taken whist within a training programme (OOPE, OOPP, OOPT) should be managed as outlined in the Gold Guide https://www.copmed.org.uk/gold-guide/

Background

Recent changes to General Medical Council (GMC) and Academy of Medical Royal Colleges (the Academy) have increased the potential for flexibility in training, and made new ‘out of programme’ options possible.

The GMC update on CCT requirements has removed the necessity for doctors to meet the minimum training time in anaesthesia as a result of the UK’s exit from the European Union. Doctors entering a combined training programme with previous experience in posts not approved by the GMC could now be eligible for a CCT rather than a Certificate of Eligibility for the Specialist Register (combined programme) (CESR[CP]).

The Academy also recently published Guidance for flexibility in postgraduate training and changing specialties. This updates the Accreditation of Transferable Competences Framework and gives guidance for doctors wishing to change specialty, experienced doctors wishing to join a training programme, and doctors wishing to count training from outside their training programme.

Principles

Experience that might count towards CCT could be from work undertaken in the UK before recruitment to a core or higher training post. The maximum length of time counted is 12 months whole time equivalent (WTE).
This is in addition to any time spent completing stage 1 or CT3 'top up' training, or any other top up training needed for transition to the 2021 curriculum. There is no requirement to complete this process for top-up training.
The experience to be counted should match the stage of training at that time, and should show an increase in capability and responsibility (ie those entering higher specialty training at ST4 would be able to count previous experience towards stage 2 training, but not stage 3).
Schools have a responsibility to deliver fair training to all of the doctors on their programme, and it may not be possible or practical to accelerate one doctor’s training at the expense of others on the rotation.

Process

All requests for recognition should be evidenced using the RCoA Lifelong Learning Platform (LLP).

Doctors should ensure their LLP indicates an Out Of Programme (OOP) placement for the review period, but they can still continue to record supervised learning events (SLEs) during this time, and/or record training evidence as Personal Activities on the LLP.
Holistic Assessments of Learning Outcomes (HALOs) or Completion of Unit Training (CUT) forms should not be submitted on the LLP while outside a training programme.

At the start of a training programme, the doctor should meet with their Educational Supervisor (ES) and Training Programme Director (TPD), and undertake a gap analysis of their experience, and develop a training plan.

The Educational Supervisor’s Structured Report (ESSR) form can be used to collate the evidence and support this process, with the TPD assigned to the College Tutor role. (TPDs may need to contact the college at lifelong@rcoa.ac.uk to get their account adjusted, to accommodate this).
The training plan, gap analysis, and any other relevant documentation should be reviewed within the first three months of starting a training post in an ARCP-style process. This may require a panel, and can be face-to-face or virtual.
The panel will then make a recommendation on how much time can count towards CCT, and summarise what domains of learning, or units of training have been completed.
A notification of the above recommendations should be sent to the College, after being approved by the TPD or Head of School, and the Regional Adviser (RA(A)) or Deputy RA(A).

The notification and supporting evidence will be reviewed by the RCoA Training, Curriculum, and Assessment Committee. Our response including, if necessary, a new prospective completion date will be confirmed by letter.

Frequently asked questions

Can I count periods of time both before getting a core training post, and between core and higher training towards my CCT?
No, the experience has to be contemporaneous, so the time before core training can only count towards core training. The maximum time allowed is 12 months WTE.

Will this make the OOP process obsolete?
No, the OOP will remain as a way of allowing doctors to gain experience while within a training programme. It should be managed as outlined in the Gold Guide.

Will this change affect the rule that the last six months of training should be in the UK?
No, the intention of this is to allow doctors and their trainers to work together on the preparation for their final ARCP, reducing the risk of unforeseen obstacles affecting the final CCT date. This also gives training programme directors full confidence in signing notifications of completion of training.

Why is the maximum amount of time only 12 months?
Although the GMC ruling can allow more time to be taken into account, we feel there is a risk of destabilising training programmes, especially considering the transition to the 2021 curriculum. Therefore the College would like to introduce the changes in a measured and structured manner. This may change in the future.

How should I provide the evidence required?
All evidence should be collated on the LLP. This will help match the evidence to the level of training in question.

If you are currently in the post you would like to count towards CCT, this application can be made prospectively. The experience can be captured on a standard SLE for, and mapped to the appropriate stage of training. (e.g. if you are entering at ST4, you would be mapping the experience against stage 2 of the curriculum. Doctors should ensure their placement shows them to be “out of programme” on the LLP.

Those applying retrospectively can still use the LLP, but evidence should be uploaded as Personal Activities, linked to the relevant stage of the curriculum.

When possible, please make contact with your TPD before starting your training programme, expressing your interest in counting experience from outside the programme towards your CCT.

Who can approve SLEs for doctors who are not in numbered training posts?
The SLEs can be signed off by any appropriate assessor, the same as those in a training post.

How can I ensure my CCT date is adjusted accordingly after the ARCP?
Once the completed and signed notification form has been sent to training@rcoa.ac.uk (accompanied by the relevant supporting documentation) it will be processed by the team in the usual manner. A letter confirming the updated CCT date will be circulated in the usual way following this.

Supporting documents and forms

You can download a copy of the Gap analysis form here (Microsoft Word form)

You can download a copy of the Notification form here (Microsoft Word form)

You can download a copy of this guidance including the above forms here (pdf)