HEKSS School of Medicine Medical Higher Specialty Trainees Induction Handbook
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www.kss.hee.nhs.uk
HEKSS School of Medicine
Medical Higher Specialty Trainees
Induction Handbook
“Through creative partnerships we shape and develop a workforce that impacts positively on health and wellbeing for all”
We are the Local Education and Training Board for Kent, Surrey and Sussex
Developing people
for health and
healthcareSchool of Medicine Structure
The School of Medicine Specialty Workforce Team (SWT) are based in offices near
London Bridge. The School is led by the Head of School (HoS), supported by Training
Programme Directors (TPD) as well as a Specialty Training Committee (STC), Royal
College of Physician’s (RCP) College Tutors and Educational Supervisors (ES). There is
also a Trainee Support Lead that sits across all specialties in the School and will provide
advice and support to trainees and Trusts, as required.
In addition we have Trainee Representatives elected by the STC who represent the
‘trainee voice’ at all appropriate forums. The STC is led by the TPD for your specialty and
members of the Committee include the HoS, Deputy Dean for Secondary Care HEKSS,
RCP College Tutors, Trainee Representatives and members of the SWT.
The STC meet 3 times per year to discuss all aspects of the training programme such as:
Recruitment
Processes of assessment (e-portfolio, ARCPS etc.)
Developing the training programme especially around subspecialties, academic
support, Less Than Full Time training etc.
Developing Specialty Training across HEKSS
Delivering the curriculum
The HEKSS Schools are very keen to involve trainees. Please contact the Trainee
Representatives or any of the STC members directly with any issues or suggestions for
discussion (no matter how large or small!)
2Trainee Representatives and their roles
Each Hospital Trust has a Medical Local Faculty Group (LFG) for local planning and
support of Medicine trainees and this feeds into the overarching Local Academic Board
(LAB).The Trainee Representatives are elected or chosen and work with the LFG, LAB
and Specialty School.
They are there to ensure views, opinions and experiences of trainee doctors are taken
into account at every level of decision-making. They may also work with Medical
Education Managers, Academic Registrars, Doctors’ Liaison Officers or Trust Education
Advisors.
The Trainee Representatives’ responsibilities include but are not limited to:
Attend the open section of the STC meeting
Represent the views and interests of all trainees including those who may not
be specialty specific i.e. Foundation or GP trainees training in specialty posts
Provide feedback to the trainees on developments in varying processes
Canvass colleagues for opinions on issues relating to specialty training within a
unit or across the region
Disseminate good aspects of training
Attend STC meetings
Attend LFG meetings within the Trust.
Trainee Representative’s skills:
Time management
Presentation and communication
Networking
Self-confidence and assertiveness
Leadership and diplomacy
Organisational and administrative
Initiative, motivation, responsibility
Commitment to activity outside your programme of study
Potential managerial skills
3All new trainees who are representatives at STC level will be invited to participate in a
training session and will become a member of the HEKSS Trainee Forum, which has
been set up to bring trainees together to raise issues and share good practice from
across the region and different specialties.
This forum is chaired by our Lead Trainee Representatives who pull together all the
issues raised by the Trainee Representatives and ensure that they are raised at the
highest level within HEKSS.
HEKSS actively promotes the trainee voice at every opportunity.
The School is administered by Medical Workforce Project Officers, Project Assistants and
Administrators. See contact details below:
Medical Paul Kociucki pkociucki@kss.hee.nhs.uk 020 7089 7508
Workforce
Jemma jthompson@kss.hee.nhs.uk 020 7089 7508
Project Officers
Thompson
(MWPO)
Medical Boskey Amin bamin@kss.hee.nhs.uk 020 7089 7508
Workforce
Project
Assistants Kayleigh Lord klord@kss.hee.nhs.uk 020 7089 7508
(MWPA)
Medical Rucynth rchristopher@kss.hee.nhs.uk 020 7089 7508
Workforce
Christopher
Administrators
(MWA)
School of Medicine Email medicinehst@kss.hee.nhs.uk 020 7089 7508
Trainee Representative Email traineerep@kss.hee.nhs.uk 020 7089 7508
4Core Features of the Training Programmes
Trainee led - the e-Portfolio is designed to encourage a self-directed learning
approach with the support of the ES. The e-Portfolio contains tools to identify
educational needs, enables the setting of learning goals, reflective learning and
personal development.
Competency based – the curricula outlines competences that trainees must reach by
the end of the programme. The curriculum is directly linked to the e-Portfolio as it
defines standards required for good medical practice and formal assessments
including the Specialty Certificate Examinations (SCE).
Continuation of Good Medical Practice – building on Foundation & Core training the
curriculum contains important emphasis on generic competences necessary for
practice as a physician.
Supervision – each trainee has a series of people with clearly defined roles and
responsibilities overseeing their training including a Clinical Supervisor, ES, College
Tutor, TPD, and HoS. He/she may have a separate ES for the parent specialty and
GIM (if applicable).
Appraisal meetings with Supervisor – regular appraisal meetings and review of
competence progression are set out in the e-Portfolio.
SCE examination - The SCE is an examination usually undertaken any time from ST4
onwards and is a compulsory component of assessment for CCT and CESR (CP).
Workplace-based assessments (WPBAs)
Regular WPBAs are conducted throughout training, building on those used in the Core
programme, these include;
- Mini Clinical Evaluation Exercise (mini-CEX) - is a workplace based method
where direct observation of trainees’ clinical skills during an everyday clinical
encounter is assessed. These skills include medical interviewing ability,
communication and clinical judgment and vary depending on the specialty.
- Case-based Discussion (CbD) - is a discussion generally in a reasonably formal
setting centred on a trainee’s reflection on his/her patient notes. The discussion
will bring out key messages of a trainee’s knowledge, case management,
5diagnostic skills and planning etc. A CbD might be included as part of case
presentations at department meetings dependent on the specialty.
- Directly Observed Procedural Skills (DOPS) - is a clinical encounter evaluating
the trainee’s competence in a particular procedure, for example central line
insertion, tracheal intubation or primary sutures.
- Multi Source Feedback (MSF) - is a version of the 360 degree assessment. A
number of multidisciplinary raters anonymously score a trainee against a number
of domains mostly concerned with attitudes and behaviours.
- Acute Care Assessment Tool (ACAT) - this is applicable to all grades from CT1
to CCT. ACAT is an observed take measuring 8 domains for example clinical
assessment, record keeping and handover. The ACAT is trainee led and takes no
more than 15 minutes. This is a formative assessment and is used in medical
specialties only. The assessment must be undertaken by a consultant.
- Audit Assessment (AA) - the Audit Assessment tool is designed to assess a
trainee's competence in completing an audit. The Audit Assessment can be based
on review of audit documentation OR on a presentation of the audit at a meeting.
If possible the trainee should be assessed on the same audit by more than one
assessor.
- Teaching Observation (TO) - the Teaching Observation form is designed to
provide structured, formative feedback to trainees on their competence at
teaching. The Teaching Observation can be based on any instance of formalised
teaching by the trainee who has been observed by the assessor. The process
should be trainee-led (identifying appropriate teaching sessions and assessors).
6HEKSS, College (JRCPTB), Trust and GMC Responsibilities:
The following information is designed to assist you in choosing which of the four
organisations would best be suited to deal with any queries you may have. However, the
description of the role of each organisation is not intended to be fully comprehensive.
1. HEKSS
Health Education Kent, Surrey and Sussex (HEKSS) is a Local Education and Training
Board and part of Health Education England. It has been established to ensure the
effective planning, education and training of the NHS workforce within the region. HEKSS
is responsible for the recruitment of trainees to provide the highest quality training
opportunities, tailored to trainees personal and professional needs and requirements, the
Annual Review of Competence Progression (ARCP), the allocation of National Training
Numbers (NTNs), the management of the training programmes, the Quality Management
of training in Kent, Surrey and Sussex, managing trainees who are working less than full
time (LTFT), managing the refugee doctor’s scheme, the approval to take time Out Of
Programme (OOP), managing doctors in difficulty, managing Inter Deanery transfers
(IDT) and all rotations and the management of the Specialty Schools.
1a. Assessments & Specialty Certificate Examinations (SCE)
Assessments
Interim Review (IR)
The IR is a formal face-to-face meeting where a panel, including at least one of the
TPDs, will review all the evidence found in a trainee’s e-Portfolio partway through the
training year. This allows the panel to check that trainees are on track for a satisfactory
ARCP outcome. It also allows a trainee to discuss their training and experience with a
consultant who is not their assigned ES. The IR also provides the opportunity for a
trainee to discuss their future training needs and preferences for their next placement,
however, please note that curriculum coverage and service needs will also be considered
when placing trainees. N.B. In specialties (such as Dermatology and Neurology) where
rotations are fixed preferences will not be requested.
7Annual Review of Competence Progression (ARCP)
For each ARCP and IR the trainee will receive an email from the School advising of the
process. By the time of the yearly ARCP, each trainee must ensure that they complete,
as a minimum, the specified number of WPBAs outlined in the decision aid and submit
an online version of the ES Report. Please note that, for the years that trainees are
training in both GIM (if applicable) and their parent specialty, they will require a separate
ES report for GIM and the parent specialty. The ARCP cannot take place if the ES
Reports are not completed and available on the e-Portfolio. Furthermore, the links to
the curriculum will also require sign off from the ES.
Links to the decision aids are included in the specialty addendum for the parent specialty
and gives a summary of the requirements at each stage of training. This must be
completed along with the requirements listed in the GIM ARCP decision aid (if applicable)
for a Satisfactory Outcome 1 to be issued. A breakdown sheet, detailing all of the
possible ARCP outcomes is provided on page 9 of this document.
All information submitted by the trainee is reviewed by the HoS, TPDs, STC Members
and representatives from HEKSS via their e-Portfolio at the ARCP meeting. 10% of
outcomes are reviewed by a Lay and External Representative. If trainees obtain an
unsatisfactory outcome, they will be required to attend a further meeting with the panel to
discuss training and failure to meet the required competencies.
Trainees may be granted an extension to undertake more WPBAs, however this is only
under exceptional circumstances, and it is the responsibility of each trainee to complete
all of the required assessments prior to the review date.
ARCP outcomes will be issued and uploaded on your e-Portfolio by the SWT, which is
the mechanism for sharing this with the JRCPTB.
Please note that registering with your specialty’s College is a Gold Guide requirement:
trainees need to ensure that they are registered with the JRCPTB throughout their
training programme.
8The following is a list of the ARCP outcomes of which trainee will receive one:
ARCP Definition
Outcome
1 Achieving progress and competencies at the expected rate.
2 Development of specific competencies 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
competencies
Released from academic programme.
5 Incomplete evidence presented - additional training time may be
required.
6 Gained all required competencies.
7.1 Satisfactory progress in or completion of the LAT / FTSTA
placement.
7.2 Development of specific competencies required - additional
training time not required LAT / FTSTA placement.
7.3 Inadequate progress by the trainee - additional training time
required LAT / FTSTA placement.
7.4 Incomplete evidence presented - LAT / FTSTA placement.
8 Out of programme experience for approved clinical experience,
research or career break.
9 Top-up training (outcome indicated in one of the above areas).
9ARCP Advice
• Do not leave assessments to the last minute!
• Ensure the portfolio and CV are regularly kept up-to-date
• Talk to ES EARLY if there are difficulties
• Keep the School informed of any changes in contact details
• If attendance is required at the ARCP, trainees are required to confirm their ability
to attend as soon as possible
• It is a trainees responsibility to know what will be assessed
• If a trainee does not provide evidence by the ARCP date, they cannot be issued
with a Satisfactory Outcome, without exception
• If a trainee does not provide an updated Form R , they cannot be issued a
Satisfactory Outcome
Penultimate Year Assessment (PYA)
The purpose of the PYA is to ensure that SpR / StR trainees are on target to achieve
their expected CCT date and should occur between 12 and 18 months before the
completion of training. Trainees in GIM or another joint CCT will require a PYA for each
specialty. The PYA is in addition to the trainee’s penultimate ARCP or RiTA and can be
run simultaneously if scheduling permits.
All trainees should be invited to attend their PYA in person. Failure to complete a PYA
may result in the trainee’s CCT date being delayed and the trainee may be obliged to
travel to the External Assessor.
It should be noted that a PYA is not a pass/fail examination but an opportunity for HEKSS
and the External Assessor to ensure that a trainee has met all curriculum requirements
and has sufficient time available to complete the outstanding training before being
recommended for your CCT.
Approximately 8 weeks prior to the PYA, the trainee will receive notification from the
JRCPTB about the documentation required for review at your PYA. This will include a
copy of their CV and a completed Summary of Clinical Experience (SOCE) form which
will need to be returned to the JRCPTB 4 weeks before the scheduled PYA date. This
10information will be presented to the External Assessor prior to the scheduled date to
ensure that they are fully briefed on a trainee’s training status before meeting the trainee.
Following the PYA, the trainee will receive a letter from the JRCPTB confirming their CCT
date and will also receive a copy of the External Assessor’s report. This will enable a
trainee to plan the remainder of their training in accordance with the recommendations
made by the PYA panel and External Assessor.
For further guidance on PYA’s please visit the JRCPTB website:
http://www.jrcptb.org.uk/specialties/Pages/Penultimate-Year-Assessment.aspx
Specialty Certificate Examinations (SCE)
All trainees who commenced specialty training on or after 1st August 2007 will be
required to sit the Specialty Certificate Examinations (SCE). The SCE is an examination
usually undertaken any time from ST4 onwards and is a compulsory component of
assessment for CCT and CESR (CP).
It is strongly recommended that Specialty Registrars allow sufficient time for at least 2
attempts at the SCE before they reach their anticipated CCT date. There is no limit to the
number of attempts you may make at the SCE during your training.
For further details on this examination, please visit the JRCPTB website;
http://www.jrcptb.org.uk/assessment/pages/knowledge-based-assessments.aspx#_sce
1b. Support and General Administration at HEKSS
Less Than Full Time Training
LTFT Training in HEKSS allows doctors and dentists to work less than full-time in posts
that are fully recognised for training. HEKSS supports access to LTFT Training through
slot sharing and, if this is not feasible, trainees may need to train on the basis of
reduced sessions in a full time placement.
11The intention of LTFT training is to keep doctors in training where full-time training is not
practical for well-founded individual reasons. LTFT training supports doctors who wish to
train part-time, while remaining as close as possible to the arrangements for doctors
working full-time.
Further information on flexible training can be found at the following site:
http://kssdeanery.org/less-than-full-time-training
Inter - Deanery Transfers (IDTs)
A trainee who is placed within the HEKSS area but wishes to be considered for an IDT to
another LETB will need to apply through the new national IDT central application system
that is managed by Shared Services (previously known as London Deanery). The
purpose of the IDT process is to support trainees who have had a significant unforeseen
change in circumstances since their appointment to training, enabling consideration to be
given to a possible transfer to another region/ LETB.
Further information can be found at: http://www.londondeanery.ac.uk/var/idt
Time out of Training
The GMC has stated that any absence of 14 days or over in any 12 month period must
trigger a CCT date review. This does not mean that trainee’s CCT date will automatically
be extended; however it does mean that a conversation about the effect that the time out
of training has had will likely take place during the ARCP/RITA.
The GMC statement covers all absences from programme other than annual leave, study
leave, or prospectively approved OOPs. All forms of statutory leave are covered including
sick leave, maternity/paternity/adoption leave, carers leave, and jury service. Doctors in
training will be asked to declare the number of days of absence they have had in the
previous year at their ARCP/RITA by completing an ‘Absence Declaration Form’. This will
then be reviewed by the ARCP panel, who will advise if training time needs to be
extended and ensure that any support that may be required by the doctor is put in place.
12 Out of Programme Policy and Overview
This guidance covers all Specialty Trainees in the HEKSS Schools with the exception of
GP, and offers direction for all Specialty Schools and trainees. This document indicates
the HEKSS Schools preferred methodology for implementing the Gold Guide ‘Out of
Programme (OOP)’ guidance. The guidance can be found online at:
http://kssdeanery.org/specialty/trainers/specialty-training-guide/recruitment-specialty-
post/out-programme
A trainee may take time out of their programme to undertake a period of research, gain
clinical experience or other appropriate training that is or is not available within HEKSS.
OOP placements are designed to accommodate this and can take place either in the UK
or abroad.
All OOP requests need to be agreed by the Postgraduate Dean, so trainees are advised
to discuss their proposals as early as possible. It is normally expected that a trainee
would have completed one year of training before submitting an application given the
short period and nature of the training.
There are four types of OOP which may be considered:
1. OOPT – Out of Programme for Approved Clinical Training
This is where a trainee is undertaking GMC prospectively approved clinical training
which is not part of the trainee’s specialty training programme. The time will
contribute towards the award of a CCT/CESR (CP).
2. OOPE – Out of Programme for Clinical Experience
Where a trainee is gaining clinical experience which is not approved by GMC but
which may benefit the doctor or help support the health needs of other countries.
This will not normally contribute to the award of a CCT/CESR (CP).
133. OOPR – Out of Programme for Research
Where a trainee is undertaking a period of research, this may/may not contribute
towards the award of a CCT/CESR (CP) depending on the content of the
programme.
4. OOPC – Out of Programme for Career Break
Where a trainee is taking a planned career break from the specialty training
programme. This will not contribute towards the award of CCT/CESR (CP).
Applications for both OOPE and OOPC do not require GMC approval as the time out of
programme does not contribute to the award of a CCT or CESR (CP). Where time out of
programme will contribute towards the award of a CCT or CESR (CP), College support
and GMC approval, in addition to support from HEKSS, will be required, prior to the
trainee commencing the OOP period – this will be the case for all OOPT applications and
some OOPR applications (where time is contributing to CCT or CESR (CP) award).
Please see the Gold Guide 2010 for more information.
Notice required for OOPs
Trainees are required to give their Postgraduate Dean as well as current and/or future
employers a minimum of 6 months’ notice, but preferably as much as possible, should
they wish to take time out of training. This is to ensure that service delivery is
appropriately covered and the needs of patients can be properly addressed. In
exceptional circumstances notice of three months may be acceptable.
14 The Trainee in Difficulty - Trainee Support Guide
HEKSS is committed to supporting doctors in training who are in difficulty or need some
extra support. Aside from this ALL trainees are monitored for satisfactory progress, not
just those experiencing difficulties.
Please see full guidance available online:
http://kssdeanery.org/TraineeSupport
If you have concerns about your own progress get in touch early, do not wait! Talk to
your:
Educational Supervisor (in the first instance), or
Clinical Tutor
Trainee Support Lead
HEKSS School Team
Trainees who may need additional help are discussed by the Trainee Support Group to
ensure all routes of support are explored. If a trainee’s ability to progress is at risk, the
TPD responsible for Trainees in Difficulty and the Trainee Support Group will be kept
informed of their progress. They are able to offer additional support if required. Should a
trainee need support for any reason, HEKSS will endeavour to provide a trainee with
additional training time, if required. If a trainee was identified as needing support due to,
for example, exam failure they would be required to demonstrate that they have
attempted the exam and have been proactive in their training throughout the year.
Trainees will always be fully informed and involved at all stages of support. The aim of
additional support is to get a trainee ‘back on track’ and for training to continue
successfully.
15 Mentoring
We believe the huge potential of HEKSS Specialty Schools’ network lies in its trainees
and the benefits they could get from interacting with each other during the mentoring
programme. The purpose of the Peer to Peer Mentoring Programme is to unleash this
positive energy by linking up Mentors and Mentees who share similar professional
interests and could help each other get the best out of themselves. This will not happen
in a set way, and each mentoring relationship will be unique. We believe that each
Mentor and Mentee pairing should, with support from HEKSS Specialty Schools, set their
objectives and agree what they want to get out of the relationship. Mentors should
facilitate a process of self-reflection and help Mentees understand their professional
ambition and the steps they need to take to achieve their aspirations.
The Mentoring Programme is designed to become an integral part of the culture in
HEKSS Specialty Schools to help junior and senior trainees to realise their potential. It is
intended to enhance the personal and professional development of Specialty Trainees,
their well-being and their working relationships. It will also be valuable in helping
mentees with relationships in the workplace, reflection on criticism in the workplace,
discussing any feelings about undermining and bullying.
Further details can be found at:
http://kssdeanery.org/he-kss-mentoring-programme
16 Study Leave Guidance
Please find below some information on study leave guidance. Please note HEKSS
currently has one of the most generous study leave allowances nationally.
Trainees are entitled to up to a maximum of 30 days study leave in a year (which is
calculated from the date of commencement of appointment or rotation)
Leave to sit necessary examinations is allowable but does not count against the
entitlement of study leave
Trainees in locum and fixed term specialty posts, that is, those in FTSTAs and LATs
exceeding three months, are entitled to study leave pro rata
There is no entitlement to study leave for LAS appointments
The study leave budget may be top-sliced by the HEKSS School to deliver centrally
run training days and simulation events that are mandatory to attend
Using your study leave:
Approval for study leave rests with your local Trust
Trainee need to ensure that they follow local Trust policy to make an application for
study leave. Applications should usually be received on the appropriate form at least
6 weeks prior to the date of the leave
Leave should not be taken within the first two weeks of a new appointment
Trainee must have an agreed Personal Development Plan before applying for study
leave
HEKSS guidance is available online: http://kssdeanery.org/study-leave
Confirmation of your allocated study leave allowance can be found in the specialty
addendum
Parent Leave
Each Trust will have a Parent or Maternity/Paternity/Adoption Leave Policy which must
be referred to and read in conjunction with the HEKSS document. Please email the
School for a copy of this document.
17 Withdrawal from programme
If a trainee is considering withdrawing from the training programme they must consult
their Educational Supervisor. If a trainee decides to resign from the training programme
they must notify both the Trust and HEKSS. A Confirmation of Withdrawal from
Specialty Programme document detailing the reasons for withdrawal will need to be
submitted, along with their resignation letter. Trainees are required to provide as much
notice as possible so that the Trust and HEKSS can arrange for appropriate service
cover. Please note that the trainee’s Trust, as the employer, are entitled to hold trainees
to a 3 month notice period.
Key Policies and Documents
Additional generic information can also be found on the HEKSS website:
http://kssdeanery.org/specialty/resources-and-downloads
The Gold Guide 2010
The Gold Guide 2010 replaces all previous versions and is relevant for the length of
training. It provides overarching guidance and standards as to the arrangements for
specialty training in the UK.
Refer to the Gold Guide together with HEKSS guidance for standards relating to:
The role of statutory bodies
Supervision
LAT and LAS
Less Than Full Time Training, Maternity Leave, OOP
Deferral
Appraisal, assessment and annual planning
18 Relocation Expenses
Since 1 April 2009, Shared Services has been responsible for processing all relocation
expense claims (covering removal and excess travel expenses) for all London and
HEKSS based trainees on a recognised training programme.
The objective will be the timely reimbursement of a trainee’s verified entitlement to
expense. However, before incurring any expenses for which a trainee anticipates
submitting a claim to Shared Services, please complete a relocation eligibility form and
return by post for authorisation, without which a claim will not be processed. This
information can be found on the Shared Services website:
http://www.londondeanery.ac.uk/var/relocation
Completed forms should be returned by post (emails will not be accepted) to:
The Relocation Department
Shared Services
Stewart House
32 Russell Square
London
WC1B 5DN
Blood Borne Virus (BBV)
There is a requirement for a trainee to report, via Occupational Health (OH), any matters
relating to certain BBVs. This is a potential patient safety issue and the trainee may also
require specific adjustments to be made to their working practices.
For further details, trainees need to contact their employing Trust’s OH Department
Taking Consent - Patient Safety and Informed Choice.
Follow best guidance in consent summarised by DH and GMC.
Trainees should familiarise themselves with local guidance and consent paperwork at
the outset of trainee’s post.
Trainees should consult with their Educational and Clinical Supervisor for queries
relating to consent.
19 Careers Support at HEKSS
The HEKSS Careers Support Team are a small team of careers advisers who are
dedicated towards providing the best quality of support possible to trainee doctors. The
Careers Support Team can give advice on:
Careers – 3 tiers of support
Referrals – trainee in difficulty guide
4 stage model – career planning
Faculty development – career support workshops and PG cert Managing Medical
Careers
Information evenings and support career fairs
ROADS – career planning book
KSS careers website
Medical careers website – www.medicalcareers.nhs.uk
Other guides e.g. to accompany Peninsula/AGCAS DVD
The Careers Support Team are:
Joan Reid – Head of Careers
Lisa Stone – Senior Careers Adviser
Margaret Holbrough – Careers Adviser
Kathleen Sullivan – Teaching Fellow
www.medicalcareers.nhs.uk
Library and Knowledge Services
Library and Knowledge services form part of the HEKSS known as the Library &
Knowledge Services Development Team (LKSDT). They manage a collaborative network
of NHS libraries, offering a variety of services that support evidence-based practice, and
the skills to use them.
http://kssdeanery.org/education/about-library-knowledge-services-development-team
20Using these service trainees will be able to:
Search a wide range of regional resources, including:
Books
Journals
Local and linked libraries
Sign up for an Athens account and gain access to:
Databases
eBooks
Specialist Libraries
Current awareness services
To gain access to the service, please follow the steps below:
Step 1: Join the local Library & Knowledge Service
Search at www.hlisd.org
Step 2: Search for national, regional and local resources via the catalogue at:
www.southeastlibrarysearch.nhs.uk
Step 3: Sign up for an NHS Athens account to access a wide variety of electronic
resources. Apply at:
https://register.athensams.net/nhs/nhseng
Step 4: Search for national, regional and local electronic content at NICE Evidence
Services:
www.evidence.nhs.uk
Functions that manage and quality control training in the HEKSS School of
Medicine:
212. The Joint Royal Colleges of Physicians Training Board (JRCPTB)
The JRCPTB is responsible for the strategic development of specialty national
manpower planning, the development and management of the specialty curriculum,
establishing training standards, the registration of trainees and determining their
projected Certificate of Completion of Training (CCT)/Certificate of Eligibility for Specialist
Registration (CESR) dates, specialty education initiatives and examinations. Please note
that all trainees should register with the JRCPTB as soon as possible after starting the
programme and membership should be renewed each year. If a trainee is not registered
with the JRCPTB, the School of Medicine will not complete their ARCP.
2a. Registration with the Royal College of Physicians
How to enrol
In order to register with the JRCPTB, trainees will require their specialty GMC Approval
Code and personal NTN (found on the welcome letter supplied by HEKSS)
Step One: Register
To register for an account with the JRCPTB, trainees are required to log on to
http://www.jrcptb.org.uk/Registration/registrationwizard.aspx. In order to complete
registration trainees will also be required to submit the official confirmation of training
letter, supplied by HEKSS, as well as an updated CV.
Step Two: Verify Registration
Once the registration form has been successfully completed and submitted, an email is
sent to the email address provided by the trainee. Trainees must click on the link
provided in the email, which will take them to a page where they must enter their
password, thus completing the registration process. Once complete, trainees will be
automatically logged into the site.
22Step Three: Enrol
Once step two is completed the trainee should be able to view ‘My JRCPTB’. This
section of the website will only become visible and accessible once a trainee has logged
in.
Step Four: Make Payment
Trainees are required to pay their enrolment fee. A trainee will have the opportunity to
pay this in 6 separate monthly installments.
Enrolment Queries:
Please see below contact details for any queries regarding enrolment.
Enrolments Department at the JRCPTB:
Email: enrolments@jrcptb.org.uk
Telephone: 020 3075 1283
Website: http://www.jrcptb.org.uk/enrolment/Pages/FAQs.aspx
2b. E-Portfolio
This web-based portfolio, developed by the JRCPTB and in line with regulations outlined
by the Gold Guide, provides a record of progress through training and the acquisition of
competencies based on the relevant curricula. The e-Portfolio includes facilities for direct
recording of WPBAs, records of appraisal, ES reports and ARCP outcomes. Within
HEKSS, all trainees including LATs must maintain the NHS e-Portfolio as evidence of
learning and progression.
The e-Portfolio is designed with three purposes in mind:
As a learning tool for trainees
To assist with educational supervision
As a central source of information for all those involved in training
23The trainee’s main responsibility is to ensure that the e-Portfolio is kept up to date; this
includes recording trainees’ reflections on learning and progress through the curriculum
by linking to appropriate documentation and providing evidence of competencies
achieved. The content of the e-Portfolio feeds directly into the ARCP and ultimately, the
final sign-off for trainee’s parent specialty & GIM (if applicable).
Access and Enrolment
A temporary e-Portfolio account is created by the SWT at HEKSS upon appointment to a
training post and is managed locally by members of the Trusts’ Postgraduate Centres.
The temporary account will be active for 3 months, during which time trainees must enrol
with the JRCPTB.
To enrol please go to the JRCPTB website via the link below and follow the steps as
outlined below.
http://www.jrcptb.org.uk/enrolment/Pages/Introduction.aspx
If, after 3 months, the trainee has failed to enrol, then the e-Portfolio account will be
locked until enrolment has been completed. Once you have been issued with an account,
you will be sent a username and password by the JRCPTB.
Using e-Portfolio
It is the responsibility of the trainee to keep up-to-date accounts of their teaching and
experience and to ensure that sufficient numbers of assessments are completed. Once
your account is created you may log in by going to: www.nhsePortfolios.org
On the e-Portfolio ensure all details on the profile are correct, in particular email
address, postal address and GMC number.
Curricula (confirmed in your specialty addendum, for this handbook) describe the
competencies required by a trainee during each training year, closely based on Good
Medical Practice. All competencies must be supported by evidence. Each competency
must be signed off by your Educational or Clinical Supervisor and must be supported
24by evidence. This will ensure that trainee’s e-Portfolio is packed full of evidence and
reflects their clinical and other activities.
This evidence is based on WPBAs, log entries, audit, teaching attendance, other
educational events, trainee’s own teaching, conferences, research, etc. In addition,
trainees should complete the self-assessment for each competency and support their
comments with evidence that they feel is relevant to support any sign off.
Trainees are responsible for arranging their own assessments. They must ensure they
do enough WPBAs – there are minimum requirements for each ARCP and Interim
Review stage, but trainees are advised to do more, in particular ACATs, to build up
evidence for their competencies.
Trainees should ensure their WPBAs are done by the most senior doctor, preferably a
consultant, or associate specialist with a minimum of 50% assessed by a doctor in one
of these grades.
Trainees must have their assessments done by a variety of people.
The MSF is a tool used to assess generic skills such as leadership, communication
and team working; for this tool to work effectively trainees should have at least 12
respondents for this to be meaningful. It is an expectation that a minimum of one third
of MSF contributions come from consultants. Other assessors could include: senior
trainees and experienced nursing and allied health professional colleagues.
Trainees must also ensure that their links to the curricula are signed off by ES in order
to verify their learning. The supervisor can do this by accessing a trainee’s e-Portfolio,
going to the curriculum and selecting and rating the trainee on each competency that
they have linked. Please note that this is a very time consuming task and should not
be left to the last minute.
Trainees should record any absences from work on their e-Portfolio – this will be
cross-referenced with medical staffing records. This is further mandated by trainee’s
sign off of their probity and health declarations. Therefore all absences for reasons of
25sickness/compassionate leave, etc. must be communicated by the trainee to medical
staffing to ensure their records are accurate.
Audit is important, audit activity needs to be demonstrated, most importantly evidence
of completion of an audit cycle. Please refer to your curricula and decision aid to
advise in which training years audit is required, also for GIM (if applicable).
Remember to use the e-Portfolio to demonstrate areas of excellence - quality evidence
and quality documentation are important.
E-Portfolio Queries
Please see below contact details for the e-Portfolio Support Team at the JRCPB, who
can be contacted for system errors:
Email: ePortfolioteam@jrcptb.org.uk
Telephone: 020 3075 1440
Please note that e-Portfolio queries should be directed to your Trust Medical Education
Team in the first instance.
3. The General Medical Council (GMC)
The GMC has a statutory responsibility for the standards of Post Graduate Medical
Education, for inspection of Health Education England (HEE) functions, for setting
standards for trainers & supervisors, for curriculum approval, the prospective approval of
training posts, the prospective approval of OOPs, quality assurance of training in HEKSS,
managing and analysing the annual trainee and trainer surveys and the final award of the
CCT, CESR or CESR (Combined Programme) to trainees.
263a. Revalidation
Revalidation is the GMC’s new way of regulating licensed doctors to give extra
confidence to patients that their doctors are up to date and fit to practice. Licensed
doctors including those in Foundation year two and specialty training will have to
revalidate, usually every five years. In addition, for doctors in postgraduate training,
trainees will also revalidate when you receive your CCT.
HEKSS expect the vast majority of trainees to revalidate without any problems, as they
are already closely supervised. The process for Revalidation for trainees is aimed at
ensuring that employers and Educational and Clinical Supervisors have a process to
share information when needed, so that trainees can be best supported in their
revalidation process.
The GMC has agreed that the ARCP process will be used as the vehicle by which
doctors in training will revalidate and there is some new and amended paperwork to
ensure all the areas required for revalidation are covered in ARCP. As part of the
revalidation process trainees will be sent an enhanced Form R which they will need to
complete and sign by the time of their ARCP. This paperwork will contribute to their
ARCP final outcome.
HEKSS is committed to enabling its doctors in postgraduate training to revalidate by
providing as much information and support as possible and regular updates will be
provided.
For further information on revalidation please visit the HEKSS website:
http://kssdeanery.org/specialty/revalidation/FAQs
274. Trust
4a. Local Support and General Administration (Trust)
There are a number of people who are able to provide support to the trainee whether it is
pastoral or career advice:
Educational Supervisor (ES)
Clinical Supervisor
College Tutor
4b. Educational and Clinical Supervision
A trainee will be allocated an ES by their Trust, either for the whole of their rotation or for
each clinical placement. The ES has an overview of their trainee’s training and is
responsible for their educational planning and career development.
It is a ‘trainee’s responsibility’ to arrange regular meetings with their ES to ensure their e-
Portfolio is reviewed. It is recommended that the ES should spend the equivalent of 1
hour per week, per trainee to allow time for educational support through appraisal,
assessment, teaching or support.
As a trainee rotates through each post, they will also be supervised clinically by an
allocated Clinical Supervisor who is responsible for their on-the-job, day-to-day clinical
work. Please understand that the completion of the required appraisals, assessments
and e-Portfolio records is a trainee’s responsibility.
Appraisal: a formative process to enable trainees to develop; a system of cyclical reviews
setting personal objectives and evaluating progress against them. The value is primarily
for the trainee.
Assessment: a summative process evaluating performance against predetermined
criteria; the value is both for the trainee and for regulation.
28Trainees need to ensure that they regularly and frequently update their e-Portfolio and
complete their assessments; arrange appointments with their own ES in a timely fashion.
The more (quality) evidence a trainee has in their e-Portfolio the more likely the time
spent with their ES will be productive in terms of addressing their Personal Development
Plan and educational planning. The ES will seek feedback on performance from Clinical
Supervisors.
During the years trainees are training in their parent specialty and GIM (if applicable),
they will need to conduct WPBAs, both in GIM and the parent specialty. Similarly,
trainees should be involved in GIM audit and attend GIM Regional Training Days.
If there is any difficulty identifying or meeting with an ES, the trainee should approach
their College Tutor or TPD.
294c. Training Committees at Trust Level
Local Faculty Groups (LFG)
Established and maintained by Local Education Providers (LEPs)
One for each specialty within the LEP
Responsible for ensuring LEPs deliver high quality postgraduate medical
education
Ensure systems are developed, implemented and evaluated.
Must comply with
- the approved curriculum of the appropriate Royal College or Faculty
- the GMC’s ‘Good Medical Practice,’ relevant GMC publications
- The NHSLA Risk Management Standards for Acute Trusts, CQC, Primary
Care Trusts and Independent Sector Providers of NHS Care.
Local Academic Board (LAB)
Meets in each Local Education Provider (LEP), established by HEKSS
Receive information from Local Faculty Groups (LFGs)
Fulfil the educational governance function
Monitor and oversee the quality of training
Centralised conduit of communication
Meet 3 times a year
Review and consider reports from LFGs
May initiate LEP internal review of programmes
Host and manage visits to LEPs
Detailed remit is contained in GEAR
30Local Educational Provider Visits (LEP)
All core and selected higher specialties are visited in each LEP
There is a 3 to 5 year cycle of visits
HEKSS forms the visiting team with an external visitor on the panel
In line with the GMC framework for quality assurance of training
Areas of concern or good practice are noted and reported
Reports are delivered by the LFG and LAB to the HEKSS Quality Management
Steering Group for consideration.
Reports feed into Annual Specialty Reports
31Working & Learning
How do I learn and work at the same time?
You are now in the world of adult learning. This requires initiative and dedication from
you as a learner. Your supervisors are there to guide you and to advise on resources to
use. They are not there to directly tell you everything in the curriculum.
Learning Opportunities
Experiential Learning: every patient encounter, every ward round, every time you are
quizzed by a senior is an opportunity for learning. In other words your day to day work is
your medical apprenticeship.
Formal Teaching: departmental teaching programmes, regional training days, journal
clubs are all protected time learning opportunities.
National Courses: use your study leave to ensure you attend Advance Trauma Life
Support, Advanced Life Support, Advanced Paediatric Life Support, revision courses and
other nationally recognised learning opportunities.
Private Study: do not under estimate the value of background reading and private study.
Use a revision timetable based on the curriculum. Decide on a topic and revise it in a
block – anatomy, physiology and pharmacology. Try to relate to clinical circumstances. It
will be easier to recall the information if you can relate it to a clinical circumstance.
Feedback: Your ES will feedback to you during appraisal meetings. Informal feedback
can always be obtained and should form part of your reflective practice. Ensure you meet
your timetable for supervision meetings.
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