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  • trainees must take increasing responsibility to ensure training happens
  • study leave top sliced
  • blunt instrument which PMETB will use
  • is MRCP still necessary with competency testing / assessments?
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    1. 1. Core Medical Training Induction for new W Yorks Trainees - August 2009 Karen Goodman Programme Director (Training) CMT W Yorks
    2. 2. Induction programme <ul><li>general background to CMT </li></ul><ul><li>Yorkshire School of Postgraduate Medicine </li></ul><ul><li>RCP College Tutors role & the ‘Gold Guide’ </li></ul><ul><li>your role </li></ul><ul><li>Curricula </li></ul><ul><li>e-Portfolio training – theory & practice </li></ul><ul><li>assessments training </li></ul><ul><li>appraisals & ARCP </li></ul>
    3. 3. introductions <ul><li>who are you? </li></ul><ul><li>where did you train & where are you now? </li></ul><ul><li>what specialty? </li></ul><ul><li>any particular interests? </li></ul><ul><li>and are there any key areas you wish to find out about today? </li></ul>
    4. 4. during the day please….. <ul><li>sign in </li></ul><ul><li>contribute actively & constructively </li></ul><ul><li>note information </li></ul><ul><ul><li>Tutors, Programmes, Admin help, contacts </li></ul></ul><ul><li>provide information </li></ul><ul><ul><li>MRCP needs </li></ul></ul><ul><ul><li>change of contact </li></ul></ul><ul><li>make contacts - introductions </li></ul>
    5. 5. by the end of the day you should <ul><li>know where CMT fits in </li></ul><ul><li>know about the training programme & how to access training & the curricula </li></ul><ul><li>understand the e-Portfolio </li></ul><ul><li>know how to get the best out of WBA </li></ul>
    6. 6. Core Medical Training general information
    7. 7. Training Pathway
    8. 8. the training pyramid SHO SpR STR
    9. 9. local training structure <ul><li>key people and their roles </li></ul><ul><li>the rules </li></ul>
    10. 10. what is the YSPM?
    11. 11. http://www.yorkshiredeanery.com/medicine/ please log on and use it for info & contacts
    12. 12. YSPM – fusion of RCP & PG Deanery <ul><li>core responsibilities : </li></ul><ul><li>ensure the provision of an education of a consistent high quality across the Yorkshire Deanery </li></ul><ul><li>to manage </li></ul><ul><ul><li>initial selection, subsequent allocation, appropriate placements </li></ul></ul><ul><ul><li>induction </li></ul></ul><ul><ul><li>appraisals </li></ul></ul><ul><ul><li>competence based curriculum delivery </li></ul></ul><ul><ul><li>assessments (work-place & ARCP) </li></ul></ul>
    13. 13. structure 1 – regional <ul><li>Head: Dr Tony Arnold (Resp. physician Hull) </li></ul><ul><li>ST 3+ trainees: Dr P Hammond, Harrogate </li></ul><ul><li>ST1 & 2 Core Medical Training: </li></ul><ul><li>NYEC – Dr Joseph John (Cardiology, Scunthorpe) & Jean Wilson, Administrator </li></ul><ul><li>W Yorks – Dr Karen Goodman (Geriatric Medicine, Halifax)/ Dr Liz Berkin (Cardiology, Leeds) </li></ul><ul><li>& Karen Bollard, Administrator </li></ul><ul><li> </li></ul>
    14. 14. structure 2 – local <ul><li>Hospital Trusts & PG Departments </li></ul><ul><li>RCP Tutors – local training programme directors </li></ul><ul><li>Educational Supervisor </li></ul><ul><li>Clinical Supervisor </li></ul>
    15. 15. RCP College Tutor He / she is your local training programme director responsible position, remunerated PMETB Gold Guide for training
    16. 16. RCP Tutors W Yorks <ul><li>Airedale: Dr Andrew Pettit </li></ul><ul><li>Bradford: Dr John Stoves </li></ul><ul><li>Calderdale Royal: Dr Sunil Sonwalkar </li></ul><ul><li>Dewsbury: Dr Hanasoge Chidambara </li></ul><ul><li>Harrogate: Dr Sutapa Ray </li></ul><ul><li>Huddersfield: Dr Asis Kumar </li></ul><ul><li>LGI: Drs Jon Cooper & Rob Murray </li></ul><ul><li>Pinderfields: Dr Frank Phelan </li></ul><ul><li>Pontefract: Dr Graham Smith </li></ul><ul><li>St James’s: Drs Nicola Turner & Emma Ward </li></ul>
    17. 17. RCP Tutors NYEC <ul><li>Grimsby: Dr Luxy John </li></ul><ul><li>Harrogate: Dr Sutapa Ray </li></ul><ul><li>Hull: Dr Richard Teoh </li></ul><ul><li>Scarborough & Bridlington: Dr Tim Houghton (demitting post) </li></ul><ul><li>Scunthorpe: Dr Mohamed Malik </li></ul><ul><li>York: Dr Maurice Pye </li></ul>
    18. 18. Local Training Programme Director <ul><li>responsibilities 1 </li></ul><ul><ul><li>selection & interviewing </li></ul></ul><ul><ul><li>training (local & regional) </li></ul></ul><ul><ul><li>liaise locally (Trust, PG Dept, ES) </li></ul></ul><ul><ul><li>liaise centrally (School, RCP & RA, DRA) </li></ul></ul><ul><ul><li>curriculum delivery </li></ul></ul><ul><ul><li>induction, appraisal & assessment </li></ul></ul><ul><ul><li>e-portfolio </li></ul></ul><ul><ul><li>ARCP </li></ul></ul>
    19. 19. Local Training Programme Director <ul><li>responsibilities 1 </li></ul><ul><ul><li>selection & interviewing </li></ul></ul><ul><ul><li>training (local & regional) </li></ul></ul><ul><ul><li>liaise locally (Trust, PG Dept, ES) </li></ul></ul><ul><ul><li>liaise centrally (School, RCP & RA, DRA) </li></ul></ul><ul><ul><li>curriculum delivery </li></ul></ul><ul><ul><li>induction, appraisal & assessment </li></ul></ul><ul><ul><li>e-portfolio </li></ul></ul><ul><ul><li>ARCP </li></ul></ul>
    20. 20. Local (hospital) CMT Faculty <ul><li>local ES & CS </li></ul><ul><li>associate tutors / trainee rep </li></ul><ul><li>Postgraduate Dept & admin support </li></ul><ul><li>link to Medical /Clinical director / Clinical Tutor </li></ul><ul><li>links with CMT administrators E & W </li></ul>
    21. 21. Educational & Clinical Supervisors
    22. 22. your role <ul><li>access all educational opportunities </li></ul><ul><li>take responsibility for your own experience, training and progress </li></ul><ul><li>refer to the curricula (via e-Portfolio) frequently </li></ul><ul><li>balance your training with patient / service needs </li></ul><ul><li>feedback </li></ul>
    23. 23. educational opportunities <ul><li>Trust level: </li></ul><ul><ul><li>experiential (WR, OP, MDT meetings etc) </li></ul></ul><ul><ul><li>Departmental & Trust teaching meetings </li></ul></ul><ul><ul><li>Grand Rounds, curricula teachings etc </li></ul></ul><ul><li>Regional level </li></ul><ul><ul><li>Generic days </li></ul></ul><ul><ul><li>PACES, IMPACT, Chest Drain courses </li></ul></ul><ul><li>e-Learning </li></ul><ul><ul><li>BMJ, Doctors.net, ACUMEN, Medical Masterclass, RCP </li></ul></ul><ul><li>Use the reflective log – ‘what have I learned today?’ </li></ul>
    24. 24. CMT Generic Training Days <ul><li>supplement to other training </li></ul><ul><li>mandatory attendance, sign in </li></ul><ul><li>target topics more difficult to provide in Trusts </li></ul><ul><li>4 per year, each repeated twice </li></ul><ul><li>G1 – Induction </li></ul><ul><li>G2, 3, 4 for CMT1 </li></ul><ul><li>G5, 6, 7, 8 for CMT2 </li></ul>
    25. 25. map of W Yorks Leeds SJ & LGI 79 Bradford 11 Harrogate 4 Dewsbury 3 Wakefield 10 Pontefract 5 Airedale 3 Halifax 5 Huddersfield 6 M62 M1
    26. 26. other educational opportunities <ul><li>RCP Regional days – 2 per year </li></ul><ul><li>local PACES courses </li></ul><ul><li>other specific courses </li></ul><ul><ul><li>Part 1 </li></ul></ul><ul><ul><li>IMPACT </li></ul></ul><ul><ul><li>ALS updates </li></ul></ul><ul><li>study leave available </li></ul>
    27. 27. study leave <ul><li>how many days? </li></ul><ul><li>how much money? </li></ul><ul><li>some top-slicing occurs for G days </li></ul><ul><li>plan ahead! </li></ul>
    28. 28. how to maximise your educational opportunities & chances <ul><li>PDP </li></ul><ul><li>get your interview scores </li></ul><ul><li>use S/L for ‘taster’ days / sessions </li></ul><ul><li>audit, presentations etc </li></ul><ul><li>look at higher level competencies </li></ul><ul><li>contribute to Trust & CMT educational forum </li></ul><ul><li>take responsibility for your own training </li></ul>
    29. 29. feedback <ul><li>alert appropriate person if things are not right </li></ul><ul><li>constructive feedback – make it better for the next trainee </li></ul><ul><li>PMETB survey & local placement feedback </li></ul>
    30. 30. PMETB survey repeat annually themed a blunt instrument and a big stick
    31. 31. local placement feedback <ul><li>http://forms.yorkshiredeanery.com/Contents.aspx </li></ul><ul><li>covers the PMETB standards (training) </li></ul><ul><li>33 questions on-line after every post </li></ul><ul><li>mandatory after every placement </li></ul>
    32. 32. questions?
    33. 33. Curricula and e-Portfolio training - theory
    34. 34. Core Medical Training induction – summary session
    35. 35. content <ul><li>role of MRCP </li></ul><ul><li>enrolling with JRCPTB </li></ul><ul><li>key meetings & documentation </li></ul><ul><li>WBA planning </li></ul><ul><li>ARCP & progression </li></ul>
    36. 36. MRCP? mini-CEX ACAT DOPS CBD M R C P
    37. 37. MRCP v Assessments <ul><li>WBA = documentation of minimum competency </li></ul><ul><ul><li>not independent </li></ul></ul><ul><ul><li>variable standards </li></ul></ul><ul><ul><li>not fully validated </li></ul></ul><ul><li>MRCP = documentation of excellence </li></ul><ul><ul><li>independent </li></ul></ul><ul><ul><li>more standardized, dual independent marking </li></ul></ul><ul><ul><li>validated </li></ul></ul><ul><ul><li>accepted by PMETB </li></ul></ul><ul><ul><li>not perfect but best we have at present </li></ul></ul>
    38. 38. MRCP(UK) & progression to ST 3 <ul><li>Part 1 - ESSENTIAL </li></ul><ul><li>Part 2 written – </li></ul><ul><li>PACES - </li></ul>DESIRABLE Completion of MRCP will facilitate getting onto the next stage, especially for competitive specialities NB changes to timing Pt 2 & nPACES & new marking scheme
    39. 39. enrolment in training <ul><li>JRCPTB – but no training number unless have run-through post </li></ul><ul><li>Form R to register with Yorkshire Deanery </li></ul>
    40. 40. Form R & enrolment <ul><li>Form R goes to deanery to get NTN </li></ul><ul><ul><li>Use generic NTN: YOR/CMT/000/C to enrol with the JRCPTB </li></ul></ul><ul><li>you MUST enrol with JRCPTB or NO CCT </li></ul><ul><li>fees pay for your training, curricula, assessments, SCE & more </li></ul><ul><li>see </li></ul>http://www.jrcptb.org.uk/OnlineEnrolment/Pages/default.aspx
    41. 41. key meetings summary <ul><li>each post </li></ul><ul><li>induction </li></ul><ul><li>mid post (optional, strongly recommended) end of post </li></ul><ul><li>annually </li></ul><ul><li>interim review - programme director (RCP Tutor) </li></ul><ul><li>ARCP – remote e-P review +/- attendance at ARCP panel </li></ul>
    42. 42. key preparation & documentation 1 <ul><li>before induction meeting: </li></ul><ul><ul><li>review curriculum & portfolio </li></ul></ul><ul><ul><li>previous post info / portfolio / appraisal </li></ul></ul><ul><ul><li>complete self assessment </li></ul></ul><ul><ul><li>view previous record of competence </li></ul></ul><ul><ul><li>prepare PDP </li></ul></ul><ul><li>tasks during meeting: </li></ul><ul><ul><li>agree objectives & PDP based on self-assessment </li></ul></ul><ul><ul><li>complete post timetable </li></ul></ul><ul><ul><li>sign educational agreements, induction, any other forms </li></ul></ul>
    43. 43. key preparation & documentation 2 <ul><li>before mid-attachment meeting </li></ul><ul><ul><li>review curriculum & update competencies assessments </li></ul></ul><ul><ul><li>review objectives in PDP </li></ul></ul><ul><ul><li>review progress in WBA, </li></ul></ul><ul><li>tasks during meeting </li></ul><ul><ul><li>review progress </li></ul></ul><ul><ul><ul><li>competencies, WBAs, PDP & reflective log, training mtgs </li></ul></ul></ul><ul><ul><li>sign off competencies achieved </li></ul></ul><ul><ul><li>amend PDP if necessary </li></ul></ul><ul><ul><li>highlight concerns, leave, career discussions </li></ul></ul><ul><ul><li>sign mid-attachment form </li></ul></ul>
    44. 44. key preparation & documentation 3 <ul><li>before end of attachment </li></ul><ul><ul><li>review curriculum & objectives in PDP </li></ul></ul><ul><ul><li>check competencies against ARCP decision aid </li></ul></ul><ul><ul><li>complete evaluation of learning on attachment form </li></ul></ul><ul><ul><li>complete placement feedback </li></ul></ul><ul><li>tasks during meeting </li></ul><ul><ul><li>review progress </li></ul></ul><ul><ul><li>sign off competencies achieved </li></ul></ul><ul><ul><li>identify future training needs </li></ul></ul><ul><ul><li>highlight concerns </li></ul></ul><ul><ul><li>sign end of attachment appraisal form </li></ul></ul><ul><ul><li>complete Educational Supervisor’s form </li></ul></ul>
    45. 45. assessments – plan ahead <ul><li>4 Mini-CEX, CbDs, </li></ul><ul><li>DOPs until independent </li></ul><ul><li>3 ACATs </li></ul><ul><ul><li>ES or CS must do at least 50% of these (exc. DOPs) </li></ul></ul><ul><ul><li>average 2 WBAs per month, plan 1 per week </li></ul></ul><ul><ul><ul><li>good habit – write weekly WBA into timetable </li></ul></ul></ul><ul><ul><ul><li>allows for nights, leave, mishaps </li></ul></ul></ul><ul><li>MSF 1 per year </li></ul><ul><ul><li>Ideally 12 responses (min.10) </li></ul></ul><ul><ul><li>can be repeated </li></ul></ul><ul><ul><li>must have CS & ES, current team members </li></ul></ul>
    46. 46. Assessment Strategy and ARCP Decision Points for Progression
    47. 47. Evidence for ARCP <ul><li>practical skills: ALS & procedures (DOPS) </li></ul><ul><li>generic – MSF / mini-CEX / CbD / ACAT </li></ul><ul><li>reflective practice incl. teaching & audit </li></ul><ul><li>attendance at teaching events / courses </li></ul><ul><li>appraisals / educational agreement </li></ul><ul><li>supervisors report </li></ul><ul><li>completed record of competence </li></ul><ul><li>MRCP progress </li></ul><ul><li>satisfactory work attendance </li></ul>
    48. 48. Decision Aid for ARCP
    49. 49. Decision Aid for ARCP
    50. 50. ARCPs <ul><li>CT1 </li></ul><ul><ul><li>M8 interim review (college tutors) </li></ul></ul><ul><ul><li>M11 ARCP </li></ul></ul><ul><li>CT2 </li></ul><ul><ul><li>M16 interim review (college tutors) </li></ul></ul><ul><ul><li>M23 ARCP </li></ul></ul>
    51. 51. ARCP timeline <ul><li>Early warning shots to the trainees </li></ul><ul><ul><li>At induction </li></ul></ul><ul><ul><li>At appraisal meetings with trainee </li></ul></ul><ul><ul><li>At interim review </li></ul></ul><ul><ul><li>Administrative monitoring of WBA completed etc </li></ul></ul>
    52. 52. <ul><li>mid May: Ed. Sup. Meeting – ESR, signing off competencies, identifying gaps etc </li></ul><ul><li>First week June e-Portfolio panel reviews </li></ul><ul><li>Those on outcome 2/5 given 2 weeks to address these  further e-Portfolio review (CMT TPDs) </li></ul><ul><li>Unable to sign off on outcome 1, called to ARCP panel (face to face) as per GG. </li></ul><ul><li>Outcome 3s identified earlier (lack of PACES etc) plan in place. </li></ul>
    53. 53. ARCP outcomes <ul><li>outcome 1 </li></ul><ul><ul><li>satisfactory progress </li></ul></ul><ul><li>outcome 2 </li></ul><ul><ul><li>targeted training, can still progress (CS,ES & PD) </li></ul></ul><ul><li>outcome 3 </li></ul><ul><ul><li>additional training (PD & Head CMT) </li></ul></ul><ul><li>outcome 4 </li></ul><ul><ul><li>out of training (Head CMT & Head of YSPM) </li></ul></ul>
    54. 54. any questions?
    55. 55. any questions? <ul><li>its your training </li></ul><ul><li>its all there – but needs you to organise it </li></ul><ul><li>we will help & guide </li></ul><ul><li>read your emails </li></ul>
    56. 56. Please complete evaluation & collect attendance certificate <ul><li>Sources of information: </li></ul><ul><li>www. mmc . nhs . uk </li></ul><ul><li>www. aomrc .org. uk </li></ul><ul><li>www.copmed.org.uk </li></ul><ul><li>www.rcplondon.ac.uk </li></ul><ul><li>www.jrcptb.org.uk </li></ul><ul><li>www.yorkshiredeanery.com </li></ul><ul><li>[email_address] </li></ul><ul><li>liz . berkin @ leedsth . nhs . uk </li></ul><ul><li>[email_address] </li></ul>

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