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ARCP guidance for trainees, trainers and assessment panels

In response to concerns highlighted to us last year by ASiT and BOTA about the pressures on elective surgery over the winter, we have produced guidance for this process for trainees, trainers and assessment panels with the support of Health Education England. In our Manifesto for Surgery we call on the next government to develop a five-year plan to tackle waiting times, including delivering at least 3,000 extra beds.

The Gold Guide has more information about ARCP requirements for trainees, outcomes, composition of ARCP panels, additional training and appeals.

Advice for trainees

If there are concerns about whether all competencies have been gained, provide supervisors and the panel with details about the scheduled training lists cancelled during the training year and, if possible, an indication of the number and types of procedures that would normally have been expected in that time. Provide any evidence you have of your competency in these procedures. This may include evidence of alternative training opportunities undertaken when scheduled lists were cancelled and learning opportunities gained elsewhere (i.e. in the private sector).

Advice for trainers

Consider if the acquisition of technical competence has been compromised by loss of elective lists (information from educational supervisors regarding levels of experience attained by trainees in previous years may be used to guide this assessment), and if so to what degree. 

Advice for ARCP panels

In keeping with current practice, assess each trainee individually.

Review the evidence for the past year to determine if the trainee is on the trajectory based on last year’s ARCP. If there appear to be deficits, determine if these reflect overall poor progress, or are purely the result of a loss of training opportunities due to reduction in elective surgery in the context of winter pressures.

For those where winter pressures have had an adverse effect, identify any gaps in competences and/or experience. Decide if these are such that it cannot be said that the trainee has reached the knowledge and skills expected at the relevant stage of training.

In the presence of significant shortfalls, determine the potential to correct these within the remaining time in the current training post or in the initial phase of next year’s post, before considering an outcome two or three.

Indicate how correction of any deficits could be incorporated flexibly into the next year's training within a new post, or detail for an outcome two the required competencies to be focused on in the next post as detailed in the current version of the Gold Guide (Version 7, 2018 – GG7). If there have been deficits identified, an interim review of progress should be undertaken by the Educational Supervisor or Training Programme Directors three months into the next post with the option of planning further training opportunities if these are still required.

Confirmation of achievement of any identified deficient competences should be determined at next year’s (2019) ARCP, ensuring this is consistent with the overall progress of the trainee.

If there remain concerns, consideration should be given to revision of the CCT date. This should be viewed as a last resort.

It is possible that up to three months of the last year’s placements could have been adversely affected by winter pressures. Addressing any deficits in the next year should be included in the work scheduling for the first three to four months. This is likely to be easier to achieve in early years and may require more focused approaches for those training in later years. 

If there are gaps identified in the acquisition of competencies by specialty trainees, their School should propose contingency plans to put in place for the coming winter, as similar pressures are likely.  

In addition, Educational Supervisors and Training Programme Directors are encouraged to review the requirements of individual trainees, plan work schedules appropriately and encourage trainees to carefully record their progress and acquisition of competencies to minimise any potential adverse effects of loss of elective work. 

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