Tips for final year assessment
Pen-ultimate Year Assessment Advice
In your penultimate year of training (ST5) you will be invited to attend a Penultimate Year Assessment (PYA). The purpose of the PYA is to compare your progress against the curriculum and identify any outstanding targets that need to be achieved in your final year of training. If you are approaching your final year of training and have not been invited to a PYA, then contact your local deanery/LETB. In practice, your PYA usually takes place as a modified ARCP at 12-18 months prior to your expected completion date. If you are a LTFT trainee then the timing of the PYA will be determined by actual clinical training time left rather than chronological time eg a trainee on 50% of LFTF would have their PYA at 24 chronological months pre CCT / CESR date in order to allow for 12 months of clinical training time.
As the trainee you must ensure that your eportfolio is up to date at least 4 weeks prior to your PYA. There should be an ARCP outcome recorded for each of year of training and all educational supervisor reports uploaded. You will be sent a Summary of Clinical Experience (SOCE) form to complete in advance of the PYA and you should save this form, as well as an up date CV in a folder titled “PYA Paperwork” in your eportfolio personal library. Any other paperwork that is requested, or that you wish to be reviewed as part of your PYA should also be uploaded to this folder.
There will be an external assessor from the JRCPTB/SAC (Specialty Advisory Committee). They will review your eportfolio, assess your progress and complete the PYA form.
You will be asked about the training you have had to date and your future aims and plans. In addition the panel will want to confirm if you are up date with training usually delivered by courses (eg Advanced Life Support (ALS), management, teaching). You should be able to identify areas where you perceive extra training is required, or courses that you need to complete in your final year. The targets identified for your final year will be documented (both mandatory and desirable) and you will be expected to achieve at least the mandatory targets by your final ARCP in order to receive your CCT / CESR.
There is a specific PYA form on your eportfolio that will be completed by the external assessor but is available to read by all supervisors. It is often completed on the day but should be available online no later than 10 days post PYA.
N.B. If you are seeking a dual CCT then you will require a PYA for both.
If you are planning on an OOP episode in your final year, then you should have your PYA in order to claim credit towards your OOP time.
Top Tips!
-
Get prepared well in advance – you don’t want to be messing around last minute for your PYA.
-
Use the personal library on the eportfolio to collate extra evidence of training, courses, audit, teaching etc – make sure you divide these up into different folders clearly labeled for easy reference and navigation – this will make it much easier for the external assessor to see your progress and achievement.
-
Contact your educational supervisor 1 to 2 months prior to your PYA so that they have time to review your eportfolio and ensure they have all the information they require to complete the educational supervisor’s report.
-
Think in advance about the areas of your training that you need or wish to complete or develop further in your final year – commonly this might be further experience in a subspecialty area (particularly if you are interested in a career involving this), management and leadership courses and teaching courses or experience. Record your suggestions for your final year targets both for yourself to take to your PYA, and in your eportfolio eg in the personal development plan (PDP) area.
-
Don’t panic! The actual PYA is just a slightly more involved ARCP. The hard work is the paperwork/eportfolio preparation beforehand.
In your penultimate year of training (ST5) you will be invited to attend a Penultimate Year Assessment (PYA). The purpose of the PYA is to compare your progress against the curriculum and identify any outstanding targets that need to be achieved in your final year of training. If you are approaching your final year of training and have not been invited to a PYA, then contact your local deanery/LETB. In practice, your PYA usually takes place as a modified ARCP at 12-18 months prior to your expected completion date. If you are a LTFT trainee then the timing of the PYA will be determined by actual clinical training time left rather than chronological time eg a trainee on 50% of LFTF would have their PYA at 24 chronological months pre CCT / CESR date in order to allow for 12 months of clinical training time.
As the trainee you must ensure that your eportfolio is up to date at least 4 weeks prior to your PYA. There should be an ARCP outcome recorded for each of year of training and all educational supervisor reports uploaded. You will be sent a Summary of Clinical Experience (SOCE) form to complete in advance of the PYA and you should save this form, as well as an up date CV in a folder titled “PYA Paperwork” in your eportfolio personal library. Any other paperwork that is requested, or that you wish to be reviewed as part of your PYA should also be uploaded to this folder.
There will be an external assessor from the JRCPTB/SAC (Specialty Advisory Committee). They will review your eportfolio, assess your progress and complete the PYA form.
You will be asked about the training you have had to date and your future aims and plans. In addition the panel will want to confirm if you are up date with training usually delivered by courses (eg Advanced Life Support (ALS), management, teaching). You should be able to identify areas where you perceive extra training is required, or courses that you need to complete in your final year. The targets identified for your final year will be documented (both mandatory and desirable) and you will be expected to achieve at least the mandatory targets by your final ARCP in order to receive your CCT / CESR.
There is a specific PYA form on your eportfolio that will be completed by the external assessor but is available to read by all supervisors. It is often completed on the day but should be available online no later than 10 days post PYA.
N.B. If you are seeking a dual CCT then you will require a PYA for both.
If you are planning on an OOP episode in your final year, then you should have your PYA in order to claim credit towards your OOP time.
Top Tips!
-
Get prepared well in advance – you don’t want to be messing around last minute for your PYA.
-
Use the personal library on the eportfolio to collate extra evidence of training, courses, audit, teaching etc – make sure you divide these up into different folders clearly labeled for easy reference and navigation – this will make it much easier for the external assessor to see your progress and achievement.
-
Contact your educational supervisor 1 to 2 months prior to your PYA so that they have time to review your eportfolio and ensure they have all the information they require to complete the educational supervisor’s report.
-
Think in advance about the areas of your training that you need or wish to complete or develop further in your final year – commonly this might be further experience in a subspecialty area (particularly if you are interested in a career involving this), management and leadership courses and teaching courses or experience. Record your suggestions for your final year targets both for yourself to take to your PYA, and in your eportfolio eg in the personal development plan (PDP) area.
-
Don’t panic! The actual PYA is just a slightly more involved ARCP. The hard work is the paperwork/eportfolio preparation beforehand.
In order for you to receive your certificate of completion of training (CCT)/CESR, and thereby be eligible for entry onto the GMC Specialist Register for Rehabilitation Medicine, the JRCPTB has to recommend you to the GMC. The process is as follows:
In the 6 months prior to your CCT / CESR date, the deanery / LETB needs to issue you an ARCP with an outcome 6 – “Gained all required competencies for the programme”. If your final year ARCP does not happen to fall within 6 months of your CCT/CESR date, then you will either need to attend for another ARCP in the last 6 months of training or it may be possible to have the ARCP form completed remotely if your deanery/LETB, training programme director and educational supervisor agree that this is appropriate. If this is the case, the operations officer at your deanery/LETB can create an ARCP form, your educational supervisor will need to complete this, sign it, then pass to your TPD and you for signing and then inform the deanery/LETB of its completion.
When the deanery/LETB creates an ARCP form with outcome 6 it automatically creates a mandatory text box. Into this box the educational supervisor needs to list the targets recommended at PYA, and if they have been achieved. If no targets were set, “no targets set at PYA” should be written in the box. If the CCT/CESR date has changed from that set at the PYA a brief explanation should be entered into the box.
An example of the text for the ARCP form:
“PYA targets
Mandatory: Complete management training -Achieved
Mandatory: ALS update - Achieved
Mandatory: Advanced competencies in 1 or 2 areas - Achieved
Recommended: Initiate research project – Achieved”
Once an ARCP form with outcome 6 has been completed, the deanery/LETB will ask the JRCPTB to complete a CCT application. You will receive a CCT recommendation confirmation letter, and the JRCPTB will recommend you to the GMC for your CCT. This can take up to 4 weeks.
After receiving the CCT recommendation confirmation letter and notification that the JRCPTB will recommend you to the GMC, you must confirm that the details for your CCT certificate are correct (or amend them). You can then apply to the GMC for your CCT and entry onto the specialist register. You should be sent an email invitation by the GMC to do this. It can be done online through your GMC online account, via the My Registration tab on the left hand menu, then the My Applications area within that tab.
See http://www.gmc-uk.org/doctors/information_for_doctors/gmc_online.asp
and
http://www.gmc-uk.org/doctors/SpecApps.asp
The GMC will issue your CCT certificate within 15 working days of receiving the recommendation from JRCPTB but no earlier than 10 days before your CCT date. You have a maximum of 12 months after your expected completion of training date to apply for your CCT. If you do not apply for your CCT within 12 months of your expected completion of training date you will no longer be eligible for a CCT. You will only be eligible to apply via the CESR route.
If the application and recommendation have been received by the GMC up to 10 days before your CCT date, your name will be added to the GMC specialist register on your CCT date. The date on your certificate will be your CCT date. If your application or recommendation is received by the GMC after your CCT date, then your name will be added to the specialist register on the date it is processed. The date on your certificate will be the date you were added to the specialist register.
Top tips!
-
If you require a second ARCP in your final year as the first was more than 6 months pre CCT date, then do ask about getting the ARCP form completed remotely without you having to actually attend another ARCP meeting. If you can clearly demonstrate having met all your targets and everyone is happy, then you can avoid having to all meet up again.
-
Send your educational supervisor the draft text that should be entered into the text box on your ARCP form i.e. list the PYA targets, and whether they have been achieved as per the example above. Then all the educational supervisor has to do is to verify each target outcome via your eportfolio evidence and then cut and paste the text into the ARCP form. Make it easy for them!
What are the management and leadership competencies required of us?
All doctors are required to demonstrate leadership and management qualities and competencies. See the GMC website:
http://www.gmc-uk.org/guidance/ethical_guidance/management_for_doctors.asp
“The Medical Leadership Competency Framework (MCLF) describes leadership competencies that doctors need to become actively involved in the planning, delivery and transformation of services” - http://www.leadershipacademy.nhs.uk/wp-content/uploads/2012/11/NHSLeadership-Leadership-Framework-Medical-Leadership-Competency-Framework-3rd-ed.pdf
The MLCF was mapped onto our Rehabilitation Medicine curriculum. It contains five domains:
1. Demonstrating Personal Qualities
2. Working with Others
3..Managing Services
4. Improving Services
5. Setting Direction
Some doctors will want to become or are already formal leaders accountable for the performance of a wider group of people / services. However, shared leadership is something all doctors should be partaking in along with their team – identifying problems, solving them and implementing actions.
How do I achieve these competencies?
Formally or informally – usually a combination of both. Acting up in your final year, if available, is an excellent way to develop and demonstrate consultant level leadership and management skills.
It is a good idea to outline your plans for achieving some leadership and management competencies each year in your PDP in the eportfolio and draw attention to this as necessary in your ARCP.
Informal
Informal acquisition of competencies can be gained through on the job experience, for example – team working and MDT leadership, case conference chairing, resolution of patient /family complaints, team conflict resolution, clinical governance including audit, organization of rotas and teaching programmes.
Ensure that these competencies are made explicit in your WBPAs, personal reflection and personal library on your eportfolio and that you link those assessments, entries and documents to the relevant competencies on the curriculum.
Arrange to shadow a manager in your department (or another department if necessary) over a period of a few days – this will demonstrate motivation to learn about their role, and you will gain an insight into management processes including liaison with commissioners. Try to shadow on some days when they will be attending relevant meetings e.g. governance, service development, commissioning. Remember to reflect on this in your eportfolio and link to the curriculum.
Teaching – development of teaching and supervisory skills with junior colleagues include elements of management.
Representative roles – each deanery/LETB will have trainee representatives on their Training Programme Management Committee. Within a training region there may also be opportunity to act as the trainee rep or organiser for teaching programmes or co-ordination of other activities. Furthermore, within your department or Trust, a number of committees or boards will exist and may welcome you as a member.
A number of trainee rep roles are available within the British Society of Rehabilitation Medicine (BSRM).
Any of the above, or similar roles demonstrate much of the leadership and management competencies required.
Again remember to document these role and responsibilities in your CV, eportfolio, summary of management and leadership list (for ARCP) and link to the curriculum competencies on eportfolio.
Formal
It is widely expected that final year trainees undertake some sort of formal management training, usually a course. There are many courses available ranging from free generic management courses run by Trusts and Deaneries/LETBs to 5 day courses costing significant amounts of money.
The type of course you choose will probably be influenced by what is available in your local area, cost implications and your interest in the area / plans for your future. Find out what your Trust and Deanery/LETB offer first and then compare against the external courses available.
Some popular courses are:
Oxford Medical - http://www.medicalinterviewsuk.co.uk/spr-management-course.html
ISC Medical - http://www.medical-interviews.co.uk/p-219-leadership-and-management-course.aspx
The King’s Fund - http://www.kingsfund.org.uk/leadership/all-leadership-programmes
BMA - http://bma.org.uk/events/tag/leadership-and-management-programme
Keele University - http://www.keele.ac.uk/cml/
Warwick University - http://www2.warwick.ac.uk/fac/med/study/cpd/medlead/str-ma/
In addition to courses, longer programmes exist with varying levels of commitment required. These may result in acquisition of a formal qualification eg post graduate certificate, post graduate diploma, Masters degree. For example:
Darzi Fellowships in Clinical Leadership
http://www.londonleadingforhealth.nhs.uk/programmes/fellowships-clinical-leadership-darzi-fellowships
National Medical Director’s Clinical Fellow Scheme at Faculty of Medical Leadership and Management
https://www.fmlm.ac.uk/
Royal College of Physicians
https://www.rcplondon.ac.uk/cpd/non-clinical-cpd/leadership
Keele University
http://www.keele.ac.uk/pgtcourses/medicalscienceleadershipandmanagement/
Open University
http://www.open.ac.uk/postgraduate/qualifications/k04
Acting up
This involves carrying out a consultant’s tasks under the supervision of a consultant at the hosting hospital, and offers the opportunity to experience transition from a junior doctor to consultant whilst maintaining some support and supervision. In order for it to count towards your training it must be prospectively accredited as an OOPT (out of programme training period).
You need to discuss and obtain approval from your Educational Supervisor and TPD, and your Deanery/LETB before applying to the JRCPTB for an OOP. You must apply to JRCPTB at least 8 weeks before the OOPT start date to allow for the JRCPTB to process the application and obtain post approval from the GMC to credit it towards your training.
See for more details:
JRCPTB
http://www.jrcptb.org.uk/training-certification/out-programme
The Gold Guide
http://specialtytraining.hee.nhs.uk/news/the-gold-guide/
How do I demonstrate the competencies?
As ever, make sure all relevant activities are recorded somehow in your eportfolio – via WPBAs, personal reflections, PDP entries, as documents in your personal library, uploaded certificates …… and link these to the relevant curriculum competencies.
In order for you to receive your certificate of completion of training (CCT)/CESR, and thereby be eligible for entry onto the GMC Specialist Register for Rehabilitation Medicine, the JRCPTB has to recommend you to the GMC. The process is as follows:
In the 6 months prior to your CCT / CESR date, the deanery / LETB needs to issue you an ARCP with an outcome 6 – “Gained all required competencies for the programme”. If your final year ARCP does not happen to fall within 6 months of your CCT/CESR date, then you will either need to attend for another ARCP in the last 6 months of training or it may be possible to have the ARCP form completed remotely if your deanery/LETB, training programme director and educational supervisor agree that this is appropriate. If this is the case, the operations officer at your deanery/LETB can create an ARCP form, your educational supervisor will need to complete this, sign it, then pass to your TPD and you for signing and then inform the deanery/LETB of its completion.
When the deanery/LETB creates an ARCP form with outcome 6 it automatically creates a mandatory text box. Into this box the educational supervisor needs to list the targets recommended at PYA, and if they have been achieved. If no targets were set, “no targets set at PYA” should be written in the box. If the CCT/CESR date has changed from that set at the PYA a brief explanation should be entered into the box.
An example of the text for the ARCP form:
“PYA targets
Mandatory: Complete management training -Achieved
Mandatory: ALS update - Achieved
Mandatory: Advanced competencies in 1 or 2 areas - Achieved
Recommended: Initiate research project – Achieved”
Once an ARCP form with outcome 6 has been completed, the deanery/LETB will ask the JRCPTB to complete a CCT application. You will receive a CCT recommendation confirmation letter, and the JRCPTB will recommend you to the GMC for your CCT. This can take up to 4 weeks.
After receiving the CCT recommendation confirmation letter and notification that the JRCPTB will recommend you to the GMC, you must confirm that the details for your CCT certificate are correct (or amend them). You can then apply to the GMC for your CCT and entry onto the specialist register. You should be sent an email invitation by the GMC to do this. It can be done online through your GMC online account, via the My Registration tab on the left hand menu, then the My Applications area within that tab.
See http://www.gmc-uk.org/doctors/information_for_doctors/gmc_online.asp
and
http://www.gmc-uk.org/doctors/SpecApps.asp
The GMC will issue your CCT certificate within 15 working days of receiving the recommendation from JRCPTB but no earlier than 10 days before your CCT date. You have a maximum of 12 months after your expected completion of training date to apply for your CCT. If you do not apply for your CCT within 12 months of your expected completion of training date you will no longer be eligible for a CCT. You will only be eligible to apply via the CESR route.
If the application and recommendation have been received by the GMC up to 10 days before your CCT date, your name will be added to the GMC specialist register on your CCT date. The date on your certificate will be your CCT date. If your application or recommendation is received by the GMC after your CCT date, then your name will be added to the specialist register on the date it is processed. The date on your certificate will be the date you were added to the specialist register.
Top tips!
-
If you require a second ARCP in your final year as the first was more than 6 months pre CCT date, then do ask about getting the ARCP form completed remotely without you having to actually attend another ARCP meeting. If you can clearly demonstrate having met all your targets and everyone is happy, then you can avoid having to all meet up again.
-
Send your educational supervisor the draft text that should be entered into the text box on your ARCP form i.e. list the PYA targets, and whether they have been achieved as per the example above. Then all the educational supervisor has to do is to verify each target outcome via your eportfolio evidence and then cut and paste the text into the ARCP form. Make it easy for them!