Background

The General Medical Council recognises that postgraduate medical training is now capability and not time-based. This means that once a trainee has achieved all the required capabilities for their curriculum, they are eligible for their certificate of completion of training (CCT). It is recognised that the General Practice (GP) training programme is already short at just 3 years with a national time to completion of training within GP of 3.8 years. Shortening of this programme therefore has potential ramifications for trainees and requires additional support for educators in terms of clear guidance as to when a trainee is eligible to bring forward their CCT date. The Primary Care School recognises that any processes introduced should align with those of the other Schools and have based the suggested approach on the COPMED document “Bringing Forward Programme Completion Dates” (2024).

Principles

a) The agreement to an application to bring forward a CCT date will normally be at the penultimate Annual Review of Competency Progression (ARCP) – In the context of GP specialist trainees (GPST) the penultimate ARCP normally is at the end of ST2 (for a run-through trainee) and at this point they would be ineligible for their Simulated Consultation Assessment (SCA). Hence, an additional ARCP ahead of the planned final one is required.

b) The decision rests with the Postgraduate Dean advised by the ARCP panel – This is planned for the penultimate ARCP panel, which would be central, and a template letter will be provided to forward to the Postgraduate Dean/Deputy Dean. Their decision is final and is not appealable.

c) The principles set out in Gold Guide Ed. 9 paras 4.1-4.17 apply – Additional resources will be rolled out to support educational supervisors regarding the proposed processes, especially in terms of opportunities to complete required workplace-based assessments and supporting evaluation of what constitutes competency regarding the Royal College of GP professional capabilities.

d) Acceleration of training and change to a programme completion date will be based on evidenced current clinical capability and speed of progression to guide a learning needs assessment and estimation of the time needed to achieve the curriculum competencies – Clear eligibility criteria are presented below. Trainees will still need to have completed all required assessments for a full 3-year programme.

e) Changes to a programme completion date do not remove the need to meet contractual requirements with an employer or placement provider, including notice periods – The Lead Employer for GPSTs will be informed of any newly agreed CCT date. It is suggested that due to this and the short nature of GP training that normally the CCT date would not be shortened to below 32 months whole time equivalent.

f) It is recognised that professional maturity and dealing with uncertainty are sometimes difficult to assess and that educators may err on the side of caution to ensure patient and practitioner safety – The Primary Care School would fully support the judgement of an educational supervisor who has concerns regarding the readiness of a GPST to CCT and would fully support that educator in the event of any dispute.

g) A reduction in training time will not normally be agreed if there are unresolved concerns about capability or conduct, including progression in specialty examinations or assessments required by the curriculum – This is incorporated within the eligibility criteria below.

h) For doctors on dual- or triple- accreditation programmers, all programmes must be completed prior to application for CCT (Gold Guide 3.87)

i) It is the responsibility of the individual trainee to indicate they wish to bring their CCT date forward

FAQs

What are the eligibility criteria? – All of the following criteria must be met to be eligible:

• The trainee must have passed both the AKT and SCA.
• The most recent ESR states that they are competent/excellent in at least 10 of the 13 professional capabilities and meeting expectations in the others.
• There should be no deficit in workplace-based assessments (Clinical Observation Tool, Clinical Assessment Tool, Clinical Case Reviews). Clinical Case Reviews must relate to actual clinical encounters.
• There must be evidence of exposure within traditional out of hours.
• The Quality Improvement Project should have been completed.
• They must have a satisfactory Patient Satisfaction Questionnaire and Multi-Source Feedback for your ST3 phase.
• There should be a learning event analysis for each phase of training.
• They must have completed all the mandatory Clinical Examination and Procedural Skills and a range of others. All of these should be graded as being able to perform competently without needing supervision.
• Their most recent ARCP panel outcome must be an outcome 1.
• They must not have any outstanding revalidation concerns.
• They cannot be applying for a dual CCT in Public Health and GP.
• Academic fellows may be eligible but the reduction in training time needs to come from the clinical component and not the academic component. They MUST have spent time in GP.

When should Trainees apply to bring forward their CCT date? – They must be in ST3 and start the process not before or after 27 months of whole-time equivalent training. Applications before this time should be deferred. Those requested after that time shall be politely declined.

What are the next steps? – It is the responsibility of the trainee to contact you as their educational supervisor stating they wish to bring their CCT date forward. You must check whether they meet all the eligibility criteria and if so, use the template letter to request a central ARCP panel. This may be sent to the assessment team via your local admins. The central assessment team will arrange a central ARCP panel that the trainee does not attend. A FULL ESR will be needed two weeks before the intended date of that ARCP panel.

What if the trainee has not met the criteria and disagrees with my decision? – If they have not met the criteria, they are ineligible and as such the primary care school will support that decision. It would be sensible to document this within the educator notes.

How much time can the CCT date forward by? – The maximum allowable is four months whole-time equivalent.

If the reduction in training time is agreed what happens then? – The central ARCP panel will seek confirmation from the Postgraduate Dean and if agreed will inform the trainee of the new CCT date and liaise with the RCGP. It is their responsibility to start to apply to join the national performers list at that time.

What happens if the trainee needs to extend their training again for any reason? – Please note that the reduction of four months training time cannot be added to any subsequent training if an extension is required.

Please click the image preview below to see the proces flowchart.