Do I have to do it all?


The Tier system acts as a guide for your career progression as an educator in HEE, EoE. The strategy is set up to permit you to ‘step on’ at the level appropriate to your practice and training, or ‘step off’ when you have reached the Tier you are happy with.

Trainees can complete Tier 1 and take it with them to their post CCT job, without the need to complete further tiers. Doctors who move to HEE, EoE can use the strategy to identify their current Tier position, and any top ups in training they may benefit from.

Eg. I am a clinical supervisor but having looked at the suggested e-LfH modules I can see that I would benefit from refreshing/doing [insert module here] at Tier 2 before progressing to Tier 3.

Eg. I am an educational supervisor but haven’t had the benefit of a PgCert or any academic background to the supervision I provide. I can see that I can attend the free HEI contact day and that I will benefit from this. You may choose to attend Tier 2 and Tier 3 HEI contact days.

Eg. I am an educational supervisor but have no desire to progress to Tier 4 or 5 OR I am a clinical supervisor but have no desire to progress any further. There is no requirement to complete all Tiers; the strategy is in place to set a baseline standard for educators in HEE, EoE, to offer support for educators at each stage, and to provide guidance if, and only if, an educator wishes to progress further. The strategy also offers guidance on how to keep up-to-date in the Tier that you have chosen to progress to, including signposting to free educational events provided by HEE, EoE.

I have completed Tier 1 as a trainee, do I have to complete Tier 2 before I can start clinical supervision?

Not necessarily.

If you are practicing independently after CCT, have completed all Tier 1 modules, and attended tomorrows teachers you can top up your training by completing the e-LfH modules in Tier 2 that are applicable to your practice. It is recommended that you attend the HEI contact day; the HEI contact day provides an academic foundation to educational concepts used in supervision. You will find the HEE contact day practical and useful for supervision in clinical practice.

Do I have to start at the beginning?


You should start at the tier that reflects your current level role. If you have recently obtained your CCT and are hoping to start clinical supervision, start at Tier 2. If you have recent evidence (within the last 3 years) to support prior learning and training in supervision there is no need to repeat an e-learning module. If more than 3 years have passed since your training, HEE, EoE recommend you refresh your knowledge by completing the suggested modules.

Which e-LfH modules do I need to do?

I am a junior trainee: Tier 1a 

I am a senior trainee OR I am a trainee and have completed Tier 1a modules: Tier 1b 

I am at the start of my development as a clinical supervisor OR I am an Out of Hours GP supervisor: Tier 2a 

I am finishing my training as a clinical supervisor OR I have completed Tier 2a modules: Tier 2b 

I am at the start of my development as an educational supervisor: Tier 3a 

I am finishing my training as an educational supervisor: Tier 3b 

I have been practicing as a clinical supervisor, which e-LfH modules do I need to do?

Tier 2a modules focus on an introduction to supervision and supporting learners; tier 2b is targeted to the practical aspects of supervision and include the basis of work-based assessments you will be expected to complete for trainees. You may find it helpful to look at the modules to confirm and/or enhance your practice of supervision.

I have been practicing as an educational supervisor, which e-LfH modules do I need to do?

Tier 3a modules focus on extending your knowledge supervision and assessment, including aspects of feedback; tier 3b is targeted to the practical aspects of supporting a trainees progression/development and their assessment at the end of a year of training, including ARCP and MSF. You may find it helpful to look at the modules to confirm and/or enhance your practice of supervision.

Which contact days do I need to do?

There is an HEI contact day at tier 2 and a second contact day at tier 3. The HEI days act to provide an academic foundation to the supervision you deliver. Both should be attended as you develop as a supervisor. The aims and objectives of both days are tailored to the role you are expected to perform.

HEI Tier 2 content includes reflection, planning teaching, educational conversations, teaching skills, teaching knowledge and feedback.

HEI Tier 3 content includes educational theory, assessment, learner needs and safety, and learning styles.

HEE contact days offer the opportunity to meet with fellow educators and consider the practical aspects of supervision in a pragmatic way. They are designed to suit educators at tier 2 and tier 3 and recognize that supervisors may be a clinical supervisor for one group of trainees and an educational supervisor for others. The HEE day can be attended during tier 2 training, or early in tier 3.

HEE refresher days are also offered for the supervisor wanting to up-date or approaching revalidation. It is anticipated that a refresher day will be attended once every 5 years as part of the revalidation cycle.

In addition HEE offer a number of face-to-face targeted masterclasses and a bi-annual educator symposium to provide a choice in ways an educator can up-date or refresh their knowledge and skills.

How do I know what I need to do?

The HEE, EoE tiered strategy sets out the expected e-LfH modules, and contact days that are to be completed at each stage of educator development. Each Tier has a descriptor to help the educator identify their stage.

Can I start supervising (any level) without having completed the tier?

If you are new to supervision as long as you have demonstrated a commitment to completing a tier for training, including having completed the recommended e-LfH modules, you can start to supervise. The tier should be completed within 18 months from starting.

If you are already supervising and you can demonstrate that you have completed training from another provider you can supervise.

The HEE, EoE educator strategy is free at the point of access and mapped to the AoME, GMC and COGPED standards for educators.

Can I spring off at one stage to develop another interest?

Yes. There is no requirement to complete all tiers. It is anticipated that HEE, EoE will develop parallel tiers of educators/supervisors in simulation, quality improvement and leadership. The baseline standard for supervisors in East if England is Tier 2.

What is the time commitment?
  Tier 1 Tier 2a Tier 2b Tier 3a Tier 3b
Contact days        
HEI contact days 1 day or 1 day plus 2 half days depending on provider   
HEE contact day* 1 day (covers tier 2 and tier 3)  
HEE Masterclasses: half to one day (Choice)      
HEE Symposium: 1 or two days (anticipated for educators to attend once every 3 years minimum)      

HEE contact day* The HEE contact day is designed to be of use for supervisors at tier 2 and tier 3. There is no requirement to attend a HEE contact day at Tier 2 and tier 3 if the training is completed in under 4 years. At 4 years it is worth re-attending in line with your revalidation cycle. At more than 4 years the HEE day should be re-attended. If training is completed in less than 4 years a HEE refresher contact day is advised.

Is there a time limit to complete each stage?

Tier 1 should be completed between FY2 and CCT; within this time frame there is no other time limit, it is up to the individual to set their own pace.

Tier 2 and 3 should each be completed within 18 months from starting; it is acceptable to complete the tier in a shorter time frame, but there should be 2 months between attending the HEI and HEE contact days. It is recommended that e-LfH modules are completed before attending any of the face-to-face contact days as they are designed to build on prior knowledge.

Tiers 4 and 5 can occur at your own pace.

Do I have to do it all at once?

No. You can set your own pace for completion of each tier that you choose to do. There is no need to complete tiers 1-5, many will start at tier 2 and complete tier 3 and choose to remain at that level of faculty.

There is no time limit for you to start tier 3 after completing tier 2; if many years have passed you may find it useful to check your e-LfH remains up-to-date and that no new modules have been recommended, and to revisit the contact days before progressing to the next tier.

When do I have to update?

HEE have set 5 years as the time frame to up-date to align with your revalidation cycle. Some secondary care providers require an up-date at 3 years; it is worth checking with your employer.

How frequently do I need to update?

It is desirable to attend HEE symposium at least once every 3 years and an HEE refresher contact day once every 5 years (minimum) in order to revalidate. Masterclasses and symposium are open to all at tier 3 and above, day 2 of the symposium is open to tier 2 and above.  Once a masterclass has been attended a period of 3 years should elapse before that same masterclass is re-booked (unless in special circumstances*)

Special circumstances* attendance at a masterclass is recommended by Medical director/responsible officer/GMC/DME/HEE faculty or in response to feedback or to an adverse outcome with a trainee.

Can I stop?

Yes. Whenever you want at whatever stage you want. And you can restart where you left off, or start again at tier 2 if it has been more than 5 years. You may no longer be able to provide supervision if you become out-of-date.

I have done ATLS/APLS instructor course, do I need to start again or where do I start?

This is a fantastic course; whilst it covers many important aspects educational style it may miss some aspects of supervision. If you are confident that the course has covered some specific areas of supervision there is no need to repeat that individual topic (unless you choose to); you will still find it helpful to attend both the HEI and the HEE contact days.

I already have a PgCert what should I do?

You may find it useful to look at the e-LfH modules, as there are specific modules for WBPAs that may not have been covered in your PgCert yet you are still expected to deliver. If you choose you can attend an HEI contact day, the programmes and dates are available here: You are likely to find the HEE contact days very useful; they offer the opportunity to meet with fellow educators and consider the practical aspects of supervision in a pragmatic way.

What is the matrix?

The matrix is a graphic representation of the national standards for medical educators plotted against three areas of supervision Assess, Identify and Develop. All HEE offerings will be plotted against the national standards to give the educator a visual representation of how their existing training meets the requirements, and to assist the educator target their future learning.

Why did you choose e-LfH?

There are many e-learning platforms available. E-LfH was chosen as;

  • it is produced by experts within their field with national credibility;
  • it is free at the point of access
  • it goes green when the module is finished which can provide the user with evidence of having completed an aspect of training
  • trainees are familiar with the format and it should make the transition to post-CCT supervisor role less onerous
  • a single platform for all supervisors in EoE ensures consistency in knowledge and practice across the region
Why did you choose RCP for CPD points?

HEE looked at many providers for CPD. The Royal College of Physicians was chosen as;

  • They demonstrate credibility across all schools
  • The process is on-line, quick, reliable and peer reviewed
  • The points are recognized by all schools
  • They provide their points free, and part of our role at HEE is to provide great value and high quality resources for our trainees and educators.
Is it mapped for primary care?

Yes. As well as mapping for AoME and GMC standards, the tiered strategy has been mapped to the ‘COGPED Guidance for Deaneries’ from experts in medical education in primary care.

How does this fit with Annual appraisal?

The strategy is mapped to national standards for educators that form the basis of the education section within most appraisal paperwork. The mapping of the strategy and wider HEE, EoE faculty development offerings should help you populate each domain of your appraisal paperwork in the easiest fashion

Eg. The symposium has the matrix mapped in delegate paperwork. This can be uploaded, along with your attendance certificate, into your appraisal folder. You will need to highlight the sessions you attended.

Eg. Each masterclass has the matrix mapping as part of delegate information that can be uploaded, along with your attendance certificate to your appraisal folder.

Is there recognition of the course?

The entire course has been submitted to AoME for recognition.

Who is responsible for approving the training?

HEE and HEI have worked together on the HEI contact days; HEE and regional hubs have worked together on HEE contact days. All have been externally approved by Royal College of Physicians for CPD purposes and completed Tiers have been submitted to AoME for recognition.

I can’t get on to the contact day in Cambridge, will the content be the same in UEA or ARU?

Yes. The core content that is required to fulfil nationally agreed standards for medical educators  is the same in each HEI, and HEE hub. How this content is delivered will differ, and there may be additional offerings at each site that may interest you. The courses and dates are advertised on the Tier 2 and Tier 3 pages. 

Tuesday, 5 February, 2019
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Tuesday, 5 February, 2019