ST1

ST2

ST3

Year 1

Year 2

Year 3

Timeline

Stage of Training

AKT

CSA

6 x CBD

6 x mini CEX

2 x MSF

1 CSR per post

 

6 x CBD

6 x mini CEX

2 x MSF

1 CSR per post

 

12 x CBD

12 x COT

2 x MSF

1 x PSQ

8 x DOPS

6 x SEAs

12-18 OOH

3 learning log entries a week

1 CSR per post

Deanery review panel at 34 mths

 

ARCP - annual review of competence to progress

ARCP - annual review of competence to progress

Definitions

 

AKT - Applied Knowledge Test

CBD - Case Based Discussion

CEX - Clinical Evaluation Exercise

COT - Consulation Observation Tool

CSA - Clinical Skills Assessment

CSR - Clinical Supervisors Report

DOPS - Direct Observation of Procedural Skills

MSF - Multi Source Feedback

OOH - Out of hours

PSQ - Patient Satisfaction Questionnaire

SEA - Significant Event Analysis

WBPA - Work Place Based Assessment

Brief Explanations about Each of the GP Training Requirements 1

 

AKT = Applied Knowledge test

One of the 3 components of the MRCGP. It has been suggested that it is taken in late ST2 or early ST3. The AKT exam statistics show pass rates are now similar in both ST2 and ST3. mymrcgp would suggest taking the exam early (i.e. end of ST2) as the ST3 year is very busy.   The test takes the form of a three-hour multiple-choice test of 200 items. It is computer-based and delivered at 150 Pearson VUE professional testing centres around the UK (where current UK Driving Test Theory takes place).

 

Approximately 80% of question items will be on clinical medicine, 10% on critical appraisal and evidence based clinical practice and 10% on health informatics and administrative issues. All questions will address important issues relating to UK general practice and will focus mainly on the application on knowledge (=higher order problem solving) rather than just the simple recall of basic facts.

 

Try our question database which will give you feedback on your performance and is curriculum referenced.

 

ARCP = Annual Review of Competency Progression

 

A review of your competency at the end of each ST year. It involves the educational supervisor deciding whether you have made satisfactory progress without any major concerns. If there have been concerns with your progress or with a training post, then you may be asked to attend a meeting with a panel to review your progress.

 

CBD = Case Based Discussion

A WPBA assessment tool.

Case-based discussion is a structured interview designed to explore professional judgement exercised in clinical cases which have been selected by the GP trainee and presented for evaluation.  Evidence collected through CBD interviews will support the judgements made about trainees at the interim and final reviews throughout the entire programme of GP training. The CbD tool has been designed to be used in both hospital and GP settings.

Basically, you have to prepare cases which you hand over to your Clinical Supervisor (Consultant/GP Trainer).  The Supervisor then selects one or two cases and asks you questions to probe and gauge your ability in certain areas.

 

Professional judgement may be considered as the ability to make holistic, balanced and justifiable decisions in situations of complexity and uncertainty.  It may include the ability to make rational decisions in the absence of complete information or evidence, and to take action or even do nothing in such situations. It requires a selection of attributes: recognising uncertainty/complexity, application or use of medical knowledge, application or use of ethical and legal frameworks, ability to prioritise options, consider implications and justify decisions.

 

COT = Consultation Observation Tool

A WPBA assessment tool.

This tool has been designed to be used by trainers (ie GP trainers) as an evidence-collecting instrument to support the more holistic judgements made about GP trainees at the interim and final reviews during GP posts. The mini-CEX tool will be used for this purpose in a hospital setting and COT for GP posts.

 

The starting point for this assessment is either a video recorded consultation or a consultation directly observed by the trainer. In either case the observation should generate discussion and feedback for the GP trainee.

 

Clinical supervisor

 

This is your consultant or GP trainer in the post you are doing. They complete assessments with you and deliver your other teaching, and they are responsible for ensuring that appropriate clinical supervision of your day-to-day clinical performance occurs at all times, with regular feedback. . They complete a report at the end of your training post, which is added to your personal e-portfolio.

Do not confuse your Educational Supervisor with your Clinical Supervisor; they are not the same.  Educational Supervisors concentrate on your educational planning and any difficulties whilst Clinical Supervisors watch, assess and give feedback on your clinical performance.

 

CSA = Clinical Skills Assessment

 

One of the components of MRCGP. It is suggested this is taken in the first 6 months of ST3 to allow time for resits if they are required. A 13 station OSCE of 10-minute consultations. See our CSA section for more details about cases and courses.

 

 

 DOPS = Direct Observation of Procedural Skills

DOPS is designed to provide feedback on procedural skills essential to the provision of good clinical care.  The mandatory procedures chosen have been selected as sufficiently important and/or technically demanding to warrant specific assessment.  Trainees will be asked to undertake observed encounters during the three years with a different observer for each encounter. Each DOPS should represent a different procedure. The registrar chooses the timing, procedure and observer.

These are usually only done in hospital posts.

 

There are 8 mandatory procedures to be covered:

1.    Application of simple dressings

2.    Breast examination                            

3.    Cervical cytology

4.    Female genital examination

5.    Male genital examination   

6.    Prostate examination       

7.    Rectal examination

8.    Testing for blood glucose                   

 

Some of these procedures may be combined e.g. prostate and rectal examinations.

 

 

Educational Supervisor / Educational supervision

 

The educational supervisor is the crucial link between the educational and workplace based assessment process. You will be allocated an Educational Supervisor, with whom you must meet twice in every 6-month post to review your progress in assessments, and to check you are making progress without experiencing any problems.

The Educational Supervisor is there to help you.   These meetings MUST happen (twice a year) and be logged onto your e-portfolio; so PLEASE meet up.  Your Programme Directors will tell you who is your allocated Educational Supervisor.   Do not confuse your Educational Supervisor with your Clinical Supervisor; they are not the same.  Educational Supervisors concentrate on your educational planning and any difficulties whilst Clinical Supervisors watch, assess and give feedback on your clinical performance.

 

 Mini-CEX = Mini - Clinical Evaluation Exercise

 

A WPBA assessment tool.   Mini-CEX is a 15-minute snapshot of doctor/patient interaction. It is designed to assess the clinical skills attitudes and behaviours of trainees essential to providing high quality care.  It’s only done in hospital posts (in GP posts, you use the Consultation Observation Tool (COT) instead).

Trainees will be asked to undertake six observed encounters during the year with a different observer for each encounter. Each of these encounters should represent a different clinical problem and trainees should sample from a wide range of problem groups by the end of the year.

Immediate feedback will be provided after each encounter by the observer rating the trainee. Clinical Supervisors (=Consultants) and trainees will need to identify agree strengths, areas for development and an action plan for each encounter.

 

MSF = Multi Source Feedback

 

A WPBA assessment tool. This tool provides a sample of attitudes and opinions of colleagues on the clinical performance and professional behaviour of the GP registrar (GPStR) and helps to provide data for reflection on performance and gives useful feedback for self-evaluation. It is like a 360 degree appraisal.

In the hospital setting, MSF is sought only from clinical staff.   However, in GP posts, feedback is sought from both clinical and non-clinical staff.

 

 

PSQ = Patient Satisfaction Questionnaire

A WPBA assessment tool. The PSQ provides useful feedback to doctors by providing a measure of patients’ opinion of the doctor’s relationship with them and the empathy shown during the consultation.  The evidence provided is useful in helping trainer and trainee to address needs and facilitate educational shift during the training period (i.e. help you become even better at consulting).

 

 

WPBA = Work Place Based Assessment

The 3rd component of nMRCGP.

WPBA for nMRCGP is the evaluation of a doctor’s progress in their performance over time, in those areas of professional practice best tested in the workplace.

It is continuous assessment from the first post on your rotation to the last (rather than the traditional model of having one big exam at the end). The assessments are all described on www.rcgp.org and are completed with your Clinical Supervisor using the e-portfolio.

Essentially made up of: Case Based Discussion (CBD), Consultation Observation Tool (COT) when in GP posts, Mini-Clinical Evaluation Exercise (Mini-CEX) when in hospital posts, Directly Observed Procedures (DOPs) in hospital posts, Multi-Source Feedback (MSF) and Patient Satisfaction Survey.   You do all of these and collect the evidence which you then log into your e-portfolio.

 

 

 

Reference: 

1.  Bradford VTS Useful List of Acronyms for GP Training

Map of Training

AKT