GMC Approval of trainers in the UK Enid Rowland and Patricia Le Rolland

Our purpose ‘to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine’

In existence and in place now  In Tomorrow’s Doctors, domains 2, 6 and 7 all make reference to the criteria and requirements to support medical students and faculty. Supplementary guidance on the support and development of teachers and trainers for implementation of the 2009 Tomorrow’s Doctors  In the Foundation Programme (FP), and monitored through QAFP, the New Doctor has a standard - 82 that requires “support, training and effective oversight must e provided for local faculty”. A criterion - 93 that states “trainers must be appropriately appointed, trained and appraised against their educational activities”.  4 standards for trainers in the GMC Generic Standards for training, in Domain 6. Trainers = educational supervisors and clinical supervisors. These are applicable to all specialty including GP training since January 2008, with compliance expected January 2010  These are extant and should be acknowledged fully in any plans for accreditation in UK medicine and medical education

Existing Standards for trainers – required for all UK PGME (1 and 2) Trainers must provide a level of supervision appropriate to the competence and experience of the trainee. Mandatory requirements 6.25 Trainers must enable trainees to learn by taking responsibility for patient management within the context of clinical governance and patient safety Trainers must understand and demonstrate ability in the use of the approved in-work assessment tools and be clear as to what is deemed acceptable progress. Trainers must be involved in, and contribute to, the learning culture in which patient care occurs. Mandatory requirements 6.28 Trainers must ensure that clinical care is valued for its learning opportunities; learning and teaching must be integrated into service provision Trainers must liaise as necessary with other trainers both in their clinical departments and within the organisation to ensure a consistent approach to education and training and the sharing of good practice across specialties and professions.

Existing standards (3 and 4) Trainers must be supported in their role by a postgraduate medical education team and have a suitable job plan with an appropriate workload and time to develop trainees. Mandatory requirements 6.30 Organisations providing specialty including GP training must ensure that trainers have adequate support and resources to undertake their training role Deaneries must have structures and processes to support and develop trainers Trainers with additional educational roles must be selected and demonstrate ability as effective trainers GP trainers must be trained and selected in accordance with the Medical Act Trainers must understand the structure and purpose of, and their role in, the training programme of their designated trainees. Mandatory requirements 6.34 Trainers must have knowledge of, and comply with, the GMC’s regulatory framework for medical training Trainers must ensure that all involved in training and assessment of their designated trainee understand the requirements of the programme.

Clinical supervisor A trainer who is selected and appropriately trained to be responsible for overseeing a specified trainee’s clinical work and providing constructive feedback during a training placement. Some training schemes appoint an Educational Supervisor for each placement. The roles of Clinical and Educational Supervisor may then be merged.

Educational Supervisor Educational supervisor A trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a specified trainee’s educational progress during a training placement or series of placements. The Educational Supervisor is responsible for the trainee’s Educational Agreement.

GP trainers  RCGP and deaneries (Cogped) agrees that a GP meets requirements, is appointed as a trainer following preparation (local and ‘national’ but to national benchmarks that regulator agreed). GP trainer checked by deanery and put forward for deselect ion and so removal of approval by regulator.  Presently updates provided by deanery on an annual bases, list published  However individual issues may well be dealt with directly by regulator

A National Framework for GMC approved trainers for all stages in a medical career  The same standards for all trainers  Trainers =?= those who supervise, support and assess trainees and students in practice settings  Trainers in the first instance will mean those who are medically qualified  Council will confirm any additional requirements depending upon the stage of training

The National Framework for approval of trainers will include:  identification of the specific role/s and responsibilities of the trainer to be approved e.g. educational supervisor and/or clinical supervisor or more  identification of the selection, training and preparation requirements necessary at local level for this role to be approved by GMC (including grand parenting) (not to prescribe courses but identify learning outcomes)  set out the GMC criteria against which local approval decisions can be made and then communicated to GMC (GMC quality assurance processes will assess the effectiveness of these systems)  identification of a process of de-selection and withdrawal of approval, linked to evaluation of the individual’s implementation of the role, and appraisal  development of guidance on appraisal for this role and the link to revalidation

A Task and finish group  To develop a national framework for trainers that is applicable across the continuum of medical education This UK framework would be based on a set of principles; with standards, criteria and requirements common to all and those specific to the context  This work will draw upon and build on existing principles and standards; it will also recognise the very different contexts (including large numbers and variety of students and trainees) and supporting mechanisms for secondary care settings in contrast to general practice  It will recognise and not diminish the contributions of other professions/healthcare workers but will focus on Doctors.

Timescales  Task and finish group – first meeting January 2011  Report to Council spring/summer 2012  Consultation and Section 60 – coterminous 2012  Finalise and implement new GMC Framework 2012/2013  Nb all existing standards and requirements remain statutory requirements for all those who wish to remain involved in medical education

Workshop 26th January 2011 Choose two of the following to discuss, you prioritise:  Attributes of a trainer  Selection to be a trainer  Training to be a trainer  Local approval mechanisms  Evaluation of the effectiveness of a trainer

Discussion structure – Rudyard Kipling  Who  What  Where  When  Why and  How

Supporting Excellence In Medical Education 9th National Multi-specialty Conference for Heads of Schools, Programme Directors, Directors of Medical Education 25 & 26 th January 2011 C O G P E D