Specialist Associate CESR Evaluation Day

Today Introduction to CESR and the evaluation process 10:15 - 11:00 Item Timings Introduction to CESR and the evaluation process 10:15 - 11:00 Introduction to Dr Ezzo's application 11:00 - 11:20 Evaluate application part 1 11:20 - 12:00 Lunch 12:00 – 13:00 Evaluation of application part 2 13:00 - 14:00 Explaining recommendations 14:00 - 14:15 Setting recommendations for Dr Ezzo 14:15 - 14:30 Review / reflection 14:30 - 14: 45 Wrap up 14:45 - 15:00 Introduce ourselves – name, role, how long have worked at GMC, what we’re responsible for. Cover no fire alarms, breaks, toilets etc. Ask all to introduce themselves too - name, specialty, where they’ve worked, how long for, why they signed up for this work.

What the Specialist Apps Team do Deal with all applications for entry onto the Specialist Register or GP Certificate of Completion of Training (CCT) Certificate of Eligibility for Specialist Registration (CESR) Certificate of Eligibility for General Practice Registration (CEGPR) Verifications and duplicates of certificates for GMC and previous bodies responsible for Specialist training / registration Coordinate GMC’s response to appeals against SR / GPR Applications for Out of Programme (OOP) approval Explain drs need SR to work as substantive consultant in non-FT NHS hospitals and GPR to work as GPs in any capacity (can’t otherwise work) Quick overview of team structure – 12 advisers, 2 assistants etc. 3

CCTs Following qualification and foundation years, doctors apply for entry into specialist training. Once appointed, they follow a GMC approved curriculum If they achieve all the competencies, they will be recommended to the GMC for the award of a CCT. Fee is £420. 6,418 CCT grants in 2014 This is where most of SAT’s work comes from. They will all know the structure. However we spend most of our time on CESRs and hand over to KB to talk about those. 6, 418 CCT http://www.gmc-uk.org/education/A-Z_by_specialty.asp Entry into specialist training is competitive depending on specialty. Training prog Process for CCT – notify, apply, recommendation. From 31 March have 12 months to do this. Mention OOP here in context of approved programme 4

What is a CESR? Entry onto the Specialist Register with a Certificate of Eligibility for Specialist Registration (CESR) A route for doctors who have not followed a full UK training programme, but feel they have equivalent knowledge, skills and experience to someone who does Set out CCT route and also CESR 5

Applications by specialties JCST are a major stakeholder for us – as shown above, over a quarter of apps in surgical specialties. So very grateful for their assistance and input.

An overview of the CESR process Run through fee, process including requesting SRs, adviser’s role, withdrawals – and that pass rate is around 50/50 7

Evidence - Validation Every piece of evidence that relates to training and experience Medical supervisors who can confirm it is a true and accurate record gives name, signature, job title, stamp: Make the point that we will have done all verification checks at the GMC beforehand Every piece of evidence that relates to training and experience must be validated by someone in a medical supervisory position at that hospital, who can confirm that it is a true and accurate record. Each piece of evidence must have: The relevant hospital stamp Name printed in full of the person validating Their job title Their signature Where a document has multiple pages, the first page and consolidation sheets must show the stamp, name, job title and signature. 8

Compliance with legal deadline This is across all Colleges. JCST’s own performance is vastly improved. Discuss improved compliance with SLA – overall met over 95% in every quarter since Jan 2013.

The GMC Specialist Applications Team Talk through how team works and that each adviser has around 30 cases 10

Associates’ role Use expertise to advise the GMC on whether an application meets the standards required in the curriculum – no more, or less Place most weight on primary evidence Secondary evidence helps to triangulate the evidence Place most weight on evidence gained over the last five years Avoid guessing or speculating If you identify a gap / deficiency add a recommendation

Compliance with legal deadline Use this graph again to explain why we’ve recruited them – JCST’s performance not always good, filling this gap

How the assessment will work Discussion of evidence, under each criterion Chair will have final sign-off and ensure form reflects discussions

Legally Compliant Recommendation Set out a way for a doctor to address deficiencies Clear and specific Divided into two parts – description of the further training, and evidence required Applicant’s responsibility to arrange further training 14

Legally Compliant Recommendation The recommendation should: Specify the period of additional training (or experience) Specify the fields to be covered (i.e. competencies to be achieved) Inform the applicant of any examination or assessment they must complete Specify the documentary evidence that would be required = We will now undertake exercise four- Based on the evaluation form from exercise two- I would like you to write a set of recommendations. You have twenty minutes to do this. 15

Exercise 4 Examples of recommendations Period of additional training (if any) and fields to be covered by it. Documentation, examination, assessment or other test of competency to satisfactorily demonstrate the standard required Recommendation 2: Supervised targeted training in a colo-rectal unit for one year - Specifically concentrating on complex, difficult cases of Anterior resection, Abdomino-perineal resection, Left hemicolectomy and at the same time further enhancing his skills in laparoscopic colo-rectal surgery. Dr Reject should also provide evidence of endoscopy outcomes. Validated log books and consolidation sheets covering the additional training Workplace based assessments (or equivalent). The WPBAs should be of the fundamental procedures. They should be sufficiently frequent to be able to demonstrate progress and should preferably be undertaken with different assessors in different settings on a variety of patients. The curriculum does not specify a specific number of WPBAs, however guidance is available on the frequency and timing of workplace-based assessments here – https://www.iscp.ac.uk/static/public/wba_guidance.pdf.  The website also outlines the purpose and use of each method – please see the following link – https://www.iscp.ac.uk/home/assessment_wba.aspx. 16

Exercise 4 Examples of recommendations Period of additional training (if any) and fields to be covered by it. Documentation, examination, assessment or other test of competency to satisfactorily demonstrate the standard required Recommendation 2: Continued… Direct observation of your clinical competence from at least 2 people that you worked directly with or for during the additional training who are general surgeons. These will be sought as part of any review/reapplication by the GMC and the individuals supplying the observations will need to refer to the curriculum and state whether you have, covered the full range, depth, breadth of experience and skills to those required of the curriculum and in particular comment on any additional training you have undertaken. Formal (external) assessments preferably to a national standard. As an example the system in the UK is called Annual Record of Competence Progression, ARCP and details of this can be found in the “gold guide” http://www.mmc.nhs.uk/pdf/Gold%20Guide%20--2009.pdf 17

And finally Feedback for today Your views and expertise are important to us 18