1. Update on MMC: Report from the Stroke Medicine SSAC BASP AGM 7 Dec 2006 Updated 6 Jan 2007 to include presentation re proposed new full specialty curriculum to National Stroke Strategy Workforce Group SSAC Chairman Martin M Brown

2. Sub-Specialty Advisory Committee Topics to report Change in SSAC membership Post approval –Numbers approved –Funding issues –Revised forms Specialty Year Assessments Feedback from Trainees Revised Curriculum: PMETB Approval Plans for MMC and new ‘full’ specialty

3. SSAC: Membership Chairman: Martin Brown Sec: Margaret Roberts replaced Gary Ford Ron MacWalter replaced Ken Lees (BASP) Ruth Kent replaced Chris Ward (BSRM) Ian Hastie replaced Alan Sinclair (SAC Ger) John Bamford left (ABN) Kath Pascoe joined as Trainee Rep Other members: Bill Burr (Lead Dean), Christine Collin, Alastair Doward, Jane Flint, Tim Hendra, JCHMT staff

4. New SSAC Constitution: Proposed membership Regional Specialty Advisors (or Heads of Specialty Training when appointed) –London, South West, Midlands, Northern, Scotland, Wales, Northern Ireland Representatives from relevant parent specialty societies if not already included –Geriatric Medicine, Neurology, Rehab Medicine Trainee representative Lay member x 1 Lead Dean and JCHMT representatives Chairman appointed after advertisement

5. Current training numbers in Stroke Medicine 47 posts approved/pending by PMETB Not all posts provide all 3 modules – hence less programmes than posts Only 17 trainees currently in post Eastern 3London10 SW & Wessex 1Northern2 Yorkshire7North Trent 1 Mersey1South Trent 3 Scotland16N Ireland 3

6. Training post funding Funding remains an issue –MMC provides an opportunity to create new Stroke Medicine posts –RSAs and others encouraged to approach their local dean to discuss funding New forms have been designed for training post approval – these can be obtained from JCHMT

7. Specialty year assessments Every enrolled trainee requires a specialty year assessment, ideally 3 months prior to proposed completion of stroke post Usually replaces RITA interview or incorporated into PYA Requires representative nominated by Stroke Medicine SSAC Should be arranged with JCHMT & Deanery informed From 2007, proposed that SYA should take place for several trainees on fixed dates at RCP London

8. Feedback from trainees Specialty specific visits by JCHMT to inspect individual training posts abolished SSAC replacement –Generic Questionnaires to trainees –Meeting with trainees at annual Stroke Forum* and BASP trainees meeting *All current and past trainees in approved posts invited to stay on at end of AGM

9. Revised curriculum Revised curriculum presented to PMETB in September: Approved December Learning objectives and modular topic grids unchanged New –Background to development –Education methods to be used –Methods to update curriculum Still to be developed: Assessment methods

10. Current subspecialty run through training for stroke medicine approved by PMETB 12 months subspecialty training

11. MMC Run through training: Proposal to establish Stroke Medicine as a “Full” speciality Background –Increasing numbers of consultants practicing as full time stroke physicians –Current one year stand-alone subspecialty training posts provide insufficient experience to become fully competent in stroke medicine –Requirement to make appointments in open competition and for trainees to move out of programme unsatisfactory e.g. on-call Proposal to develop a curriculum designed to provide the competencies needed to practice as a full time stroke physician supported by PMETB

12. “Full” specialty training in stroke medicine: proposed model Trainees selected after minimum 2 year core stem training in medicine 4 year minimum period of higher specialty training in a stroke medicine programme –Posts would include Neurology Care of the Elderly Neurological rehabilitation Neuroradiology Cardiovascular medicine

13. “Full” specialty training in stroke medicine: proposed model Years 1 & 2 could incorporate existing SpR posts in General Neurology/Geriatric Medicine with attachments to Neuroradiology and Cardiovascular Medicine Years 4 & 5 could incorporate existing and new stroke medicine sub-specialty training posts based on comprehensive stroke services

14. “Full” specialty training in stroke medicine: possible parallel schemes leading to limited competencies Existing geriatric/neurology SpRs could move across to full stroke medicine training Existing one-year subspecialty posts could remain but specify that only penultimate or final year SpRs could apply Training posts could be developed in single modules e.g. acute stroke leading to a certificate of competency e.g. for emergency physicians

15. “Full” speciality training in stroke medicine Run through training 2 years training in stroke services 2 years training in neurology/geriatrics/neuroradiology/cardiology

16. “Full” specialty training in stroke medicine: preconditions Deans willing to develop the training programmes Neurologists and geriatricians willing to transfer existing training posts to stroke medicine training programmes –But they would not necessarily lose an SpR or need to find someone else to do the on-call Funding for the additional training posts for years 4 & 5 based in comprehensive stroke services Commitment by Department of Health to fund FT consultant posts in stroke medicine Trainees willing to commit to a new specialty without existing consultant posts Trainees willing to give up option of work in parent specialty

17. SSAC Contacts SSAC Chairman –m.brown@ion.ucl.ac.uk Kirstin Barnett, Specialty Co-ordinator –kirstin.barnett@rcplondon.ac.uk JCHMT Website –http://www.jchmt.org.uk/