The trainee who’s in an extension

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Dear Trainee

The information provided below is for those trainees who have been granted an extension by the Yorkshire & Humber Deanery.   If this is you, please [highlight]read this section VERY carefully[/highlight] because it is highly unlikely you will be granted another extension if these requirements are not met.   The aim of this section is to define what you need to do in respect of your ePortfolio and WPBA during your extension.  If you have been granted an extension simply to give you another chance of doing an examination (like AKT or CSA), the bottom line is that [highlight]you still need to continue working on your ePortfolio, doing WPBA and engaging in OOH.[/highlight]  If you succeed in getting your AKT or CSA during your extension but fail to maintain your ePortfolio and WPBA, you will still be at risk of not being given your CCT.

The aim of this webpage is to make your life easier.  Please read it VERY carefully and send a link to it to your Clinical and Educational Supervisors.

Ramesh Mehay, TPD (Bradford)

Important Dates to Work Out Now

  • Date of the last working day: how many months have you been granted an extension?   From this, work out your last working day (Y&H Deanery should help furnish you with this if you remain unsure).
  • Date of your ARCP panel: You will need a central ARCP panel roughly 2 weeks before this end date.   Again, drop the Deanery an email to confirm this, that it is all in hand and in particular that they will ‘notify the Certification Unit that the CCT needs a fast turnaround action’.  This will help you get your CCT on time for you to be able to apply for jobs in a timely way once you are qualified.
    • For West Yorkshire, the contact person is Grace Coghill: [email protected]
    • For South Yorkshire, the contact person is Sarah Cuckson
    • For North Yorkshire & North Lincolnshire, the contact person is Rachel Cadwallader
  • Date of your ES meeting: Now that you have a central ARCP panel date, you will need to arrange an Educational Supervision Meeting about a week before that date.
    • Contact your Educational Supervisor early to sort that out.  Please send them a link to this webpage and ask them to read the bottom bit.
    • As for you (the trainee): In preparation for your ES meeting, you will still need to re-do your self-assessment of the 12 professional competencies.   Again, if there are competencies that were marked in the last ESR as ‘Competent for Licensing’, you can refer back to the evidence you used there.   However, for Professional Competencies that were highlighted as a concern, you must provide more fuller evidence and incorporate any additional newer evidence acquired during the extension.
  • Date for your CSR: Now that you have a date for the ES meeting, don’t forget that you will need to get a CSR done a week or two before that.  So, work out that date too and plug it into your diary.
  • In fact, plug all of these dates into your diary and share them with both your Clinical and Educational Supervisors.

What You Need to do in terms of Your ePortfolio

There are TWO things that you need to show in your ePortfolio.

  1. Evidence for the competencies which the ARCP panel felt you were deficient on.
  2. Evidence to show continued learning

More detail on each of these below.

DEFICIENT COMPETENCIES

From your ARCP panel report and the ESR….

  • List the Professional Competencies which were highlighted for further work or development
  • List anything else they felt was missing, needs extra work or what they expect to see at the next panel.
  • Try and understand why they feel you need to do this extra work (you may need to enlist the help of your Trainer or Training Programme Director).
  • Now make a list of exactly what you need to do in terms of your ePortfolio, WPBA and OOH – make a list of specific evidence you need to provide to prove your competence.
  • Make sure this list includes evidence which the panel have specified.
  • The type of evidence which provides a good basis for each competency can be found on the following webpage:  www.bradfordvts.co.uk/educational-supervision/evidence-rating-scales.

[toggle title_open=”An example – Fitness to Practise (click to close me)” title_closed=”An example – Fitness to Practise (click to open me)” hide=”yes” border=”yes” style=”default” excerpt_length=”0″ read_more_text=”Read More” read_less_text=”Read Less” include_excerpt_html=”no”]

An ARCP panel have given John (the trainee) a 3 month extension on a full-time basis because he has failed one area of his Work Place Based Assessment – namely, the competency ‘Fitness to Practise’.   They have writen that they felt that he needed further development in this competency because…

Attitudinally….

  1. He did not respond appropriately to a recent complaint in a timely way.  His attitude towards the complaint showed a lack of regard for the patient and did not consider their perspective.
  2. He has documented a number of times in his ePortfolio the pressures between personal and professional life but fails to detail how he plans to make this better.
  3. Not reflecting on his own ability to work as a safe doctor – he was recently very ill looking and came in to do a surgery (despite how commendable others have viewed this).
  4. Some of his colleagues have concerns as detailed in a recent MSF

Organisationally…

  1. Not engaging with the eP in a timely way despite repeated reminders.
  2. Delay in replying to the complaint despite being told to do so.
  3. Not organising OOH in a timely way – all rather last minute.
  4. Needing repeated reminders about things
  5. He seems to be getting behind with administrative tasks because of these struggles (as noted by the Clinical Supervisor – outstanding blood results and referrals).

So, what evidence  will John need to provide for this competency?

  • Provide a min of 3 CBDs, with a big focus on item 10 – fitness to practise
  • Provide 1-2 SEAs – where he demonstrates a positive attitude towards SEAs (rather than defensiveness)
  • CSR – the Clinical Supervisor will need to write a detailed write up for items under Professionalism – in particular ‘shows respect for others’ and ‘deals appropriately with stress’ and ‘is organised, efficient and takes responsibility’ and under Management – in particular ‘keeps up to date and a commitment to learning’
  • A new MSF – two reasons – because ARCP panel thought last one wasn’t good and also because other team members need to verify his Fitness to Practise – ie. good time keeping, does letters, does results, on top of paper work, and respectful of colleagues.
  • A new end of post reflection – to demonstrate what John has LEARNED in the 3 month extension (rather than being defensive and providing all sorts of reasons as he did in the last one).  Providing some specific comments on learning with respect to ‘Fitness to Practise’ (John should read the RCGP’s competency descriptor) in his end of post reflection will help John enormously.
  • He must continue to engage with the other elements of WPBA as is required of a trainee not in extension (i.e. 3 x COTs, 3 x CBDs etc)

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EVIDENCE TO SHOW CONTINEUD LEARNING

[highlight]You still need to do what any GP trainee would be expected to do in any training post IN ADDITION to the things specifically required by the ARCP panel.[/highlight] So, as a ROUGH guide…

  • Continue to do COTs/CEXs – (full-time: 1 per month;  part-time: 1 per two months)
  • Write some PDPs – (full-time: 2 per 3 month period;  part-time: 1 per 3 month period)
  • Continue to write log entries – (full-time: approx 6 per month;  part-time: approx 3 per month)  – remember to balance the clinical and non-clinical.
  • Still engage in OOH – (full-time: 1 per month;  part-time: 1 per two months) – see PPS note below
  • If you need to do an MSF and/or a PSQ – PLEASE DO NOT LEAVE THESE TIL THE LAST MINUTE!!!   Do these in a timely way so that you and your Educational Supervisor can use the evidence from them to write the ESR and provide evidence to the panel.  If you don’t keep an eye on these and find that towards the panel date you are still waiting for people to reply, you will find the panel unforgiving and you will not be granted any additional chances to ‘prove yourself’.
  • Before your panel and ES meeting
    • upload an updated ES Workbook that covers the whole of the last ST year (including the extension).  You will need to add new evidence to the existing one.    The ES workbook is available from the Educational Supervision pages of Bradford VTS (www.bradfordvts.co.uk).
    • upload a new Form R – detail any new complaints.  (also from www.bradfordvts.co.uk).
  • Perhaps a FINAL learning log entry pulling all of your evidence together (especially around the any competencies that were deemed deficient).

PS Round off any decimals to the integer above (for example, 1.5 COTs for a part-time 3 month extension becomes 2 COTs).

PPS The total number of OOH sessions needs equal the total number of full-time equivalent months spent in GP posts over the entire training period (including the extensions).  For example, consider an ST3 who has already done 18 months ‘full-time equivalent’ BUT was given a 3m full-time extension in GP in ST2 and NOW in ST3 in GP is given an additional 3 month extension (but as part-time 50% over 6 months).   This trainee needs to have done = 18 + 3 +3 = 24 sessions.

What your Educational Supervisor Needs to Do

  • If the end of extension ES meeting is within 3 months of the last ESR, then you can adopt what we call a ‘light touch approach’ to the ES meeting.
    • What this means is that you only need to concentrate on the areas that were marked as deficient in the ePortfolio, WPBA or the 12 Professional Competencies. Prioritise the evidence and your analysis on the areas which have been assessed as being below the expected standard but having required new WPBA evidence to be done.
    • Be sure to make reference to the more recent CSR, COTs, CBDs, MSF, PSQ or other recent WPBA especially if these have been borderline in the past.
    • For other areas of no concern – you can ‘refer to previous ESR’.
  • If the ES meeting is more than 3 months of the last ESR
    • A  new detailed ESR needs to be done covering all competencies.
    • Again, you can quote previous evidence for those areas which were deemed satisfactory.
    • But remember to pay extra attention to those which were borderline or less than satisfactory and make use of the NEW evidence.
  • Note: New COTs and CBDs should be marked competent overall if the trainee is ST3 and their next stage is for CCT.   Otherwise, the panel mgiht have concerns that there was not continuing evidence of competence.

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