Clinical Supervisor's Report (CSR)
Someone will be watching you work and writing a report on you. Make it an easy one for them to write — and a good one for you to receive.
📥 Downloads
📄 Clinical Supervisor's Report (CSR)
Blank CSR forms, the 2021-onwards version, and the instruction sheet — all in one place.
🎓 Clinical Supervision Resources
Workshop materials, background reading, and a plain-English guide to clinical supervision — useful for both trainees and supervisors.
🌐 Web Resources
A hand-picked mix of official guidance and real-world GP training resources. Because sometimes the best pearls are not hiding in the official documents.
⚡ Quick Summary — If You Only Read One Thing
⚡ One-Minute Recall
- The Clinical Supervisor (CS) oversees your day-to-day clinical work in each post — in GP this is usually your GP Trainer.
- The CS changes with every post. Your Educational Supervisor (ES) stays with you throughout the whole 3-year training programme.
- The CS meets with you formally three times per post: beginning (induction/placement planning), middle (mid-post review), and end (CSR meeting).
- The CSR (Clinical Supervisor's Report) is a structured written report completed by the CS at the end of each post, recorded on the FourteenFish ePortfolio.
- The CSR covers seven domain clusters: Professionalism, Communication, Working with Colleagues & in Teams, Clinical Assessment, Management of Patients, Clinical Record Keeping, and Context of Care.
- The CS also answers an entrustability question — grading your overall supervision level (1–4). ST3 trainees should be aiming for level 3–4.
- There are three different CSR forms: hospital posts, GP posts in ST1/ST2, and GP posts in ST3. The grading standard differs.
- The CSR must be completed before the Educational Supervision meeting (ESR). Chase your CS if needed — it is your responsibility.
- A CSR is compulsory in primary care posts if the CS is not the ES, the trainee or supervisor requests it, or information is missing from the portfolio.
- If serious concerns arise, contact your Training Programme Director (TPD) and the deanery early — do not wait until the end of the post.
👩⚕️ What is a Clinical Supervisor?
Definition
A Clinical Supervisor is a qualified specialist with responsibility for the day-to-day supervision, training, and assessment of a trainee in their post. The Gold Guide requires every trainee to have a named Clinical Supervisor for each placement — usually a senior doctor.
In a GP post, your CS is your GP Trainer — or occasionally another GP in the practice. In a hospital post, your CS is the consultant (or senior doctor) nominated to oversee your clinical work in that specialty.
Finding out who your CS is at the start of a post is not optional — it is essential. If you are in a hospital post, sometimes this isn't clearly communicated to you. Ask at induction.
What Should a Clinical Supervisor Actually Do?
According to the Gold Guide and RCGP guidance, a Clinical Supervisor should:
- 🤝 Understand their responsibilities for patient safety in relation to the trainee's work.
- 🏥 Be fully trained in the specific area of clinical care relevant to the post.
- 🎚️ Offer appropriate levels of supervision tailored to the trainee's experience and stage — more hands-on early in training, increasingly independent later.
- 🚫 Ensure trainees do not assume responsibility for clinical tasks beyond their competence or experience.
- ✅ Only permit unsupervised work once they are satisfied the trainee is competent — both parties must be aware of their responsibilities at all times.
- 🔄 Delegate supervision appropriately (e.g. out of hours) — but the named CS remains responsible and accountable.
- 🗣️ Provide regular feedback and assess competence appropriately, including completing WPBAs.
- ⚖️ Be trained in equality, diversity, and human rights best practice.
What Good Clinical Supervision Actually Looks Like
Good supervision is not just about catching errors. It is about creating a safe space where a trainee can reflect, be challenged, and grow. The best supervisors are those who know when to step back and when to step in — and who make the trainee feel supported rather than scrutinised.
🔄 Clinical Supervisor vs Educational Supervisor — What's the Difference?
These two roles confuse almost every trainee at the start of training. Here is the clearest comparison possible.
Insider Tip — The key question to ask yourself
"Who will I see most days and who oversees my clinical work right now?" → that's your CS. "Who follows my whole journey through training?" → that's your ES. In GP posts, the answer to both might be the same GP Trainer.
📅 The 3-Meeting Cycle of Clinical Supervision
You should see your Clinical Supervisor informally on most working days. But there are also three formal meetings per post that structure the supervisory relationship.
- Discuss the trainee's learning needs and objectives for the post
- Agree an educational plan tailored to the post and the trainee's current stage
- Agree dates for the mid-post review and the final CSR meeting
- Ensure the trainee completes a mandatory Placement Planning Meeting log entry on the FourteenFish ePortfolio
- Reviewing progress against the learning plan agreed at the start
- Identifying any areas of concern early — before they become problems
- Adjusting the learning plan if needed
- Completing any outstanding WPBA assessments (CbD, MiniCEX, COT)
- Reviews all evidence gathered during the post (WPBAs, log entries, direct observations)
- Completes and discusses the CSR with the trainee
- Addresses the entrustability question (supervision level 1–4)
- This must happen before the Educational Supervision meeting (ESR)
Trainee Responsibility
These meetings do not arrange themselves. Especially in hospital posts, your supervisor may not even realise they are required to complete a CSR. It is your responsibility to chase your CS, arrange the meetings, and ensure the CSR is completed before your ESR date.
Day-to-Day Contact
Outside of these three formal meetings, your CS should be available on most working days. Regular informal contact — checking in on cases, seeking advice, discussing learning points — is the real heart of clinical supervision. The three meetings are the scaffolding; everyday conversations are the building material.
📄 The Clinical Supervisor's Report (CSR) — In Detail
What is the CSR?
The Clinical Supervisor's Report is a short, structured written report completed by the Clinical Supervisor towards the end of each placement. It is completed electronically on the FourteenFish ePortfolio.
It is designed to provide a holistic summary of the trainee's performance based on everything the CS has observed — direct clinical work, WPBAs, log entries, feedback from other colleagues, and the mid-post review.
The CSR feeds directly into the Educational Supervisor's Report (ESR) at the 6-monthly review. The CS's observations are a key piece of evidence for the ESR, and in turn for the ARCP panel.
The CSR sits between your day-to-day WPBA evidence and the formal 6-monthly ESR review. It is what allows your Educational Supervisor to make judgements about a post they may not have personally observed.
The Seven Domain Clusters
The CSR assesses performance across seven structured areas. Each area has a written strengths section and an areas-to-develop section, plus a rating.
The 7 CSR domains radiate from a common core: patient-centred, evidence-based, safe GP practice.
Insider Tip — Preparing for the CSR Meeting
Before your CSR meeting, go through your own FourteenFish ePortfolio and identify one or two genuine strengths and one or two honest development areas for each domain. Share them with your CS beforehand. A trainee who comes prepared with self-reflection tends to receive much more useful and specific feedback — and the meeting takes half the time.
📊 CSR Grading — How Performance is Rated
The Rating Scale
Each of the seven domain areas is graded. The scale used differs between hospital and GP posts — this is important to understand:
- Hospital posts: Compared against other GP trainees at the same stage of training.
- GP posts (ST1/ST2): Compared against the standard expected at CCT.
- GP posts (ST3): Compared against the standard expected at CCT, with the addition of a Level 4 supervision grade.
Compared against the expected performance of a GP trainee at the same stage of training in that specialty.
Compared against the standard of a newly qualified independent GP (CCT standard). Grades match those used in the Educational Supervisor's Report.
Below Expectations
Meeting Expectations
Above Expectations
For Licensing
Note: The RCGP grading framework assumes trainees "need further development" throughout most of training — this is by design, not a criticism. "Competent for licensing" and "Excellent" grades in primary care posts indicate performance at or beyond the CCT standard, and become more common as trainees approach the end of ST3.
Important: "Needs Further Development" is Normal
Many trainees are alarmed when they receive "NFD" grades. This is the expected and correct grade for most trainees in most domains. The phrase "needs further development" simply means "you are still in training" — which is accurate. It is not a red flag. The concern would be if you received "below expectations" specifically — that is the grade requiring action.
The Final Feedback Box
At the end of the CSR form, the CS can add free text — further observations, recommendations, or areas of concern — to inform the Educational Supervisor. This is particularly important and should always be completed. An empty final box is a missed opportunity for useful feedback.
🔑 The Entrustability Question — Supervision Levels
What is the Entrustability Question?
In addition to the seven domain areas, the CSR includes a dedicated entrustability question. The CS is asked: "Overall, what level of supervision does this trainee require?" — and selects one of four supervision levels.
This is a summary measure of clinical trust — how independently can this trainee work? It is one of the most important single questions in the entire CSR.
What to Expect by Stage
- ST1: Most trainees are at Level 1–2, especially early in training. Level 2–3 is reasonable by end of ST1.
- ST2: Level 2–3 is expected. Level 3 by end of ST2 is a good target.
- ST3 (GP): Level 3 at minimum; Level 4 is expected by the end of training for CCT. Level 4 only appears on the ST3 GP form.
📋 Three Versions of the CSR Form
There are three different CSR forms. Using the right one matters — not only does the format differ slightly, but the grading standard is different.
Short Posts (3 Months or Less)
A CSR is particularly important in short posts — it ensures there is a proper assessment of engagement and learning even when the post is brief. Pro-rata WPBAs (CbD, MiniCEX, COT) should also be completed for short posts.
Less Than Full Time (LTFT) Trainees
If you are working less than full time and your placement spans a full year, a CSR is still required after the six-month point so that your Educational Supervisor can use it for the interim ESR. The requirement does not disappear because you are LTFT — it simply follows the review period timing rather than the end of a post.
Integrated Posts (Dual Specialty)
If you work concurrently in more than one specialty in an integrated post, each Clinical Supervisor should complete a separate CSR. More than one CSR in a post is allowed and expected in this situation.
📝 Worked Example — A Real CSR
This is a real anonymised CSR. Read it to understand both what goes in and how to write and read a high-quality report. Annotated notes explain the teaching points.
Context
Trainee graded in relation to the standard expected at CCT (GP post). Report provides constructive feedback based on direct observations as CS, plus colleague observations during the post.
1. Professionalism▾
Professionalism
Includes being respectful, diligent and self-directed in their approach to patients and others and to their own learning needs, developing resilience, making appropriate ethical decisions.
XXX is a diligent learner who looks things up when she does not know them. She consistently analyses cases in the ethical dimension — both in log entries and during professional conversations. Has a good understanding of ethical frameworks. Always contributes to team meetings.
To think about work-life balance and self-care. Does not have to do 10-minute consultations — many practices are happy with 15 minutes as long as the same number of patients are seen. Remember to pace herself.
Teaching Point
Notice how the strengths are specific and evidence-based ("in log entries", "during professional conversations"). Generic praise like "she is professional" is much less useful. When reading your own CSR, look for whether the feedback is specific — if it isn't, you can ask your CS to expand at the meeting.
2. Communication▾
Communication
Includes communication with patients, establishing patient rapport, managing challenging consultations, third-party consulting, the use of interpreters.
Phenomenal improvement in consultation skills during this post. Has used advanced consultation skills including Motivational Interviewing. Very good understanding of the Calgary Cambridge model. Explanations have improved enormously — now able to use analogies effectively.
Consider attending a Motivational Interviewing course and continue building on consultation skills after qualification.
Teaching Point
The "areas to develop" here is forward-looking and constructive — it extends the learning rather than criticising. This is the ideal tone for a CSR. A CSR should never feel punitive; it is a professional dialogue about growth.
3. Working with Colleagues and in Teams▾
Working with Colleagues and in Teams
Includes working effectively with others, sharing information with colleagues, leadership, management, and team-working skills.
The whole practice team has really loved having Dr XXX. She has been an excellent team player, contributing ideas to meetings. Handovers well, especially in secondary care. There have been occasions where a secondary care colleague suggested a patient didn't need referral, but Dr XXX stood by her decision — appropriately and with good reasoning.
Written skills are very good. Perhaps using more verbal signposting during colleague discussions would help make contributions sound more structured and easier to follow.
4. Clinical Assessment▾
Clinical Assessment
Includes patient history, clinical examination and procedural skills (CEPS), choosing investigations, and making an appropriate diagnosis or decision.
All CEPS achieved. No concerns from any colleague about examination skills. Uses appropriate and proportionate examinations.
The more experience gained, the more pattern recognition will develop. Speed will improve naturally over time.
5. Management of Patients▾
Management of Patients
Includes recognition and appropriate management of medical conditions, safe prescribing, co-morbidity, poly-pharmacy, managing uncertainty and risk.
Good clinical knowledge in terms of current guidance for common presentations. Familiar with NICE guidelines. No concerns over prescribing. Does not over-investigate, over-prescribe, or over-refer — an important balance to strike.
Continue attending GP update courses — at least once a year. A good way of keeping abreast of a wide variety of clinical topics across the whole breadth of general practice.
Teaching Point
"Does not over-investigate, over-prescribe, or over-refer" — this is a genuinely important observation about GP working style. It reflects the professional capability of Medical Complexity (managing uncertainty and risk appropriately). A trainee who orders unnecessary tests or makes excessive referrals "just in case" is actually demonstrating a development need, not a strength.
6. Clinical Record Keeping▾
Clinical Record Keeping
Includes appropriate use of administration systems, effective and appropriate record-keeping, use of IT for the benefit of patient care.
Very clear, concise, and structured documentation entered in a timely way. Competent with System One, ASSIST, and Ardens.
Notes are noticeably better when not under pressure. The development suggestion here is self-management — consciously writing up notes at a moment of calm rather than mid-clinic stress.
7. Context of Care▾
Context of Care
Includes seeking to understand and support patients through an appreciation of the interplay between their disease and their lives, and considering local pathways, formularies, and resources.
Regularly explores the patient's ideas, concerns, and expectations. Also explores the psycho-social and occupational impact of a problem on the person's life. Lots of examples of this in log entries — very evident. Also familiar with local pathways and formulary.
If moving to a new geographical area in the future, remember that local pathways, resources, and formularies will differ. Always take time to map what is available locally when starting in a new post or area.
Teaching Point
Context of Care maps strongly to the RCGP professional capabilities of Holistic Practice & Health Promotion and Community Health & Environmental Sustainability. In hospital posts, this domain is harder to evidence — the CS should acknowledge this in their comments rather than rating it poorly when the post simply doesn't offer the opportunity. In GP posts, evidence from consultation observations and log entries demonstrating ICE exploration, social history, and awareness of the local system is what the CS is looking for here.
🎓 Trainee Guide — Getting the Most from Clinical Supervision
✅ What to Do
- Find out who your CS is on day one — especially in hospital posts. Do not assume it is obvious.
- Arrange the induction meeting within the first two weeks. Don't wait to be invited.
- Complete the Placement Planning Meeting log entry on FourteenFish — it is mandatory.
- Read your CS's log entry validations regularly throughout the post.
- Chase WPBAs (CbD, MiniCEX, COT) proactively — don't leave them to the last week.
- Chase the CSR with enough time before your ESR date — ideally at least two weeks before.
- Come to the CSR meeting prepared — self-reflect on each domain in advance.
- Engage genuinely with the feedback — it is designed to help you grow, not catch you out.
🚫 What Not to Do
- Don't leave the CSR to the week before your ESR — your CS may not be available.
- Don't be defensive in feedback conversations — curiosity serves you better than self-protection.
- Don't complete all your WPBAs in the final two weeks of the post — spread them out.
- Don't assume your hospital consultant knows how to access FourteenFish — offer to help them create an account early.
- Don't confuse your CS and your ES — they have very different roles.
- Don't ignore your CSR once it is done — read it carefully and bring any queries to your ESR meeting.
Insider Tip — Hospital Supervisors and FourteenFish
In hospital posts, the biggest practical challenge is getting your CS to complete the CSR on FourteenFish. Many hospital consultants have never heard of it and have no account. Give them plenty of notice, offer to explain the system, and let them know that creating an account is free and quick. Do this at the mid-post meeting — not the week before your ESR.
What a Good CSR Does for You
A well-written CSR is not just a form — it is a piece of triangulated evidence that supports your ESR and your ARCP. A CSR that highlights specific strengths and genuine development areas gives your Educational Supervisor something to work with. A generic or vague CSR helps nobody. Help your CS write a good one by preparing carefully and engaging openly.
💡 Insider Wisdom — What the Trainee Community Has Learned the Hard Way
Drawn from recurring patterns in trainee forums, GP training scheme communities, deanery resources, and GP educator discussions across the UK. Included only where it aligns with official RCGP guidance — these are the things that keep coming up, and that formal documents rarely say out loud.
📅 The Ideal Timeline for a 6-Month Post
What trainees wish they had followed from day one
The Single Most Common Mistake
Starting the CSR conversation in the final two weeks of the post. By then, your CS may be on leave, at a conference, unable to access FourteenFish, or simply overwhelmed. They cannot complete a thoughtful, evidence-based report in the last three days if they haven't been engaged throughout the post. Start earlier than feels necessary.
🎓 What Trainees Repeatedly Wish They Had Known Earlier
Consistent themes from UK GP trainee communities, VTS forums, and GP educational resources
🏥 The Hospital CS Challenge — A Visual Reality Check
What trainees consistently find in hospital posts — and what to do about it
Hospital posts present a specific supervision challenge that GP posts don't. Understanding it in advance is half the battle. Here's what the trainee community consistently reports, and the strategies that actually work.
RCGP Guidance on Persistent Non-Engagement
The RCGP explicitly states: if there is persistent lack of engagement from a supervisor, the registrar should inform their Training Programme Director at the time and record this in their Portfolio. Non-completion of a CSR due to a supervisor's non-engagement is not the trainee's fault — but it does need to be documented and escalated in real time, not mentioned six months later at ARCP.
✍️ What Makes a Good Log Entry (That Your CS Can Actually Use for the CSR)
Consistently flagged by GP educators and CS reviewers across UK training schemes
- 80% case description, 20% reflection
- "I will do more reading on this topic"
- No capability links
- Generic and vague ("went well")
- Criticises colleagues
- Some reflection present
- Learning needs loosely identified
- Capabilities linked (but obviously
- No action taken yet on learning
- Generic GP application
- 20% case, 80% reflection
- Specific completed action ("I read X and now...")
- Capabilities genuinely demonstrated
- Clear link to GP practice
- Honest uncertainty acknowledged
Think about the patients that stay in your head after the working day is done — the ones you're still turning over at 9pm. Write about those. You don't need the perfect dramatic clinical case. A simple consultation about chest pain that made you uncertain, or a team handover that felt off — those are the entries that show real insight. The clinical minutiae matters far less than what you thought, felt, and learned.
🌍 If You Are an International Medical Graduate (IMG) — Read This
Nearly half of UK GP registrars are IMGs. The supervision system can be bewildering if you've trained in a different healthcare framework. These insights come from IMG-specific GP training resources and educator experience across UK deaneries.
In many international healthcare systems, it would feel disrespectful to chase a senior doctor. In UK GP training, it is not only acceptable — it is expected and explicitly required. You are responsible for organising your own assessments. Your CS will not chase you.
Trainees from non-UK systems often find the FourteenFish portfolio system entirely new. Don't be afraid to ask for help at your induction, from your Educational Supervisor, or from your peers. Getting to grips with it early makes a real difference to your training experience.
Reflective writing is deeply embedded in UK GP training. If you're used to a more factual, clinical documentation style, the portfolio's emphasis on personal reflection can feel uncomfortable at first. It gets easier — and it is genuinely valuable. Your ES is not looking for self-criticism; they are looking for insight.
Many IMGs find capability linking the most confusing part of WPBA. Ask your ES at the start of the post to go through a couple of example entries with you. The BradfordVTS Professional Capabilities page has detailed descriptors that explain what each capability means in plain language.
🎓 What GP Educators Consistently Teach About Getting the Most from Supervision
Drawn from GP training scheme educational materials, trainer resources, and deanery guidance across the UK
The Purpose of Supervision is Not Assessment — It's Growth
GP educators consistently make this distinction: the CSR is not primarily a pass/fail tool. It is a structured reflection on development. Trainees who approach supervision as a professional growth experience — rather than an assessment to survive — consistently get more out of it. The CSR becomes easier to write, more specific, and more useful to everyone involved.
Supervision Should Be Gradual and Drip-Fed
GP trainers and clinical educators emphasise that the best supervision is progressive: regular, small feedback conversations throughout the post — not a single overwhelming feedback dump at the end. If your CS validates log entries gradually and gives informal feedback throughout, the CSR meeting becomes a calm review of already-known themes rather than a surprise revelation.
Self-Direction is What the System is Designed to Test
UK GP training is explicitly designed around adult learning principles — the trainee is expected to take responsibility for identifying and meeting their own learning needs. A trainee who waits to be told what to do, never arranges meetings, and only writes log entries when prompted is demonstrating a development need in the Professionalism capability. The system is testing whether you can manage your own learning. This is not accidental — it directly mirrors the self-directed CPD expected of all qualified GPs throughout their careers.
Breadth Matters as Much as Depth
GP educators repeatedly note that a portfolio full of similar cases from a narrow clinical area does not demonstrate the breadth of GP training. The CSR draws on everything the CS has observed — which is why doing assessments and reflecting on diverse cases from day one is so much more valuable than leaving variety to the last minute. Deliberately choose cases that show ethical dilemmas, clinical uncertainty, team interactions, and complex management — not just standard clinical presentations.
⚠️ Common Pitfalls & Trainee Traps
Leaving the CSR Too Late
The single most common problem. Trainees assume the CS will organise the meeting. They don't — especially in hospital posts. By the time you chase them, they may be on leave, at a conference, or unable to access FourteenFish. Chase early and confirm the meeting date at the mid-post review.
Using the Wrong Form
Hospital posts require the hospital CSR form. GP posts require the relevant GP form (ST1/2 or ST3). Using the wrong form means the grading standard is wrong. Check this before your CS starts filling in the form.
Confusing the CS and the ES
The CS oversees this post. The ES oversees your whole training. In GP posts these can be the same person — but in hospital posts they are always different. A trainee who directs clinical queries to their ES (a GP in Bradford) when they are working in a Respiratory job in Leeds has got confused.
Not Reading the CSR
Trainees often treat the CSR as a box to tick. Read it carefully. If something in it surprises or concerns you, ask your CS about it at the meeting — and then raise it with your ES at the ESR if needed. It is evidence you can use.
Panicking About NFD Grades
"Needs Further Development" is the expected grade for most trainees in most domains. It means you are in training. It is not a red flag. The concern is "NFD – Below Expectations" — that is different and warrants a conversation.
Hospital Supervisors Without ePortfolio Access
Many hospital consultants have never heard of FourteenFish. They cannot complete the CSR without an account. Help them set one up early — free and quick. Don't wait until the last two weeks of the post.
🏫 Trainer / Clinical Supervisor Guide — Writing an Excellent CSR
For Trainers and Clinical Supervisors
This section is specifically for GPs and hospital clinicians who are completing CSRs. It draws on common patterns in both excellent and poor CSR writing.
What Makes a High-Quality CSR?
- Specificity: Name specific observations, cases, or behaviours. "She demonstrated good consultation skills in a challenging consultation with an angry patient in week 6" is far more useful than "she communicates well".
- Balance: Include both strengths and development areas for every domain — even if the trainee is doing very well. A CSR with no development areas for any domain raises questions about whether the CS has been paying close attention.
- Forward-looking development points: Frame development areas as growth opportunities, not criticisms. "To develop confidence with prescribing in elderly patients with complex co-morbidity" is helpful. "Her prescribing is uncertain" is not.
- Evidence-based: Where possible, link observations to what you have seen in WPBAs (CbD, MiniCEX), log entries, or direct clinical observations.
- Complete every section: Including the final feedback box. An empty final box is a missed opportunity.
- Timely: Complete it before the ESR date — never leave a trainee waiting for their CS report at the last minute.
Tutorial / Teaching Prompts for the CSR Meeting
These questions work well to guide a rich feedback conversation during the final CSR meeting:
- "Tell me about a consultation this post that you felt went really well — what made it work?"
- "Which aspect of the clinical work here do you feel you've grown the most in?"
- "Is there a case from this post that has stuck with you — and what did it teach you?"
- "When you look back at your first week here and now — what feels different in how you practise?"
- "What would you do differently if you could repeat this post from the start?"
- "What are you taking into your next post as your main personal development goal?"
Common Trainee Blind Spots — What to Look For as a Supervisor
- Over-investigation and over-referral: Many trainees, especially early in training, investigate or refer "just in case". This reflects uncertainty management — a key development area worth exploring in the CSR.
- Professionalism under pressure: How does the trainee behave when running late, dealing with a difficult patient, or receiving critical feedback? The CSR is a good place to note this.
- Self-directedness: Does the trainee identify their own learning needs and act on them, or do they wait to be told? This is often revealing of long-term professional development.
- Documentation quality under pressure: Many trainees write excellent notes when calm and rushed notes when busy. Note the difference if you see it.
🔴 Raising Serious Concerns
⚠️ When and How to Raise Concerns
If serious concerns arise about a trainee's performance, health, or conduct during a placement, they must not wait until the end-of-post CSR to be addressed.
Normal channels: Issues should be handled through the normal acute trust / primary care / deanery mechanisms.
Always contact early: The CS, ES, and Training Programme Director (TPD) should all be involved as early as possible — ideally as soon as a concern is identified, not at the end of the post.
Honest CSR: The CSR must honestly reflect any conduct, capability, or significant events that occurred during the post. A misleadingly positive CSR that conceals real concerns does not serve the trainee, patients, or the system.
For Trainees: If Your CSR Raises Unexpected Concerns
If the CSR raises issues that feel unfair, inaccurate, or that you were not told about during the post, you have the right to raise this. Speak to your Educational Supervisor at the ESR meeting, and if needed contact your Training Programme Director. Do not sign or accept a CSR that contains factually inaccurate statements without discussing this with your ES first.
Involvement in Conduct, Capability or Significant Events
The CSR includes a specific question about whether the trainee has been involved in a conduct, capability, or Significant Event during the post, and what the outcome was. This must be answered honestly. The existence of a significant event does not automatically indicate a problem — how the trainee responded and learned from it is what matters.
❓ Frequently Asked Questions
🏁 Final Take-Home Points
🏁 The Bits to Remember Tomorrow
- Find out who your Clinical Supervisor is on day one of every post — especially in hospital posts.
- The CS oversees this post. Your ES oversees your whole training. They are different roles, sometimes the same person in GP.
- Three formal meetings per post: induction → mid-post → CSR meeting. Don't wait to be invited. Arrange them yourself.
- The CSR is completed on FourteenFish ePortfolio and must be done before your ESR. This is your responsibility to chase.
- There are three versions of the CSR form — hospital, GP ST1/ST2, and GP ST3. The grading standard differs between them.
- "NFD – Meeting Expectations" is a positive result. You are in training. Everyone needs to develop. Only "Below Expectations" warrants concern.
- The entrustability question (supervision level 1–4) is one of the most important single items in the CSR. By ST3, you should be aiming for Level 3–4.
- Help your hospital CS create a FourteenFish account at the mid-post meeting — don't leave it to the final week.
- Prepare for the CSR meeting by self-reflecting on each domain in advance. A prepared trainee gets better feedback and a more useful report.
- Raise serious concerns early — with your TPD and deanery — don't save them for the end-of-post CSR.