In response to the current workforce crisis that is affecting breast imaging services in the UK, the College is working with the Association of Breast Clinicians (ABC) and Health Education England (HEE) to develop and pilot a credential in breast disease management with two main aims:
- to standardise and recognise the training of breast clinicians
- to increase the breast clinician workforce to support breast screening and symptomatic services
The implementation of this credential through a pilot programme for 10 trainees in England has the support of Health Education England (HEE) which will be providing funding of £30,000 per trainee per year for the three years of the pilot.
ABC has drafted its Vision for the future which outlines how the pilot trainees will contribute to, and support the service once trained.
The credential curriculum is based around a number of high-level capabilities in practice. This is what a breast clinician will be expected to be able to do upon completion of the training. It includes considerable overlap with the breast content of the clinical radiology curriculum as well as covering clinical examination, risk factors such as family history and genetics, and the understanding of the use of prognostic and biological factors that influence oncological treatments. Download the curriculum to see the full programme.
Trainees will be required to pass the physics module of the First FRCR Examination in their first year of training. In addition to the physics examination, assessment is workplace based and formative in nature leading to an annual review and summative assessment to confirm progress. Full details of the assessment programme are included in the curriculum. Trainee breast clinicians will be given access to the RCR’s trainee e-portfolio, Kaizen, to document progress. Kaizen user guides are available for trainees and for supervisors.
Structure of training
The three year training programme detailed in the curriculum covers multiple elements of training which will be learnt concurrently, and will often dovetail across each other. There is no definite order in which each element of training or capability in practice should be undertaken but in order to provide some structure and logical progression in training, the first year focuses on clinical skills, family history, and physics teaching in order to pass the FRCR examination. The clinical and family history skills are built on during the second year whilst now incorporating imaging interpretation and reporting, in a highly supervised capacity. During the final year, increasing independence is expected in ultrasound and mammography work in addition to interventional procedures such as biopsy and localisation. Trainees will be employed by the breast screening units which will largely lead the training, but they will also be linked to the local radiology training programme to access relevant training and physics teaching.
Review of progression
Closely based on the Annual Review of Competence Progression (ARCP) process for specialty training, the review of credential trainees will be carried out by a national panel, convened by the Credential Project Board. A national review panel will ensure that a consistent standard is applied to all trainees across all training sites in this small pilot programme. It will be wholly independent of any of the pilot sites thereby ensuring impartiality and avoiding decisions on progression being made by the same people responsible for the training of any individual trainee. The 'Process for the review of trainee performance and progression' gives full details of the process and the panel.
Guidance for pilot sites
We have drafted a guidance document for the pilot sites which covers a variety of areas including the structure of training, supervision arrangements, the support that is expected to be given to trainees and much more. We hope this will be useful but if there is any other information you require please contact us.
Guidance on supervision
HEE has produced a suite of resources providing guidance on "Enhancing Supervision for Postgraduate Doctors in Training". This is of relevance for both trainees and supervisors in this programme and we would urge all those involved to read these documents:
- A report that sets out the different kinds of supervision (educational, clinical and workplace) and what good supervision looks like
- A handbook for trainees and trainers
- A benchmarking document for Trusts to help them to assess whether they are providing good supervision
- An animation for trainees explaining in simple terms what good supervision looks and what they should expect from their supervisors.
The pilot programme
With HEE’s support a pilot programme has been implemented in England starting in August 2019. Pilot locations are listed below along with their recruitment status.
|Region||Employing trust||Host site||Number of trainees||Link to job advert*||Closing date||Status|
|North East||Newcastle upon Tyne NHS Foundation Trust||Royal Victoria Infirmary||1||Job advert||CLOSED||1 appointment made|
|North West||Manchester Foundation Trust||Nightingale Centre, MFT, Manchester||1|
|1 apointment made|
|South East||InHealth Limited||Jarvis Breast Centre, Guildford||1||Job advert||As soon as sufficient applications are received|
|South East||Mid Essex Hospital Services NHS Trust||Broomfield Hospital, Chelmsford||1||Job advert||CLOSED||Shortlisting|
London North West University Healthcare NHS Trust
|Northwick Park Hospital||1|
|South West||Royal United Hospitals Bath NHS Foundation Trust & North Bristol Trust||RUH Bath & Bristol Breast Care Centre||2|
RUH Bath: Job advert
NBT: Job advert
|2 appointments made|
|South West||Gloucestershire Hospitals NHS Foundation Trust||Cheltenham General Hospital||1||CLOSED||1 appointment made|
|South West||Taunton & Somerset NHS Foundation Trust||Musgrove Park Hospital||1||CLOSED||Shortlisting|
|Yorkshire & Humber||Leeds Teaching Hospital NHS Trust||Leeds Teaching Hospital NHS Trust||1||Job advert||CLOSED||1 appointment made|
Recruitment of pilot participants
Individual training posts are being advertised and recruited to locally by each pilot site, using the same nationally agreed person specification. Jobs are being advertised on NHS Jobs and links to each advert are in the table above. Successful appointments made will be added as soon as the RCR is informed of them.
The first trainees in the pilot started training in late August 2019. Exact start dates for trainees vary slightly depending on their location and the timescale of their recruitment.
The credential training programme will be open to anyone post-Foundation Training but it is anticipated that it may be attractive to those currently in SAS posts or those looking for a change of career and a better work/life balance. The person specification details the entry requirements and the curriculum details the content of the training programme.
As soon as each pilot site starts to recruit links to the job adverts will be added to the table above.
Welcome day for trainees and supervisors
We held a welcome day for credential trainees and their supervisors on Monday 30 September 2019 at the RCR.