We know that at this time there are uncertainties about what will happen with progression through the credential training programme and that this will be causing considerable anxiety.
The COVID-19 pandemic will lead to changes in learning opportunities for credential trainees both in terms of experiences and in assessment. Their ability to take part in essential training opportunities is already being compromised with the suspension of the NHS Breast Screening Programme, suspension in some areas of family history clinics and the need to minimise contact which will be impacting on credential trainees’ ability to attend surgical clinics. In addition, at a time when clinical teams are likely to be stretched significantly, opportunities for specific workplace-based assessments (WPBAs) may be limited.
Credential trainees’ welfare is very important to us and we will do all we can to provide clarity and reassurance to all involved in training. This advice details the RCR’s current advice for credential trainees and their supervisors, with the aim of ensuring that any disadvantages experienced in training are minimised and that trainees are appropriately supported. For further information and support please contact firstname.lastname@example.org.
Credential trainee welfare
As the situation progresses it is possible that credential trainees, like many specialty trainees, could be redeployed to critical care and exposed to clinical situations and decisions that they have not had to encounter until now. It is critically important that they do not feel isolated, that they have ready access to senior members of the team who can support decision making and that they feel part of a mutually supportive team. All credential trainees should have the ability to discuss their experiences in a clinical forum, with regular debriefing as circumstances allow. This should be performed in a positive way to provide training but also to facilitate sharing of experiences and concerns.
The four UK Statutory Education Bodies (HEE, NES, HEIW and NIMDTA), GMC, and AoMRC are providing guidance for specialty trainees and supervisors and updating this regularly. Links to this can be found on the COVID-19 training and education resources page of the RCR website. While aimed at those in formal specialty training programmes, it is also relevant for those on the credential programme and wherever possible, this advice should be followed.
Annual progression reviews
Progress in the credential is dependent on a satisfactory progression review at the end of each indicative year of training. In recognition of the impact the pandemic will have on training for those on the credential programme, the RCR has made the decision to allow for a pause in credential training, giving credential trainees the option to postpone the annual progression review that is scheduled for July if circumstances mean they are unable to continue normal training at this time. For the credential trainees opting for a postponement, we will plan for a three-month delay, aiming to reschedule the reviews for October. We will, however, keep this under constant review and update you if anything changes. If a credential trainee wishes to continue with the July review as scheduled we will do our best to accommodate this, although it will be dependent on panel member availability. Credential trainees will be contacted in the coming weeks to determine their preference.
For those opting to delay, all efforts will be made to keep to the October timeline and it may be necessary for the review panel to recognise that the credential trainee may not have had opportunity to gain all the necessary experiences, sat the required examination or completed the number of WPBAs that would normally be required, as outlined by the progression grids in the credential curriculum. If this is the case the review panel will use their professional judgement to assess whether the credential trainee has engaged with the training process during the year, in ways appropriate to the circumstances, and has sufficient evidence of this in the e-portfolio. The evidence required will include:
- completion of at least some of the necessary WPBAs
- an educational supervisor’s report, taking account of input from clinical supervisors, that is supportive of the credential trainee.
The review panel will indicate which, if any, of the essential components of the programme have been missed in the present training year so that the subsequent training can be tailored appropriately.
Many of the generic skills that we look for in doctors in training will come to the fore as they help to manage the many patients who may present to the hospital during this pandemic. There should be a significant attempt made to recognise their progression in generic capabilities as they apply themselves to clinical work in this extremely trying time.
It is hoped that this approach will ensure that any disadvantages experienced in training are minimised and all credential trainees are adequately supported, particularly those who may be redeployed to frontline service.
Impact of exam cancellations
We are aware that some credential trainees were planning to sit or re-sit the physics exam on 11 June however, the current situation has caused the cancellation of all FRCR exams until at least September. The next scheduled sitting of the physics exam is 10 September, the application window for which is due to open on 29 May. While at present the intention is to run this exam as normal, we are monitoring the situation closely and if that changes credential trainees and supervisors will be notified. For more information on the situation regarding all FRCR examinations see the separate statement on the website.
Credential trainee time off due to illness/self-isolation
Consideration must be given to any credential trainee who loses time at work as a result of developing COVID-19 symptoms, having specific health vulnerabilities that prevent them working at the present time, or self-isolating due to COVID-19 related concerns with a member of their household. Please refer to national guidance on this subject.
Funding of the pilot training and maintenance of the SLA
The National Breast Imaging Academy (NBIA) which is managing the HEE funding for this pilot is keen to support credential trainees in the pilot as flexibly as possible. It is hoped that the service level agreement (SLA) in place with each employing trust provides reassurance and security, enabling the employing trusts to support credential trainees through this pause in training to successful completion of the credential. In the event that substantial training time is lost due to COVID-19 and credential training is extended beyond the funded three years, the employing trust is obliged to support the credential trainee’s completion of the credential. Credential trainees and their supervisors should be assured that training must pick up where it left off once the crisis has passed and that the funding will remain present. This reflects the situation for specialty trainees.
Employing trusts can expect to receive confirmation from the NBIA that there is scope within the funding they have received to support their COVID-19 response by pausing training with any time lost being added to the end of the trainee’s three years.
Trainees recently recruited – deferral of start dates
A number of credential trainees have only recently been recruited. Some have only just begun training and others are due to start in the next couple of months. For those that have just started we would recommend a pause in training as detailed above. For those due to start soon we would recommend that employing trusts, supervisors and the credential trainee discuss possible deferment of their start date. It is unlikely that training sites will be in a position to begin training in the manner required at this time and deferring start dates until the Autumn is likely to be the better option for all concerned.
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