Annual review of competency progression (ARCP)
14 May 2020
The four UK Statutory Education Bodies have published updated guidance for ARCPs, which provides a generic ARCP decision aid for ARCPs taking place between May 2020 and August 2020. This decision aid incorporates derogations to the Gold Guide, which include two new ARCP outcomes and new coding for ARCP outcomes that allow recognition of the impact of COVID-19 on training. They have also published guidance for managing extensions to training during COVID-19.
The RCR has amended curriculum requirements to allow trainees affected by COVID-19 to progress at ARCP where possible, provided that they are otherwise making expected progress. These changes have been approved by the GMC and will apply to ARCPs held from May 2020 until August 2020. We have produced specialty-specific guidance that outlines these changes and is intended to support ARCP panels in applying the generic guidance to clinical radiology and clinical oncology:
- guidance and amended decision aids for clinical and interventional radiology ARCP
- flowchart for clinical and interventional radiology ARCP
- guidance and amended decision aids for clinical oncology ARCP
- flowchart for clinical oncology ARCP
Trainees in England are now required to complete a self-assessment form prior to ARCP, to document the impact of COVID-19 on their training. This form is available from HEE local offices. We recommend that trainees discuss this with their educational supervisor before the educational supervisor's report is completed. This is not a requirement in the devolved nations.
For radiology trainees who anticipate a three month period or longer away from training, we have adapted our return to training toolkit to facilitate a structured and supported return to training following the COVID-19 period. These new COVID specific resources are available on the supported return to training page and can be uploaded to Kaizen to facilitate discussion with supervisors.
Implementation of the new clinical radiology and interventional radiology curricula has been postponed until 2021 - see the curriculum webpages for further information.
26 March 2020
Progress in specialty training is dependent on a satisfactory ARCP. In a statement released on 19 March 2020, the four UK Statutory Education Bodies set out a contingency policy for ARCPs. This policy details the minimum level of engagement required to ensure that the ARCP process can proceed this year, however the precise mechanism by which the ARCP operates will be decided by each local office or deanery and remains their responsibility.
The ARCP process must recognise that the trainee may not have had opportunity to gain all the necessary experiences, sat required examinations or completed the number of WPBAs that would normally be required, as outlined by the decision aid for the relevant specialty. Furthermore, trainees may have experienced modification of their rotations that may have impacted their learning opportunities. It is strongly recommended that ARCP panels should use their professional judgement to assess whether the 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. It is recommended that the evidence required should 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 trainee.
The ARCP should 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.
Trainees may find it useful to document the level of training they were at prior to any redeployment/change in rotation or period of absence to ensure that their return to normal training accurately recognises their individual level of competence. For radiology trainees the 'prior to absence' form that is part of the radiology SuppoRTT toolkit has been adapted for this purpose. The new COVID19-record of radiology training status form is available for all radiology trainees to use if they wish.
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.
If trainees have recently had an outcome 3 and are in a period of extended training time, allowing them further extension without having met the requirements should be considered if the current situation has made it difficult or impossible for them to do so.
Impact of exam cancellations
The current situation has caused the cancellation of FRCR exams for both specialties. Progression at some points in training usually requires trainees to have passed specific parts of the FRCR exams. If they have not attained a pass in the required exams, trainees are usually issued an ARCP outcome 3 or 5, depending on individual circumstances.
However, in the current emergency, trainees will be able to progress to the next stage of training if cancellation of exams has meant that they have not had the opportunity to meet this requirement, provided that their educational and clinical supervisors are confident that they are otherwise competent to do so and they meet the requirements set out under the guidance for ARCP, above.
Progression in training will continue to be assessed over the 2020-2021 training year and no trainee will progress further without attaining the necessary parts of the FRCR. Interim ARCPs may be appropriate to review the position for some trainees if they fail examinations once normal operations have resumed. Trainees who have not achieved this by the end of the next training year will be reviewed at their ARCP and will likely be issued with an outcome 3 to extend training by an agreed period.
Completion of training
Trainees in both specialties would normally be expected to have passed all parts of the relevant FRCR exams before entering the final year of training. Trainees will not be awarded a certificate of completion of training (CCT) without obtaining FRCR. Where there are examinations and/or specific practical capabilities that are critical to progression to CCT the trainee must review with their educational supervisor whether these can be achieved within the anticipated training time that is left or whether an extension to training should be sought. Given the unprecedented nature of the crisis and how long it may go on for there may need to be extensions to training times. We would expect that ARCP panels recognise this and usual time limits do not apply. Additional training time may be specific to different trainees at different stages in training in the absence of a blanket suspension of training.
Trainees currently out of programme (OOP)
It is recognised that out of programme time, whether for research, teaching or other experience, can be an important part of training and at the present time it is not suggested that all trainees should return immediately to clinical training. This, however, will be subject to local decision-making and trainees should discuss with their supervisor(s) the best course of action to take. For any that do suspend their OOP time to return to clinical training we would look at supporting individuals to resume their OOP as soon as possible after the current situation eases. Our recommendation is that trainees who are suspending OOP arrangements should notify their TPD in advance and subsequently agree the impact on their training progress with their TPD afterwards, taking account of competency and minimum training times.
OOP trainees who under normal circumstances would be expecting to return to training during this period should ideally discuss the plans for this with their TPD, though this may not be practical. Where possible, they should return to training as planned, with the same support that they would have at any other time. As above however, this will be subject to local decision-making and trainees should discuss with their supervisor(s) the best course of action to take. HEE has published advice for those returning to training at this time.
Trainee time off due to illness/self-isolation
Consideration must be given to any trainee who loses time at work as a result of develop 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 soon to be published.
Updated 14 May 2020