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Better assessment of doctors in training will cut burden

Trainee doctors could be allowed to pause and re-enter training more easily, without penalty

Louise Prime

Thursday, 22 February 2018

Doctors in training could be allowed to pause and re-enter training more easily, and should have improved assessment, appraisal and feedback on their progress, under new proposals from Health Education England (HEE). They also recommend offering greater support to people who support others’ training.

HEE has completed its review of the Annual Review of Competency Progression (ARCP) process, which it started because doctors in training had raised concerns about inconsistencies in how their performance was assessed under the current system. Trainees had said that the process was stressful, burdensome and did not always provide them with the support or feedback they needed, and was applied inconsistently depending on geography or specialty.

The review has, over the past year, undertaken a call for evidence; actively engaged with the BMA, General Medical Council, Medical Royal Colleges among others; and has canvassed the views of trainees themselves.


HEE makes several recommendations that it said will support the delivery of safe, high quality patient care, by promoting greater support and career development to healthcare professionals; and it emphasises that training should be flexible and support those who wish to take time out. The planned improvements include:
  • Making the ARCP process more uniform across the country, with assessment requirements that do not change during the training year, ensuring that trainees and those who support them know what they have to do to prepare for their ARCP, how the process itself will work and what feedback and support they can expect, whether they work full-time or part-time.
  • Making it easier for trainees to temporarily come out of their training, for example to undertake research or for family reasons, and then restart training without losing credit for skills already gained.
  • Development for doctors not in formal training to enable progression within the profession, and enhanced support for those doctors who are preparing to re-enter training after time out.
  • Ensuring that every doctor in training gets feedback on their training, clarifying the support around doctors in training and the role of educational supervisors and ensuring trainers have sufficient time and training to deliver.
  • Applying the principles established through the review about high quality appraisal and assessment to benefit other healthcare professionals who wish to train to expand their skills and scope of practice as part of multidisciplinary teams.
HEE’s executive director of education and quality, and national medical director, Professor Wendy Reid said: “Doctors in training don’t need a process that is overly burdensome and adds additional pressure to what is already a very challenging front-line job.

“The assessment process remains an important part of ensuring patient safety, as it provides evidence of the progress doctors in training are making and assures the public that they are in safe hands. What we have to make sure is that it works for all involved.

“The review has highlighted what we can do to improve things to make doctors in training feel valued, such as not waiting until the end of the year for feedback and support, but having more regular face to face feedback and support that also acknowledges where they are excelling.”

She added that there are many reasons why the review had found variation in how the system works across the country, but it is important that the system is fair and consistent. She said: “There needs to be a more standardised and consistent approach so doctors in training go through the same process regardless of where they are based and what hours they work.”

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