To ensure a consistent approach to assessment and progression through training, the RCOG has developed a matrix of educational progression.
The matrix provides guidance on all aspects of training, both clinical and non-clinical, for each year of training. The matrix is updated annually in consultation with the Heads of School.
2021-2022 matrix of progression COVID-19 for ST6-7 who have switched to the 2019 core curriculum
ST1-2
|
|
ST1 |
ST2 |
|
Curriculum progression |
CiP progress appropriate to ST1 as per the CiP guides and matrix of entrustability levels.
|
CiP progress appropriate to ST2 as per the CiP guides and matrix of entrustability levels. |
|
Examinations |
|
MRCOG Part 1 |
|
At least 3 summative OSATS (unless otherwise specified) confirming competence by more than one assessor. At least one OSATS confirming competence should be supervised by a consultant. (can be achieved prior to the specified year) |
|
Caesarean section (basic)Ω Non-rotational assisted vaginal delivery (ventouse) Non-rotational assisted vaginal delivery (forceps) Perineal repair Surgical management of miscarriage/surgical termination of pregnancy Insertion of IUS or IUCD*
|
|
Derogated competencies |
Cervical smear |
Endometrial biopsy |
|
|
Where trainees are progressing satisfactorily, but acquisition of the above derogated competencies has been delayed as a result of COVID-19, they are able to successfully progress to the next stage of training with and ARCP 10.1. In line with GMC guidance we expect that competencies which have not been demonstrated will be provided as part of evidence for the next ARCP but also recognise that in the current circumstance it may take longer for trainees to catch up; if at critical progression point trainess can progress to next stage of training. CCT can only be awarded when all required experience and competencies have been achieved. Where trainees are missing elements of this as a result of COVID-19, an outcome 10.2 should be awarded and training time extended. |
|
|
Formative OSATS |
Optional but encouraged |
|
|
Mini-CEX |
✓ |
✓ |
|
CBD |
✓ |
✓ |
|
Reflective practice |
✓ |
✓ |
|
NOTSS |
✓ |
✓ |
|
TEF |
Not required for 2021 ARCPs |
Not required for 2021 ARCPs |
|
TO2 |
From the next rotation (August 2022 onwards), two separate TO1's and TO2's will be required. For the 2022 ARCP one will suffice unless significant concerns are raised. |
From the next rotation (August 2022 onwards) two separate TO1's and TO2's will be required. For the 2022 ARCP one will suffice unless significant concerns are raised |
|
Required courses / required objectives
|
Basic Practical Skills in Obstetrics and Gynaecology CTG training (usually eLearning package) and other local mandatory training Obstetric simulation course (e.g. PROMPT/ ALSO/other) |
Basic ultrasound 3rd degree tear course Specific courses required as per curriculum to be able to complete basic competencies Resilience course |
|
The above competencies may be achieved by attending recommended courses or by demonstrating to the ARCP panel that content and learning outcomes have been achieved using alternative evidence. Trainees who do not demonstrate the required objectives or attendance at the relevant course will be awarded a 10.1. |
||
ST3-5
|
|
ST3 |
ST4 |
ST5 |
|
Curriculum progression |
CiP progress appropriate to ST3 as per the CiP guides and matrix of entrustability levels. |
CiP progress appropriate to ST4 as per the CiP guides and matrix of entrustability levels. |
CiP progress appropriate to ST5 as per the CiP guides and matrix of entrustability levels. |
|
Examinations |
|
|
MRCOG Part 2 MRCOG Part 3** |
|
At least 3 summative OSATS (unless otherwise specified) confirming competence by more than one assessor (can be achieved prior to the specified year) |
Manual removal of the placenta Transabdominal ultrasound of early pregnancy Transabdominal ultrasound of late pregnancy |
Hysteroscopy Diagnostic laparoscopy 3rd degree perineal repair
|
Simple operative laparoscopy (laparoscopic sterilisation or simple adnexal surgery e.g. adhesiolysis/ ovarian drilling) Caesarean section (intermediate)Ω Rotational assisted vaginal delivery (any method) |
|
Derogated competencies |
Surgical management of retained products of conception (Obstetrics†) Vulval biopsy |
Endometrial ablation |
|
|
|
Where trainees are progressing satisfactorily, but acquisition of the above derogated competencies has been delayed as a result of COVID-19, they are able to successfully progress to the next stage of training with and ARCP 10.1. In line with GMC guidance we expect that competencies which have not been demonstrated will be provided as part of evidence for the next ARCP but also recognise that in the current circumstance it may take longer for trainees to catch up; if at critical progression point trainess can progress to next stage of training. CCT can only be awarded when all required experience and competencies have been achieved. Where trainees are missing elements of this as a result of COVID-19, an outcome 10.2 should be awarded and training time extended.
|
||
|
Formative OSATS |
Optional but encouraged
|
||
|
Mini-CEX |
✓ |
✓ |
✓ |
|
CBD |
✓ |
✓ |
✓ |
|
Reflective practice |
✓ |
✓ |
✓ |
|
NOTSS |
✓ |
✓ |
✓ |
|
TEF |
Not required for 2021 ARCPs |
Not required for 2021 ARCPs |
Not required for 2021 ARCPs |
|
TO2 |
From the next rotation (August 2022 onwards) two separate TO1's and TO2's will be required. For the 2022 ARCP one will suffice unless significant concerns are raised. |
From the next rotation (August 2022 onwards) two separate TO1's and TO2's will be required. For the 2022 ARCP one will suffice unless significant concerns are raised. |
From the next rotation (August 22 onwards) two separate TO1's and TO2's will be required. For the 2022 ARCP one will suffice unless significant concerns are raised. |
|
Required courses / required objectives
|
Obstetric simulation course – ROBUST or equivalent. The above competencies may be achieved by attending recommended courses or by demonstrating to the ARCP panel that content and learning outcomes have been achieved using alternative evidence. Trainees who do not demonstrate the required objectives or attendance at the relevant course will be awarded a 10.1. |
||
ST6-7
|
|
ST6 |
ST7 |
|
Curriculum progression |
CiP progress appropriate to ST6 as per the CiP guides and matrix of entrustability levels. |
CiP progress appropriate to ST7 as per the CiP guides and matrix of entrustability levels. |
|
Examinations |
|
|
|
At least 3 summative OSATS (unless otherwise specified) confirming competence by more than one assessor. At least one OSATS confirming competence should be supervised by a consultant. (can be achieved prior to the specified year) |
|
Subspecialty training specific Caesarean section (complex)Ω Laparoscopic management of ectopic pregnancy Ovarian cystectomy (open or laparoscopic) Surgical management of PPH*¥ |
|
|
Where trainees are progressing satisfactorily, but acquisition of the above derogated competencies has been delayed as a result of COVID-19, they are able to successfully progress to the next stage of training with and ARCP 10.1. In line with GMC guidance we expect that competencies which have not been demonstrated will be provided as part of evidence for the next ARCP but also recognise that in the current circumstance it may take longer for trainees to catch up; if at critical progression point trainess can progress to next stage of training. CCT can only be awarded when all required experience and competencies have been achieved. Where trainees are missing elements of this as a result of COVID-19, an outcome 10.2 should be awarded and training time extended. |
|
|
Formative OSATS |
Optional but encouraged |
|
|
Mini-CEX |
✓ |
✓ |
|
CBD |
✓ |
✓ |
|
Reflective practice |
✓ |
✓ |
|
NOTSS |
✓ |
✓ |
|
TEF |
Not required for 2021 ARCPs |
Not required for 2021 ARCPs |
|
TO2 |
From the next rotation (August 2022 onwards) two separate TO1's and TO2's will be required. For the 2022 ARCP one will suffice unless significant concerns are raised. |
From the next rotation (August 2022 onwards) two separate TO1's and TO2's will be required. For the 2022 ARCP one will suffice unless significant concerns are raised. |
|
Required courses / required objectives
|
Basic Practical Skills in Obstetrics and Gynaecology CTG training (usually eLearning package) and other local mandatory training ATSM course Leadership and Management course |
Basic ultrasound 3rd degree tear course ATSM course Leadership and Management course |
|
The above competencies may be achieved by attending recommended courses or by demonstrating to the ARCP panel that content and learning outcomes have been achieved using alternative evidence. |
||
† Surgical management of retained products of conception (Obstetrics)- surgical evacuation of retained products of conception after 16 weeks gestation using suction curettage or a surgical curette
¥ Surgical techniques used by the trainee to control postpartum haemorrhage, including intra-uterine balloons, brace sutures, uterine packing, placental bed compression sutures, and hysterectomy
Ω Caesarean section complexity
- Examples of ‘basic’: first or second caesarean section with longitudinal lie
- Examples of ‘intermediate’: are twins/transverse lie, preterm more than 28 weeks, at full dilation, BMI≥40
- Examples of ‘complex’: preterm less than 28 weeks/grade 4 placenta praevia and fibroids in lower uterine segment
Further guidance on evidence required for CiPs in the Core Curriculum
The philosophy of the new curriculum is about quality of evidence rather than quantity and a move away from absolute numbers of workplace based assessments (WBAs) and the tick box approach and the new training matrix above demonstrates this.
The CiP guides developed are available for trainers and trainees to give information about what would be appropriate evidence at different stages of training CiP guides.
Rules for CiPs:
- There must be some evidence linked to each CiP in each training year to show development in the CiP area.
- In each stage of training (Basic ST1-2, Intermediate ST3-5, Advanced ST6-7) the expectation is that there should be a minimum of one piece of evidence linked to each key skill for all clinical and non-clinical CiPs. This evidence needs to be appropriate for the stage of training.
Expected progress for clinical CiPs
| Basic training | |||
|---|---|---|---|
| Capabilities in practice | ST1 | ST2 | |
| CiP 9: The doctor is competent in recognising, assessing and managing emergencies in gynaecology and early pregnancy. | 1 | 2 | Critical progression point |
| CiP 10: The doctor is competent in recognising, assessing and managing emergencies in obstetrics. | 1 | 2 | |
| CiP 11: The doctor is competent in recognising, assessing and managing non-emergency gynaecology and early pregnancy. | 1 | 2 | |
| CiP 12: The doctor is competent in recognising, assessing and managing non-emergency obstetrics. | 1 | 2 | |
Expected progress for clinical CiPs
| Intermediate training |
||||
|---|---|---|---|---|
| Capabilities in practice | ST3 | ST4 | ST5 | |
| CiP 9: The doctor is competent in recognising, assessing and managing emergencies in gynaecology and early pregnancy. | 3 | 4 | Critical progression point | |
| CiP 10: The doctor is competent in recognising, assessing and managing emergencies in obstetrics. | 3 | 4 | ||
| CiP 11: The doctor is competent in recognising, assessing and managing non-emergency gynaecology and early pregnancy. | 3 | |||
| CiP 12: The doctor is competent in recognising, assessing and managing non-emergency obstetrics. | 3 | |||
Expected progress for clinical CiPs
| Advanced training | CCT | ||
|---|---|---|---|
| Capabilities in practice | ST6 | ST7 | |
| CiP 9: The doctor is competent in recognising, assessing and managing emergencies in gynaecology and early pregnancy. | 5 | Critical progression point | |
| CiP 10: The doctor is competent in recognising, assessing and managing emergencies in obstetrics. | 5 | ||
| CiP 11: The doctor is competent in recognising, assessing and managing non-emergency gynaecology and early pregnancy. | 4 | 5 | |
| CiP 12: The doctor is competent in recognising, assessing and managing non-emergency obstetrics. | 4 | 5 | |