Timing of the annual assessment in relation to training year
It is acknowledged that not all trainees are being assessed at the end of their training year due to the timing of the ARCPs and changes in an individual’s anticipated CCT date for a variety of reasons.
Likewise many trainees have an annual ARCP (calendar years) whilst not undertaking 12 months of fulltime training during the time since the last assessment e.g. Less than full time training (LTFT).
In this situation the ARCP panel will judge the progress the trainee has made during, the time period, pro rata against the standards detailed in the Matrix (which describe the standards to be achieved over a 12 month period).
The educational supervisor must confirm that the trainee has met the specific requirements to pass through way points (see below). Alternatively a panel may wish to have a further formal assessment.
Failure to achieve all the competencies and standards
If there is failure to achieve any standard for that training year then the trainee should not be issued an outcome 1. The determination of which alternative outcome will be made by the ARCP panel with the advice and support of the LETB as appropriate. This document provides the RCOG guidance for the ARCP outcome to be issued for trainees who fail to achieve the standards. The purpose is to provide consistency between deaneries, and within deaneries between ARCP panels.
ARCP outcome 2
The issuing of an outcome 2 signifies that the development of specific competences are required, but additional training time is not required. This will enable the Postgraduate Dean (PGD) to ensure that the trainee’s next attachment will be appropriate to achieve the necessary training opportunities.
An outcome 2 should not be regarded as a failure by the trainee, but as an opportunity to undertake an educational package that will help the trainee achieve the standard.
An outcome 2 does not alter the CCT date for the trainee. Trainees issued with an outcome 2 at the end of ST5 should usually be allowed to register for ATSMs.
ARCP outcome 3
The issuing of an outcome 3 will enable the trainee to obtain specific competencies with additional training time. It should be noted that the total additional training time available to trainees is limited to one year as outlined in the Gold Guide 2016. Exceptionally this additional training time may be extended at the discretion of the PGD, but with an absolute maximum of 2 years within the total duration of the training programme.
For LTFT trainees, should an extension to training be required following the award of Outcome 3, this will be on a pro rata basis if training requirements for progression have not been met. If an extension to training is required following the award of Outcome 3 and the LTFT trainee has failed to progress solely on the basis of exam failure, then an extension to training will be on a fixed-term basis and is not pro rata.
ARCP outcome 4
Issuing an outcome 4 means the ARCP panel recommends releasing the trainee from the specialty training programme, following insufficient and sustained lack of progress despite having had up to 1 year of additional training to address concerns.
ARCP outcome 5
Outcome 5 is reserved for a very small number of cases where the panel can make no statement about progress or otherwise since the trainee has supplied either no information or incomplete information to the panel.
The trainee will have to supply the panel with a written account within five working days as to why the documentation has not been made available to the panel.
The panel does not have to accept the explanation given by the trainee and can require the trainee to submit the required documentation by a designated date, noting that available “additional” time is being used in the interim.
If the panel accepts the explanation offered by the trainee accounting for the delay in submitting their documentation to the panel, it can choose to recommend that additional time has not been used.
Once the required documentation has been received, the panel should consider it (the panel does not have to meet with the trainee if it chooses not to and the review may be done “virtually” if practicable) and issue an ARCP outcome.
Alternatively, the panel may agree what outstanding evidence is required from the trainee for Outcome 1 (and the timescale in which it must be provided) and give authority to the Chair of the panel to issue Outcome 1 if satisfactory evidence is subsequently submitted. However, if the Chair does not receive the agreed evidence to support Outcome 1, then a panel will be reconvened.
Outcome 5 should also be recommended as a consequence of failure to submit Form R.
ARCPs at key way points in the curriculum (ST2 and ST5)
There are key Way Points in the curriculum for obstetric and gynaecology trainees when the ARCP process is particularly important. It is particularly important to ensure that trainees are clinically competent to move from junior to middle grade level (ST2-3) and from middle to a senior trainee level (ST5-6).
At important Way Points the trainee needs to provide evidence to confirm they have achieved the competences and achievements as stated in the matrix. An outcome 3 should normally be issued if they have failed to achieve these targets listed:
- ST2s should have passed Part 1 MRCOG; completed the basic logbook competencies; and have the OSATS as listed in the Matrix of Educational Progression confirming that they have the skills to work 2nd on call in obstetrics and gynaecology. If they have achieved the competencies to work 2nd on call but failed to pass MRCOG Part 1 then the trainee can be allowed to work 2nd on call under the educational plan issued after an outcome 3. Manual removal of placenta (MROP) is a specific exception to this. Please see the table below for details.
- ST5s should have passed MRCOG; completed the core section of the logbook; completed the basic ultrasound modules, have undertaken all appropriate training as specified in the Matrix of Educational Progression; and have all the OSATS listed in the matrix to show evidence of practical procedures competences required to move to ST6 level. Trainees issued with an outcome 2 at the end of ST5 should be allowed to register for ATSMs. Trainees issued with an outcome 3 should not register for an ATSM until the ARCP panel have agreed that the standards to pass to ST6 have been met.
The ARCP provides a formal process that uses the evidence collected by the trainee, relating to their progress in the training programme.
It should normally be undertaken on at least an annual basis for all trainees in specialty training, and it will enable the trainee, the Postgraduate Dean and employers to document that the competences required are being gained at an appropriate rate and through appropriate experience.
The process may be conducted more frequently if there is a need to deal with performance and progression issues outside the annual review. It is not in itself a means or tool of assessment.
Using the matrix of educational progression to screen for potential future issues
The matrix of educational progression (available at the top of this page) is a useful objective tool for benchmarking trainees. For guidance regarding the ARCP outcome for each of the standards within the matrix, please read the screening for future issues page.
If you have any questions about ARCPs that can’t be resolved at deanery/local level, please email the Policy Coordinator or call +44 20 7772 6294.