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Training Requirements for the Matrix FAQs

These FAQs, produced by the Trainees Committee, aim to address issues relating to the requirements of the Matrix of Educational Progression.


What evidence is required to sign off logbook competencies?

This should not vary significantly between regions, educational supervisors and ATSM preceptors. The matrix should help to standardise the process.

Some competencies may be directly observed by your educational supervisor and need no further evidence, but OSATs, CBDs, mini-CEX, reflective practice and records of attendance at teaching sessions can all be used to provide evidence using the link function of the logbook. Minor variations do exist between LETBs/ Deaneries and if so the Head of School will clarify with you and your educational supervisor if there are concerns.

On the training matrix it says as ST1s we need evidence of training for MROP and forceps etc, but on the supervisor end of year report there are spaces for summative and formative OSATs, do we need to complete all of these each year?

The end of year supervisors report is a generic form across all years and so may have skills that are not appropriate for your training level. You only need to complete those boxes that are relevant for your training grade following the matrix.  However, make sure you keep up to date with the training matrix as changes are made at the start of each training year.

Can senior trainees sign off curriculum items from the log book?

Those trainees who have completed MRCOG and are now members of the college and participate in clinical supervision of junior colleagues are considered tier 2 medical educators. They can therefore complete logbook competencies that are required to be completed by the end of ST2/basic level. All other logbook competencies need sign off by a consultant.

Which grade of colleague can sign off which form, and does a post-CCT doctor count as a consultant?

OSATS, Mini-CEXs and CBDs can be completed by Senior Colleagues including trainees who have been themselves signed off as competent to perform the procedure without direct supervision.  At all levels, for any OSAT one of the 3 summative forms needs to be completed by a consultant. Forms have to be filled in by a number of different seniors. 

On some occasions it may be appropriate for clinicians in other specialties to complete OSATs, for example senior midwives completing perineal repair OSATs, or sonographers completing ultrasound OSATs. It is important to note however that only those competent to perform a procedure without direct supervision can complete a WBA for that procedure. 

Exactly who is considered as a consultant may vary between LETBs/ Deaneries and is at the discretion of your Head of School. If in doubt you can enquire from your Head of School whether post CCT trainees who are on the specialist register or locum consultants can complete these forms as a consultant in your region. In addition your Educational Supervisor will go through all of your WBAs with you at your educational meeting to ensure quality. 

Is it only consultants that can sign off summative OSATS to confirm continuing competence for those skills that you have already gained 3 adequate summative OSATs?

Yes.

Can consultant summative OSATs from ST1 be carried forward to ST2? For example, I have a consultant summative OSAT for surgical management of miscarriage in ST1 and then 2 summative OSATs for the same thing in ST2 completed by trainees- will I need a consultant summative OSAT in my ST2 year as well?

Yes, you would need a consultant summative OSAT confirming competence in ST2, or if you had achieved 3 competent assessments in ST1 you would need a consultant summative OSAT in ST2 to confirm ongoing competence.

For the majority of trainees ARCP is in May and we rotate in August, do assessments done in between count for new training year and if so where do we put them on eportfolio?

Assessments completed after ARCP, but prior to progressing to the next year of training should be filed in the same (preceding) year of the portfolio. The ARCP is an annual review to assess that you are progressing adequately with your training, but the training year is still 12 months. However, these documents would be available for review at your next ARCP and could count towards appropriate targets for OSATs etc.

Who can complete Summative OSATS to assess continuing competence?

Each year at least one of the Summative OSATS to assess continuing competence must be completed by a consultant. You may wish to complete more than this to evidence different aspects of your training and if so these could often be completed by ST6-7s. Formative OSATs can be completed by more junior trainees if they are signed off as competent for the particular skill being assessed.

For the ST5 waypoint on the matrix 3 OSATs for rotational assisted vaginal deliveries are needed. Which methods are acceptable?

The training matrix states ‘any method’. You should gain 3 summative OSATs showing you are competent in any method of instrumental delivery you go on to use independently eg ventouse, manual rotation and forceps or rotational forceps. If you have not achieved 3 competent OSATs in one method you would not be competent to perform rotational deliveries without supervision.

When filling in Reflective Practice forms I can opt to share them or keep them private, which forms should I keep private?

The reflective practice forms are a useful tool to give structure to a process of improving, challenging and exploring our day to day practice. There may be occasions when you feel it would be useful to use the structure of the tool, or the act of writing, to more deeply engage with a recent clinical experience, but do not feel it is relevant  to share. On other occasions you may not yet be ready to share the experience. In these cases place it in the private area, but remember you can edit this to include it in the shared area at a later date if you feel it would be useful. The forms which you are using to satisfy the matrix requirements MUST be seen by your educational supervisor when completing the end of year report.

I am currently an ST1 and work LTFT at 60%. ARCP deadlines are fast approaching, how much of the ARCP paperwork do I need to complete?

As a LTFT trainee you need to complete the ST1 competencies in the equivalent training time, for example if you work at 60% it will take 20 months to achieve the equivalent of 12 months of full time training. At 12 months you will have completed just over 7 months of training equivalence. Therefore at ARCP your progress will be judged on a pro rata basis.

You will need to complete the TEF annually and you should have competed at least one TO2. It is important to still have regular meetings with your educational supervisor at least every 6 months throughout your training. You may find the FAQs about less than full time training helpful.

What are the current requirements for the DRSH diploma in our training?

The Diploma of the Faculty of Sexual and Reproductive Healthcare is no longer a requirement for your training, neither the e-learning nor the practical component. You may find it useful as a way to help evidence your competence for the relevant intermediate competencies, or there may be other ways to complete the relevant learning.

What are the WBPAs required for those of us in Sub-specialty training?

In the first 5 years of training all trainees work with a mixture of Obstetrics and Gynaecology and assessments reflect this. In ST6-7 the WBAs should reflect the attachments undertaken. Certain SSTs work in units with no or minimal exposure to some parts of our routine workload, for example Oncology trainees who work in units without Obstetrics or Obstetric SSTs who work in units with minimal gynaecology. In these situations your WBPAs will reflect that and this is appropriate, however you must still fulfil the matrix requirements eg evidence ongoing competency with 1 summative OSAT for complex caesarean section and another for operative laparoscopy.

What is the TEF form? Is it the same as the GMC survey?

No, the TEF (Trainee Evaluation Form) form is a separate survey and is run from the RCOG. There are 2 national mandatory surveys each year. Your deanery may also have a local survey each year. The GMC survey yields national results across all specialties and allows bigger trends to be seen, however there are only a limited number of specialty specific questions (SSQs) within the questionnaire. The TEF is run from the college and gives more detailed information about O&G training standards both across the UK, and also in individual trusts. It is also useful to be able to triangulate the results from these and other sources to give a more complete picture of training in different units and regions.

Which part of our training are the RCOG responsible for, and which parts are the GMC and Deanery responsible for?

The RCOG sets the standards for training in Obstetrics and Gynaecology, but it is the GMC that is responsible for ensuring and assessing you are adequately trained to those standards. They do not carry this out directly but delegate the responsibility to the LETBs (Local Education and Training Boards) / Deanery who appoint a Head of School (or equivalent) to oversee training in each specialty. It is up to the Head of School and the Post Graduate Dean or their Deputy to interpret these standards at a local level. This can lead to some degree of variance between regions on the implementation of the standards, but overall the matrix, logbook, and ARCP ensure a good deal of congruity in training across the UK. The mainstay of the assessment of your training is the ARCP

In addition to this the GMC is also responsible for ensuring the revalidation of all doctors not just trainees. This is to ensure trainees are fit to practice. For trainees this process is part of the ARCP and requires an enhanced form R to be completed (and SOAR declaration in Scotland). There is a separate section of the RCOG website with FAQs on revalidation for trainees.

In Obstetrics and Gynaecology we report a lot of day to day events as critical incidents to improve our clinical governance eg third degree tears, massive PPH. Which critical incidents should we include as Serious Untoward Incidents (SUIs)?

An SUI is:

  • Any Never Event
  • Acts or omissions that result in unexpected or avoidable death
  • Unexpected or avoidable injury that has resulted in serious harm
  • Unexpected or avoidable injury that requires further treatment to prevent death or serious harm.
  • Any event which prompts a root cause analysis or for which you are asked to give a statement about your involvement.

If you are in doubt then discuss the case with your Educational Supervisor. For all SUIs you are involved in a reflective practice should be completed and discussed with your Educational Supervisor and they need to be included in Form R.

With regards to SUIs, how are exception exit reports, form Rs and the educational supervisory forms triangulated at the Deanery level for our revalidation?

ARCPs have for several years been an assessment of your progress in training but with the advent of revalidation they are now also part of the appraisal process required by the GMC to enable revalidation. The person in your deanery or LETB who oversees this is the Post Graduate Dean they function as your Responsible Officer and make recommendations to the GMC regarding your fitness to practice. To gather the relevant data the enhanced Form R was added to the ARCP process and as part of this you must report any SUIs or complaints you have been involved in. 

Every 6-12 months your employer fills out a Collective Exit Report about all the trainees in their trust which records whether they have been involved in any Formal SUIs, Significant Event Investigations, or named in a complaint. These are submitted to the Responsible Officer – the Postgraduate Dean. For any trainees that fall into these categories an individual, more detailed Exception Exit Report is also completed. 

The Form R and any relevant Exception Exit report should be largely congruent as the Form R makes the same requirements on the trainee to self-declare these incidents, and these should also be noted on the Educational Supervisors Report. 

However, all of these are outside the remit of the RCOG who are responsible for setting standards in training but not assessing how well you are adhering to them or your fitness to practice. There is extensive information about revalidation on the GMC website and RCOG website and any further questions should be directed to your Postgraduate Dean.

Elsewhere on the site

About specialty training
Overview of specialty training in O&G, including assessment, progression and certification of training
Curriculum
The full specialty training curriculum in O&G: core modules, ultrasound, ATSMs, subspecialty and academic