Skip to main content

Managing requests for early completion of training

This page provides guidance on the process for trainees who have completed training earlier than the original date of their Certificate of Completion of Training (CCT) or Certificate of Eligibility for Specialist Registration through the Combined Programme CESR (CP), including trainees requesting accreditation of transferable competencies.

Background

Postgraduate medical training is currently competency-based, and that recognises that not all trainees will achieve competencies at the same rate. Some trainees will require additional training time and are awarded an Annual Review of Competence Progression (ARCP) outcome 3, to recognise those competencies that may require more time to achieve. However, there is an indicative time that the majority of trainees would require in order to successfully complete their training programme. This is published in the RCOG curriculum and stands currently at 7 years.

The situation for trainees who are acquiring their competencies more rapidly than anticipated is less clear, and this page provides guidance to the Specialty Education Advisory Committee (SEAC) and Heads of School about how a trainee may be recommended for CCT or CESR (CP) earlier than the date predicted by their indicative training time within the curriculum. It is important to note that the European Union currently insists that the minimum time spent in training to become a specialist in Obstetrics and Gynaecology is five years.

Guidance on the process for recommending an earlier CCT date

Any recommendation for a CCT date earlier than is indicative for their training programme should be based on sound educational principles. The trainee and their educational supervisor should have discussed this at an educational meeting, in advance of it being raised more formally during an ARCP. It would seem reasonable that in order for an early CCT or CESR (CP) to be recommended, the following conditions would need to be met:

  • Ideally the trainee should have had a satisfactory ARCP outcome 1 throughout their period of training.
  • There should be no significant concerns about professional behaviour noted at the last two ARCP panels.
  • The trainee and the educational supervisor should agree that it is in the trainee’s educational interest to obtain an early CCT or CESR (CP) and this recommendation should be supported by both the Training Programme Director (TPD) and Head of School.
  • If the trainee is seeking subspecialty accreditation then the dates for both completion of subspecialty training and CCT must be the same.
  • The duration of training must not be less than the EU minimum (5 years).
  • A request for an earlier CCT date should be made to the ARCP panel in advance of their penultimate ARCP (i.e. approximately one year before the currently agreed CCT date and with sufficient time for the ARCP panel to form a decision). It should not be a request submitted on the day of the ARCP panel.
  • Any panel receiving a request for an earlier CCT date should notify the Postgraduate Dean, who should then arrange for appropriate RCOG externality at the penultimate ARCP. This should fall into the 10% of ARCPs each year which need external RCOG review.
  • The final CCT or CESR (CP) date must be agreed and documented at that penultimate ARCP.
  • At the final ARCP, where the outcome 6 is awarded, the CCT or CESR (CP) date on the ARCP form must be updated to the new date and the previous completion date should be recorded in the “detailed reasons for recommended outcome” with text to confirm that on review of progression an earlier completion date is supported.
  • Once the final CCT or CESR (CP) date has been recommended at the ST6 ARCP, no further alterations to make it earlier are acceptable. In the unlikely event that the trainee fails to meet the mandatory targets required for an outcome 6, then the panel would subsequently need to award an ARCP outcome 3, detailing the need for a further period of training and a further ARCP review.

Transferable competencies

  • Trainees entering the specialty at ST1 who have completed more than one year in another specialty may wish to have their previous competencies transferred and bring forward their CCT date in Obstetrics and Gynaecology. The Academy of Medical Royal Colleges has therefore developed the Accreditation of Transferable Competences Framework (ATCF) aimed at the early years of training, to assist trainee doctors - where appropriate and valid - in transferring competencies achieved in one core, specialty or general practice GMC-approved training programme to another. These are limited when transferring into obstetrics & gynaecology; see page 9 of the ACTF PDF for a summary.
  • Trainees entering the specialty who wish to have the competencies they have acquired in previous specialties recognised by shortening their time in ST1/2 in O&G must meet all the following criteria:
  1. The trainee and the educational supervisor should agree that it is in the trainee’s educational interest to recognise the competencies acquired in a previous specialty by bringing forward the way point at ST2 and this recommendation should be supported by both the TPD and Head of School.
  2. The trainee should have had a satisfactory ARCP outcome 1 throughout their period of training in their previous specialty.
  3. There should be no significant concerns about professional behaviour noted at the last two ARCP panels. (In some cases only one ARCP may have been undertaken.)
  4. A request for progression into ST3 in less than 2 years should be made to the ARCP panel in advance of their ARCP at the end of ST1 (i.e. approximately one year before the currently agreed ST2 way point date and with sufficient time for the ARCP panel to form a decision). It should not be a request submitted on the day of the ARCP panel.
  5. Any panel receiving a request for earlier progression into ST3 should notify the Postgraduate Dean, who should then arrange for appropriate RCOG externality at the ST1 ARCP. This should fall into the 10% of ARCPs each year which need external RCOG review.
  6. The final CCT or CESR (CP) date must be agreed and documented at the ARCP at the end of ST1 based on the documented progress of the trainee to date.
  7. The trainee must meet all the requirements of the curriculum to progress through the way point into ST3 as per the RCOG training matrix.
  8. At both the ARCP at the end of ST1 and the final ARCP, where the outcome 6 is awarded, the CCT or CESR (CP) date on the ARCP form must be updated to the new date and the previous completion date should be recorded in the “detailed reasons for recommended outcome” with text to confirm that on review of progression an earlier completion date is supported.
  9. Once the final CCT or CESR (CP) date has been recommended at the ST1 ARCP, no further alterations to make it earlier are acceptable. In the unlikely event that the trainee fails to meet the mandatory targets required for an outcome 1, then the panel would subsequently need to award an ARCP outcome 3, detailing the need for a further period of training and a further ARCP review.
  10. RCOG advice is that shortening training in ST1/2 by 6 months would be very challenging and 3 months more realistic from specialties that do not have approved transferable competencies given this is a craft specialty. This should be assessed on an individual basis.

This guidance was produced to aid SEAC and Heads of school and is drawn almost entirely from guidance issued to Postgraduate Deans from Health Education England (HEE).

Case study examples

Case study 1

  • An ST4 in anaesthetics is successfully recruited into ST1 in Obstetrics and Gynaecology.
  • They have had outcome 1 in their previous anaesthetic ARCPs.
  • They request that a year of their previous training is counted towards CCT in O&G.
  • The ATCF does not allow for this transfer to occur.
  • The educational supervisor agrees with the trainee that, given this is a craft specialty, they would recommend only changing the CCT date by 3 months and 6 months would be the maximum.
  • They alert the TPD (as the dean’s representative) of the request and their support so that an external RCOG representative is present at the ARCP at the end of ST1.
  • The TPD and Head of school also support the request based on the information from the educational supervisor.
  • In ST1 the trainee is signed off for their competencies in the usual way.
  • They pass their MRCOG Part 1.
  • At the ARCP at the end of ST1 the panel decides, based on the progress of the trainee in achieving their competencies and the educational supervisor's report, that they could bring forward the way point to ST3 by 3 months (i.e. complete ST1 and ST2 in 21 months instead of 24 months).
  • The updated CCT date is documented.
  • The next ARCP is organised 9 months after the ST1 ARCP and the trainee successfully completes their log book, has their competencies signed off, and meets all the criteria to move to ST3.
  • At the final ARCP when an outcome 6 is awarded, there is documentation that the CCT date has been brought forward by 3 months in ST1 to take into account competencies achieved in the previous anaesthetic specialty.

Case study 2

  • A senior trainee is approaching their ARCP at the end of ST6.
  • They have almost completed their ATSM in benign gynaecology, since this had been started during an out of programme training (OOPT) as a laparoscopic fellow in a tertiary unit, lasting 2 years, where 3 months of their time counted towards CCT.
  • They have 75% completed their advanced labour ward ATSM and intend to start the hysteroscopy ATSM as soon as their benign gynaecology is signed off.
  • They are keen to bring forward their CCT by 4 months as they are aware that a job in a local unit will be advertised in 6 months when the current post holder retires. This would be an ideal opportunity for the trainee.
  • The trainee has an exemplary record with a good CV, outcome 1s in all ARCPs and is highly regarded by their educational supervisor who supports their request.
  • The educational supervisor notifies the TPD and Head of school who ensure that an RCOG external representative attends the panel which occurs 1 month prior to the end of ST6.
  • The request for an earlier CCT is supported by the panel and the updated CCT date is documented.
  • A subsequent panel at the end of ST7 is organised 8 months later where all competencies have been achieved. The CCT is awarded with the previous completion date recorded in the "detailed reasons for recommended outcome", with text confirming that - on review of progression - an earlier completion date is supported.
  • The trainee has already been successfully appointed to the consultant post and is due to start 6 weeks later.