The North Western Deanery Obstetrics & Gynaecology Specialist Training Committee

(STC) has had a history of assessing trainees fairly but robustly, with record of in-training

assessments (RITAs). Trainees who are on the “old contract” (SPRs) and have not taken

the opportunity of taking up the new contract (STRs) will continue to have RITA

assessments. All new trainees must have the alternative annual review of competency

progression (ARCP). The regulations for this are highly specific and documented in the

Gold Guide (see PMETB Website).

RITA’s and ARCP’s have similarities but also specific differences. Unfortunately this does

require, therefore, parallel systems to be incorporated for the two different types of trainee.

The ARCPs are a new system, and it is important that the STC follow the Gold Guidelines.

There is a concern, however, that some of the benefits of the RITAs will be lost, and

therefore, some of the better points of the RITAs will be incorporated into the overall ARCP


Preparation for the ARCPs

There will be at least 6 weeks notice of the dates of the ARCPs. In general, the

“assessment” will have been booked and announced a year ahead.

      Trainees will not be “chased” to provide the documentation by the required date, but

       should be aware that failure to do so will result in the panel failing to consider their

       progress (Gold Guide 7.44).

                                                               1. ARCP document by AJSW 25.2.08
      Trainees will be expected to keep a folder of information and evidence (portfolio)

       which includes work based assessments, evidence of audit, evidence of

       presentations, evidence of publications/research, and their log book.

      Trainees should have educational appraisal at the beginning, middle, and end of

       each section of training, normally marked by the ARCP progress (Gold Guide 7.18).

       This will be undertaken by the Educational Supervisor at the Unit where the trainee

       is working.

      The RCOG Tutor for each Unit will be responsible for completion of Appendix 4

       (enclosed) (see Gold Guide). It is very well understood that some Units are much

       bigger than others, and it may well be only practical and pragmatic for some of this

       work to be delegated within a Unit. Nevertheless, only one individual is ultimately

       responsible for the completion of this work.

      The trainee and the Educational Supervisor should meet locally to fill in Appendix 4

       and document the work based assessments, log book, audits, research projects,

       publications, teaching, management development, presentations and courses

       attended. This will be forwarded through to the Deanery in good time for the ARCP.

Work based assessments required before ARCP

This will be reviewed regularly by the STC. At the time of writing this document it had been

determined that the minimum should be:-

      6 mini CEX

      6 clinical based discussions

      2 reflective practice documents

      Team observation forms (3600 Appraisal) from at least 12 individuals

                                                             2. ARCP document by AJSW 25.2.08
     OSATs appropriate for the trainees level of training. In addition all ST3-7s will be

      expected to produce at least one OSAT per year for caesarean section, laparoscopy

      and operative vaginal delivery. It is expected that the level of complexity for the case

      directly observed by the assessing consultant to reflect the stage of training of the

      trainee. For instance the ST6/7s should produce an OSAT for a patient undergoing

      caesarean section for placenta praevia, multiple adhesions or fibroids or similarly

      complicated comorbidities.

     Objective evidence of appropriate progression in terms of audit, research,

      presentations, publications, and management experience. The level of this to be

      determined at the previous annual review with consideration to the trainees year of

      training and previous progression in these areas.

ARCP Panel

     The panel will consist of a minimum of 3, but ideally 4, members. Of these, at least

      one (chairing) has to be either a Programme Director, Chairman of the STC or senior

      member of the Deanery (Associate Dean/Dean). There are stipulations about a

      minimum lay member present and also external membership (for instance members

      of STCs from other Deaneries). The STC will comply with Gold Guide standards.

     The trainee will be advised of the date and time of their ARCP and asked to bring

      their portfolio with them. They will not, however, attend the ARCP itself.

     The ARCP panel will deliberate on the evidence provided and will determine the

      adequacy of the evidence and documentation provided by the trainee and

      summarised by the Educational Supervisor. An outcome will be issued from that

      assessment to determine the trainee’s suitability to progress to the next stage of

      training or confirm training has been satisfactorily completed.

     The panel will feed back to the Educational Supervisor on the quality of their

      structured report.

                                                             3. ARCP document by AJSW 25.2.08
      The panel will issue one of the numbered outcomes, as documented in the Gold

       Guide. In summary these are:

       (1) Satisfactory assessment and progress acceptable (equivalent to RITA C)

       (2) Development of specific competencies required but no additional training time

          required (equivalent to RITA D)

       (3) Inadequate progress and training. Additional training time required (equivalent to

          RITA E)

       (4) Released from training programme with or without specific competencies.

       (5) Incomplete evidence presented. Additional training may be required.

       (6) Award of CCT (or equivalent)

       (7) Acceptable progress by FTSTA

       (8) Acceptable progress for out of programme activity

       (9) Outcome for doctors undertaking top-up training in a training post

Annual Planning

      The Gold Guide infers that not all trainees need to have an “annual regional

       appraisal”. This is very different from the RITA’s. The STC felt that the review of the

       previous year’s training and a considered debate on whether this progression was

       good, satisfactory or unsatisfactory. It was always felt that trainees who were barely

       satisfactory should be advised of this and given fairly robust and specific training

       needs in the next year. This was sometimes issued without their being a formal RITA

       D, but with documentation sent to the trainer and new Educational Supervisor, as

       well as being recorded on file. For this reason it is felt strongly by all the senior

       members of the STC that an annual planning meeting for every single STR would be

       appropriate, and it is envisaged that this will occur immediately after the ARCP.

      After the decision of the ARCP outcome, the trainee will be invited through into the

       panel room.

                                                                4. ARCP document by AJSW 25.2.08
       The ARCP outcome cannot be changed based on information from the trainee at the

        annual review. The annual review should be regarded as a separate process even

        though it occurs immediately after the ARCP.

       The trainee will give a short presentation summarising their experience from the

        previous year, and then their hopes and plans for the next 12 months.

       The panel will then debate with the trainee specific training objectives and the

        evidence required to confirm these have been achieved. Specific additional evidence

        for the next ARCP may be requested.

       After the annual planning meeting, a letter will be sent to the trainee and the

        Educational Supervisor at the next attachment.

       Based on the ARCP outcome and the annual planning review, the training needs of

        the trainee will be utilised in determining placement of the trainee for the next 12

        months. His/her needs will need to be weighed against those of all the other trainees

        and the training opportunities available within each of the Units. The placement of

        the trainees will be based on educational as opposed to locality needs of the



       Trainees on the old contract will not be going through an ARCP process. Ideally,

        documentation with appendix 4 should be completed by the Educational Supervisor

        before the RITA panel and forwarded through in advance of the RITA.

       The Committee will be similar in structure to that of the ARCP.

       The trainee will give a 5 minute presentation with 2 overhead slides. The first will

        document their achievements in the previous 12 months and the second will plan for

        the next 12 months.

       Of the panel members, one panel member will scrutinise the presentation and ask

        questions regarding this. The second will scrutinise the portfolio and discuss this with

                                                               5. ARCP document by AJSW 25.2.08
    the trainee, and the third will scrutinise the work based assessments and summarise

    these for the panel.

   The trainee will routinely be asked to leave the room as the Committee weighs up

    the evidence.

   The trainee will be invited back to hear the outcome (C, D E or G).

   An educational plan for the next 12 months will be discussed and documented. The

    trainee will receive written documentation of this.

   The training needs of each trainee will be taken into consideration with placement in

    the next 12 months. This depends on the training needs of each trainee being

    weighed together with the educational facilities available in the Region.

                                                          6. ARCP document by AJSW 25.2.08

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