Guidance on the Combined Programme route to CCT

• An awareness of the capability levels required for Stage 1 and what is expected of a Specialty Registrar (StR) at the beginning of ICM training is an important consideration. Most non-training posts will add some useful experience to the StR’s portfolio.
• This process should be straightforward. If there is considerable doubt about the proposed prior learning, then the time in that post should not be counted. Patient safety is of prime importance.

A doctor in training may request that prior experience is recognised for part of the ICM training programme. This request should be made to the Training Programme Director (TPD) / Regional Advisor (RA) prior to commencement of the CCT training programme.

Considerations for the TPD and RA in assessing prior training undertaken in the UK (which can include non-training posts)

The post has been undertaken in a hospital or clinical environment which is recognised by the General Medical Council (GMC) for training. This suggests equivalence of exposure to clinical work, education, training and supervision.

• The trainee has evidence of the contract worked: for example, full time/less than full time, duration of appointment etc.
• On call commitment and supervision.
• Educational/clinical supervisor report(s), or commentary of time and progress in that post.
• Logbook of activity/evidence of any assessments done.
• Course and teaching sessions attended, with certificates. CPD in teaching, research and management is important here to help with High Level Learning Outcomes (HiLLOs) 1-4
• Examination certificates.
• Feedback such as Multi Source Feedback (MSF)/summative assessments/appraisals/
• Evidence of reflective practice.

Considerations for the TPD and RA in assessing prior training undertaken overseas

ICM key educators in the UK may be unfamiliar with the training programmes in overseas hospitals, particularly regarding the number of patients/case mix. The onus is on the StR to present evidence regarding the hospital’s size/case mix/on-call commitment etc. Evidence of the national body recognising that hospital for training will reinforce any application for recognition of prior training.

Ideally a letter, written at the time of the attachment, outlining the above signed by a consultant recognised for training in their own country is very useful.

The above points regarding logbooks, reflections, continued professional development activities (CPD) etc. remain relevant to these overseas posts.

The information can be used to evidence training for the relevant HiLLOs. It will then become clear how much further training is required to complete the remaining HiLLOs.

It is recommended that the StR completes at least 3 months in Stage 1 ICM training to allow introductions to the Educational Supervisor (ES), and time for the RA and TPD to review the StR’s portfolio to assess if prior training can contribute towards achieving the HiLLOs and thereby reduce indicative training time in that stage.

It will be HiLLOs 1-4, and the GMC’s Generic Professional Capabilities (GPCs - integral to all HiLLOs) that the majority of StRs will be required to provide extra evidence for. This point is of particular relevance to those with most of their training performed outside the UK. StRs who have undertaken considerable time in training overseas may require additional support and time, to adapt to working in the UK healthcare system.