1 The Junior Doctors’ JourneyAlison Keightley Director of Medical Education Frimley Park Hospital

2 Training for a Hospital SpecialtySince 2007 F1/FY1(1) GMC registration F2/FY2(1) Core Trainee CT/ST1-3(2-3) Higher Specialty Trainee StR(3-5) CCT Consultant 7-10 years (without time out)

3 Training for General PracticeF1/FY1(1) GMC registration F2/FY2(1) Specialty Trainee (ST1/2) mainly based in hospital (2) ST3 in General Practice (GP registrar)(1) CCT in General Practice (5 years after qualifying)

4 Training for a Hospital Specialty Post 2007 PRHO(1) F1/FY1(1) GMC registration F2/FY2(1) SHO(1-?) Core Trainee CT/ST1-3(2-3) SpR(5-8) with NTN StR(3-5) CCST CCT Consultant 7-10+years 7-10 years

5 Modernising Medical CareersMore structured and streamlined Aiming to produce specialists earlier in their career Revised curricula for all specialties Portfolios (electronic and paper) Workplace based assessments Controlled by PMETB

6 Foundation Programme 2 years in 1 or 2 different TrustsUsually 6 jobs of 4 months one of which may be in General Practice Apply for Specialty training starting in December of their F2 year Career planning important Continuous assessment. No exams that they have to take

7 Training for a Hospital SpecialtySince 2007 F1/FY1(1) GMC registration F2/FY2(1) Core Trainee CT/ST1-3(2-3) Higher Specialty Trainee StR(3-5) CCT Consultant 7-10 years (without time out)

8 Foundation Programme 2 years in 1 or 2 different TrustsUsually 6 jobs of 4 months one of which may be in General Practice Apply for Specialty training starting in December of their F2 year Career planning important Continuous assessment. No exams that they have to take

9 Miller’s Pyramid DOES SHOWS HOW KNOWS HOW KNOWS

10 Specialty Groups for ST1/2Acute Care Common Stem (ACCS) Anaesthesia Neurosurgery Chemical Pathology General Practice Histopathology Medical Microbiology Core Medical Training Obstetrics and Gynaecology Ophthalmology Oral & Maxillofacial Surgery (OMFS) Paediatrics Psychiatry Public Health Radiology Core Surgical Training *There are 16 definite specialty groups to apply to for ST1/2 entry – at 06/09/06, we are still awaiting confirmation of whether Otolaryngology is a separate specialty group or part of Surgery in General.

11 Core Specialty Training2 or 3 years depending on specialty CT 1-3 or ST 1-3 at same Trust Exams: at least the first part of the relevant Royal College exam has to be passed to proceed plus workplace based assessments

12 Run-through vs Uncoupled TrainingIn some specialties there is a single competitive entry point into the speciality at ST1 level Other specialties have 2 competitive entry points: the first into CT1 and the second into ST3 or 4 depending on the specialty

13 Offer of run-through training in 2010 Offer with Uncoupling in 2010ST1/2/3 etc Offer with Uncoupling in 2010 CT1/2/3 ST3/4/5 etc Obstetrics and Gynaecology Core Medical Training (2 years) Ophthalmology Anaesthesia (ACCS) (2/3 years) Paediatrics and Child Health Psychiatry (3 years) General Practice Emergency Medicine (ACCS) (3 years) Public Health Medicine Neurosurgery Core Surgical Training Cardiothoracic surgery General surgery Otolaryngology (ENT) Paediatric surgery Plastic surgery Trauma & orthopaedic surgery Urology (2 years) Histopathology Chemical Pathology Medical Microbiology Clinical Radiology

14 Higher Specialty TrainingST3/4 and above usually move Trusts every year Further Royal College exams plus workplace based assessments Subspecialisation

15 For all Specialty and GP TraineesDecision as to whether they can progress to the next year is determined by the ARCP: Annual Review of Competency Progression (previously RITA) Portfolio Satisfactory completion of workplace based assessments and Royal College exams Educational Supervisors Report Curriculum requirements

16 Training for a Hospital SpecialtySince 2007 F1/FY1(1) GMC registration F2/FY2(1) Core Trainee CT/ST1-3(2-3) Higher Specialty Trainee StR(3-5) CCT Consultant 7-10 years (without time out)

17 Study Leave All trainees FY2 and above30 days per year with limited funding Compulsory courses Preparation for professional exams Educational meetings Personal professional development

18 Other Hospital DoctorsFTSTA: Fixed Term Specialty Training Appointment Specialty Doctors (formerly called Associate Specialists or Staff Grades) Trust doctors/fellows

19 Stakeholders PATIENTS Medical Schools/universities GMC/PMETBRoyal Colleges Deaneries Trusts Strategic Health Authorities PATIENTS

20 Libraries How do junior doctors use them and what more can libraries do to support them in 2010?