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Scotland Deanery

Scotland - home of medical excellence

Trainee Information

MRCGP & WPBA

When you successfully complete your GP training, you will be issued with a Certificate of Completion of Training (CCT), which confirms you can work independently as a General Practitioner in the UK. To achieve CCT you need to satisfactorily complete the MRCGP assessment. 

There are three components within the MRCGP that must be completed. Two of these are assessed externally - the Applied Knowledge Test (AKT) and the Clinical Skills assessment (CSA). The third is Work Place Based Assessment (WPBA), which is a set of structured tools used to assess your performance over time and captured in your e-Portfolio. 

Below is some local information about satisfactory progression through your training, but for more detailed information please visit the RCGP website

The following document provides COGPED and RCGP supported TeP guidance created by the UK Deanery Assessment Reference Group. The guidance has comments on gathering evidence for satisfactory progression at the Annual Review of Competence Progression (ARCP) - E-portfolio Guidance for Satisfactory Progression at ARCP Panels (pdf).

Please also see the following guidance regarding ARCP for all Scotland based trainees - ARCP Information

RCGP Intensive CSA Workshop

RCGP Intensive CSA support Workshop 5th May 2018 - Glasgow For those who are unsuccessful at CSA

    This table (pdf) shows the capability and competence areas which underpin the RCGP training curriculum. To access the curriculum please follow this link to the RCGP website.

    As mentioned above please find the attached E-portfolio Guidance for Satisfactory Progression at ARCP panels (pdf), a COGPED and RCGP supported TeP guide created by the UK Deanery Assessment Reference Group. 

    A summary of this guidance, as well as the RCGP minimum requirements, is available in the next for download here (pdf).

    This ESR Checklist (pdf) may also be helpful for both trainees and trainers in preparation for planned reviews. 

    GPST3 ARCP REQUIREMENTS MANDATORY DOCUMENT ENSURE YOU COMPLETE AND UPLOAD THIS TO YOUR TeP FOR FINAL CCT ESR

    Please also note the additional information below. 

    NOTE: OOH sessions

    If you have not completed your 108 hours in OOH before your ARCP is due (36 in ST1 and 72 in ST3) , your ES should document the dates of the remaining sessions and accumulated hours in your ESR.   Under these circumstances missing OOH hours, if less than 6 hours, will not impact on ARCP outcome. However, if there is no documentation as to why OOH sessions are missing then an Outcome 5 missing evidence will be given

     

    NOTE: SEA & AUDIT:

    Please also note the following from the RCGP:

     

     

    Demonstration of competence in competency area 10 explicitly requires the trainee to provide evidence in the areas of SEA and audit. Although the need to write a structured report as per existing summative assessment requirements has been removed, the trainee will still need to demonstrate competence in these areas by participating in an audit and engaging in significant event processes. It will be up to the educational supervisor to assess competence in these areas through reviewing the evidence presented by the trainee at the regular reviews

     

    NOTE: Fitness to Practice

     

    There are 3 places that you should document sickness absence.

    ·       Fitness to Practice self-rating

    ·       Absence declaration as part of SOAR revalidation process (your regional administrators will email you)

     SOAR revalidation health statement (including all locum work, voluntary or paid work of any description

     

    CCT Final documentation completion

    GPST3 ARCP REQUIREMENTS MANDATORY DOCUMENT ENSURE YOU COMPLETE AND UPLOAD THIS TO YOUR TeP FOR FINAL CCT ESR

    Please also note the additional information above. 

    All e-portfolios are reviewed as part of the ARCP process to check the quality of the evidence provided by both you and your Educational Supervisor. FOR CCT you must have completed AKT and CSA in addition

     

    Available for download is a year planner with suggestions to help you manage your training requirements. Please select the appropriate planner for the month that you first started your training.

    GPST Year Planner August starts (pdf)

    GPST Year Planner February starts (pdf)

    Download the summary advice sheet here (pdf). Further information about reflective log entries is available at the AOMRC website

    Try to see the potential of the EP as a resource to show your abilities, as a learning tool and keep the overall end in sight – showing progression can be satisfying and give a sense of achievement (plus preparing for appraisal and revalidation skills!). It is mandatory but don’t over think.

    SUMMARY

    • Suggest competency that you are trying to cover at the top (use the word pictures to help  you)
    • Analyse
    • Synthesize
    • Bite size
    • Chunking
    • Transferable from other arenas/environments
    • Translatable from other arenas/environments
    • Feelings – your and other people’s (put yourself in their shoes)
    • Openness and honesty

     

    Aim for quality log entries

    • Minimise descriptive element – keep this concise/ limited to essential information
    • Focus on learning points achieved/ learning needs and what will do differently i.e. behaviour change
    • Consider how much personal reflection you are doing – discussing and analysing your thoughts/ feelings/ actions and drawing conclusions (don’t need to share everything -some things too personal). Put yourself in someone else’s shoes i.e. try to analyse how the patient or colleague might have felt about your interaction.
    • Entries should provide evidence/ relate to curriculum
      • Use competency ‘word descriptors’ that outline descriptors for needs further development/ competent for licensing/ excellent as a guide to the evidence that you provide i.e. suggest to your ES which competences you feel are robustly covered in the learning log entry
      • Look at the competent and excellent descriptors – helps provide focus/ a goal for where to aim with the evidence that you are providing. Ask yourself how can I move to excellent?

     

    Targeted focussed entries:

    • Begin with the end in mind
    • Ask yourself what am I trying to evidence/ achieve with this entry?
    • Suggest which competency that the entry relates to and write it at the top of the entry
    • Choose your perspective use the RDMP model (Is it Relationships; Diagnostics; Management or Professionalism or can I write 4 log entries from the same encounter?) Remember the competency areas map into these 4 areas – review the relevant word pictures
    • Tailor your approach keeping the end in sight (e.g. complex case – may wish to choose several aspects and write up separate entries under different competencies or may wish to write it up from a complexity point of view with a brief summary of the details but more focus on the nature of the complexities involved)
    • Be concise – consider starting with bullet points or try asking yourself - how would I summarise this to someone without a medical background?
    • Consider where there is lack of evidence by looking at the summary screens of your EP and concentrate efforts in these areas

     

    Transferable skills make use of discussions you have had in assessments (CBDs and COTs) to focus the mind

    • CBD discussions (not the assessment itself) - LLE - PDP - self-ratings - LLE showing application of new learning and change in behaviour = evidence of completed learning cycle

     

    The time factor – finding the time:

    • Establish a routine that suits you, do it during the working week in the GP practice (when in GP)
    • Little and often or it may mean a longer session every couple of weeks doing lots of entries – bite size pieces – analyse and synthesize what you want to cover.
    • Benefit to little and often/ prompt entries after event may be that info is fresh in mind
    • A different viewpoint is to wait a short time to be able to think and reflect on the case before writing (possibly helpful to put in brief factual details early before writing up more fully – help recall of facts and acts as prompt to complete the entry)
    • Consider whether you prefer doing entries at home or work
    • Reward yourself for doing the entries

     

    Ways of prompting yourself to do entries:

     

    • Keep note of PUNS/DENS or cases in a notebook/ print patient sticker out for speed
    • Try to prioritise which you will tackle
      • Does one area recurrently appear?
      • Can you group into themes and tackle a few PUNS/ DENS together
      • Target the areas that are lacking evidence or where you perceive the greatest learning need

     

    PDP - When considering your learning needs and how you will address these consider SMART:

    • S = specific
    • M = measureable
    • A = Achievable
    • R = Realistic/ relevant
    • T = time limited
    • EXPORT TO PDP and REVIEW regularly to tick off when complete

     

    Also consider the resources available to you to complete learning needs

    • Books/ e-learning/ trainer and other colleagues/ tutorials/ courses

     

    Try to establish a dialogue with your supervisors:

     

    • When they put a comment under your entry see if this can trigger further learning (if they ask a question/ suggest a further resource to look at – aim to follow up on this and reply with a further comment/ PDP etc.)

    This advice is available for download here (pdf).

    The aim of the self-ratings is to self-assess your progress against the RCGP competency word pictures (see RGCP website). In doing this you can guide your educational supervisor to the robust evidence that you have gathered in your portfolio.

    What makes good and effective self-ratings

    1. Analyse your progress since your last ESR
      1. Review previous ESR action points
      2. Review where you feel you are now
      3. What have you achieved?
      4. What remains to be developed?
    2. Synthesize the evidence to support your rating against the word pictures
    3. Comment on the evidence provided, try not to describe individual pieces of evidence, but comment on how you have addressed learning needs identified and what you have done about it – review your learning log entries and pdp.
    4. Point to the evidence by tagging (3) and signposting additional evidence e.g.
    5. Action plan areas for development, make them specific 

     

    Communication and Consultation Skills

    I have discussed complex patient problems requiring acute and long term care in my CBDs (see 12/11/15; 23/11/15 and also LLE 23/10/15; 25/09/15. I have developed my skills in using ICE in multiple settings see COT 21/10/15; 24/11/15 and LLE 11/09/15; 14/10/15. I have made some progress in dealing with patients whose agenda is different to mine see COT 22/09/15 and LLE 13/09/15 but I realise that I still struggle with this. I have attended a negotiating skills and dealing with difficult conversations course 21/08/15 in an effort to gain further skills. I have now applied that knowledge when dealing with a difficult and angry patient (LLE 21/10/15 and 26/11/15)

    You do this by

    • Being open and honest about what is going well and what is not
    • Critically analysing your progress, why are things are going well or not
    • Identification of learning needs and how you might address them in the next 6 months
    • Little and often, try to do one or two self-ratings at a time rather than all 13

     

    Pitfalls to avoid 

    • Leaving it all to the last minute
    • Describing individual pieces of evidence
    • Not tagging evidence
    • Not utilising additional evidence if you have it in your TeP
    • Describing only the positive evidence – remember the need for self-awareness

    The Scotland Deanery has provided guidance as to how you might be able to meet the RCGP curriculum requirements for Level 3 Child Safeguarding by the end of GPST3. This guidance provides examples of how you might enhance the theoretical knowledge gained when completing the RCPCH Level 3 Safeguarding e-modules.

    Scotland Deanery Child Safeguarding Level 3 Guidance (pdf)

    AKT

    The Applied Knowledge Test (AKT) is a summative test, which can be taken from ST2 onwards. It is computer-based and delivered at 150 Pearson VUE professional testing centres (driving test centres) around the UK. There are usually three sittings each year. For information about applying for and sitting the test, please follow this link to the RCGP website

    CSA

    The Clinical Skills Assessment (CSA) is an OSCE style assessment, which takes place at the RCGP Headquarters in London. The majority of trainees sit this examination in their ST3 year. Please check the Educational Opportunities page to see what resources your region can offer you to prepare for this. Full information is available on the RCGP website

    TIP: The more consultation practice you do in your normal working day i.e. seeing patients - the better prepared you are for passing CSA.  Video your consultations and use for tutorials, do joint surgeries and get feedback from your educational supervisors.  




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