Download - Preparing for GIM ARCP - RCP London
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Preparing for GIM ARCP
Mo AyeTraining Programme Director
General Internal Medicine
With thanks to:Dr Sega Pathmanathan
Lead Training Programme Director
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Key Points
• Training is trainee led
• Generic ES training doesn’t address:
o ePortfolios
o Specific specialty or GIM requirement
• The GIM SAC now mandates a separate GIM ES report
• ARCP outcomes should not be a surprise
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Objectives
• ES Report
• GIM StR requirements
• ARCP Process
• PYA
• Adverse Outcome
• ARCP 6
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Educational Supervision
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Educational Supervision
• Initial meeting
• Regular updates
• Prepare for ARCP
• Support
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The initial meeting
• Make it as early as possible, on rotation, and allocate adequate time
• Review previous ARCPs, ES reports, Form R
• Consider an agenda
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The initial meeting
• Identify training needs and how they will be achieved:
• SLEs, study leave, attachments elsewhere
• Ensure GIM & Speciality issues are addressed
• Refer to ARCP decision aids
• Populate the PDP and an honest, achievable timetable
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Meet regularly
• Mark progress against ARCP decision aids
• Ensure the curricula are linked appropriately
o Self-rate and get ES sign off for competencies
• Use the free text to justify competency
• SLEs, MSF, MCR
• Identify and escalate concerns early
• Clear targets for next meeting
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Prepare for the ARCP
• Allow plenty of time for the ES reports
o Separate ES report for GIM and speciality
• ARCP outcomes are predictable!
• Remember the lockdown date:
o 1 May for GIM
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https://1drv.ms/w/s!AutJJhphvf-
KmCNIaJ2oxTjQxvw7?e=dfu4cu
Guide to ES report
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GIM training requirements
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GIM Requirements
• ALS
• CPD
• ACAT, assessments
• ES report/MCR/MSF
• GIM Logbook
• Curriculum
• GIM placement
• (Adequate Reflection)
• Form R
• Other
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ALS
• Valid: 4 years
• Must be valid at ARCP
• If expired, local Trust must be informed
• Instructor status allowed
• Must be in certificates section and verified by ES
NO ALS = Outcome 2
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ACAT and other SLEs
• Minimum 18 ACATs at CCT
• 6 must be in final year
• Must be GIM - 2 allowed from speciality (eg 16 GIM + 2 respiratory)
• Minimum 5 patients
• Must be on AMU or ACU
• Must all be satisfactory
• Ideally lead the ward round
• Allowed up to 8 links
• Minimum 10 SLEs per year
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ES Report
• Must have a separate GIM ES report completed in addition to speciality ES report
• Does not necessarily need completion if in an non-GIM year
• Can be completed by any consultant with MRCP and CCT:
o even those not ‘doing’ GIM
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Multiple Consultant Report (MCR)
• 4-6 per year
• At least 2 should be from GIM consultants
o AAU, other MEDICAL specialities
• Should all be Satisfactory
• ES should not do an MCR
o MCR should inform ES
• Avoid MSF consultants
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MSF
• At least 2 satisfactory MSFs before CCT
• Minimum 12 responders
• Minimum 3 consultants
• A mix of clinical and non-clinical staff
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Curriculum
• Must be signed off by both ES and trainee
• At least 2 links per item
• Only 1 can be a reflection
• Emergency Presentations complete by end of ST3
• Mandatory (Part A) procedures complete by end of ST3
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https://www.jrcptb.org.uk/sites/default/file
s/GIM%20ARCP%20Decision%20Aid%2
0%28August%202017%29.pdf
JRCPTB decision aid
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Emergency Presentations
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Procedures
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Procedures
• Cannot count signoff from CMT
• Part A – Must be live summative DOPS
• 2 x DOPS for ascitic tap (∵ potentially life threatening)
• 1 x DOPS for knee aspiration
• 1 x DOPS for DC cardioversion
• Part B – Can be simulated
• Chest drain course certifcicate accepted
• CVP course certificate accepted
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Curriculum
• Cannot use assessments from prior to Training Programme
• Max number of links:
o ACAT – 8
o Mini-CEX – 2
o CbD – 2
• Avoid excessive links:
o Less is more — a few good quality links suffice
o Keep links up to date
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Stages of GIM
• STAGE 1: First year of GIM
• ST3 unless the first year is in a Teaching hospital with no GIM
• if there are rotation-specific variance with reduced the educational activity an ARCP can assess pro rata and should clearly list the outstanding requirements to achieve stage 1
• STATE 2: ST4-6
• If second year is in a DGH, aim to have Stage 2 signed off
• CCT: ST6-7
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GIM Placement
• Minimum 3 years of GIM Acute on calls
• ICU exposure
• CCU cover
• Ideally at least 18-24 months of DGH
• At least 3 months GIM in final year
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CPD
• Minimum 100 hours
• Must be external- not Grand Round etc
• Can count 6 hours of speciality CPD
• Can have up to 20 hours online- RCP, BMJ
• Upload certificates
• Can also count SAM conference, RCP updates
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GIM Logbook
• Firth Calculator
• Updated yearly
• Signed by ES to verify
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Form R
• Upload to portfolio
• Includes:
• Time off work
• Complaints or SUI’s
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Other
• Management course
• Evidence of leadership
• 1x GIM Audit- out-with speciality
• Needs an assessment
• Teaching course
• Evidence of teaching non clinicians (excl med students)
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Reflection
• Must have reasonable Detail
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ARCP
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ARCP Process
• Joint ARCP with speciality
• Remote assessment
• Minimum panel of 3
• Follows decision aid
• Outcome decided remotely
• Must have an updated Form R
• Lockdown date for requirements to be met- 1st May
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ARCP Outcomes
Outcome 1: Satisfactory progress
Outcome 2: Development of specific competencies, no additional time
Outcome 3: Inadequate progress, additional training time required
Outcome 4: Released from training programme
Outcome 5: Incomplete evidence, additional time may be required
Outcome 6: Gained all required competencies, recommended for CCT
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• Judgements based on available evidence (eg SLEs)?
• Appropriate suggestions for trainee’s development
• Areas of good practice
• Report produced with regard to ARCP decision aid and stage of training
• Areas of development identified, appropriate advice/guidance
• ALS uploaded and confirmed
• GIM external CPD hours confirmed
• No of acute patients seen and outpatient clinics attended and confirmed
Constructive Feedback
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Adverse outcomes
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Adverse outcome
• Face to face
• Presence of APD
• No OOPE
• No chance of accelerated CCT
• Reviewed after 6 months
• Consecutive adverse outcome may extend training
• 2 x Outcome 5 = 2
• 2 x Outcome 2 = 3
• 2 x Outcome 3 = 4
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Adverse Outcome
• Invalid ALS
• No ES Report
• No Form R
• Insufficient SLEs
• Curriculum competencies not signed off
• Not at appropriate stage
• Unsatisfactory report/assessments
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Outcome 5 vs Outcome 2
• Outcome 2: Assessment/evidence not undertaken
• Outcome 5: missing evidence
• Outcome 5 can be upgraded to Outcome 1, but has to be done by specified time-usually 2-4 weeks
• Cannot have more than 1 outcome 5
• Either outcome means you CANNOT Accelerate (5 is under review)
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Penultimate year assessment (PYA)
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PYA
• At least 12-18 months prior to CCT
• Undertaken by external assessor
• Local TPD Present
• Full assessment of Eportfolio and documentation
• Presentation and CV
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PYA
• Mandatory Targets Set
• Specified time for targets
• CCT can be altered
• Must match parent speciality
• THIS IS NOT AN ARCP
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PYA
• If OOPE/Maternity is taken after PYA, A repeat PYA may be needed if CCT date is 2 years or more from PYA
• Virtual PYA
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ARCP 6
• Completed training requirements and ePortfolio
• Must have a panel of 3
• PYA targets must be completed
• Sent to external for scrutiny:
• PYA Assessor
• JRCPTB
• GMC
• Need at least 2 months for completion
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ARCP 6
• Do not resign until you have been given your CCT
• If you haven’t completed your PYA requirements by the CCT date- you will be given an automatic outcome 3 and extension to training
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Tips
• Organise your portfolio
• Make it easy to be assessed
• Keep up to date with assessments
• Remember your dates
• Continuous update
• Give your ES time
• Be proactive
• Use the decision aid
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Any Queries?
• Programme Support
• Contacts:
• Dr Sega Pathmanathan - Hull
• Dr Joe Hogg - Pinderfields
• Dr Sathish Kallankara - Hull
• Dr Mo Aye - Hull
• Dr Mohsen El-Kossi - Doncaster
• Dr Imran Aslam - Sheffield
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Some web links
• http://www.yorksandhumberdeanery.nhs.uk/medicine/general_(internal)_medicine/
• https://www.jrcptb.org.uk/specialties/general-internal-medicine-gim
• https://www.jrcptb.org.uk/specialties/core-medical-training-and-acute-care-common-stem-medicine
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