SAS Survey ResultsMark Radcliffe – Chair of the

Yorkshire & Humber SAS Tutors Group, South West Yorkshire

Partnership NHS Foundation Trust

www.hee.nhs.uk

Outline

• Background

• Findings– Demographic

– Competence & experience

– SPAs

– Revalidation & job planning

– Career progression & development

– Changing grades / CESER

– Management & teaching

• Key Messages

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Background

• Last survey on SAS education and training done in 2008 by BMA

• 403 SAS doctors filled in our survey

• Ran from 12 Jan - 13 Feb 2015

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Demographics

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Demographics

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Demographics

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Qualifications

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Competence & Experience

Work appropriate level to competence / experience

Receive due recognition of competence / experience

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CPD Variety

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SPAs

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SPA Use

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Study Leave

Proportion get funded study leave

Proportion using full allowance of leave

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Revalidation & Job Planning

Time for revalidation, appraisal evidence gathering

Proportion with agreed job plan

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Aspirations

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Aspirations

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Aspirations

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Job Grade

Remain in current grade Grades want to move to

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CESR

Currently working towards CESR

Aspire to achieve CESR at some point

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CESR

Work towards CESR if circumstances allow

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Management & Other Roles

Adequate recognition of management, educational, appraisal role

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Management & Other Roles

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Positives:

– 82% believe they work at a level appropriate to their competences / experience

– 67% believe they receive due recognition of their competences / experience

– 93% receive a good, regular appraisal

– 74% have an agreed job plan

Key Messages

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Challenges

• 10% of respondents do not have any SPA time in job plans. In some cases SPA time is not given or is cancelled for service.

• Although 94% get funded study leave, only 56% utilise full allowance

• 60% get time for revalidation and appraisal evidence gathering

Key Messages

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• 44% feel able to work effectively towards their development and career progression aspirations (for various reasons but largely due to too much clinical workload)

• 75% would like to become a consultant but there are lots of barriers to achieving CESR

• 53% of those who have roles as a manager / educational supervisor / appraiser feel they receive adequate recognition for these roles.

Key Messages

©British Medical Association

Barriers and blockers to professional development -

table discussions

Dr Amit Kochhar

Chair

BMA SAS Committee

9 March, 2015

©British Medical Association

Barriers and blockers

5 March 2015

What is preventing SAS doctors from achieving their

professional development goals?

CESR / CEGPR applications

5 March 2015

Leeds

Steve Cunliffe – Head of Specialist Applications –General Medical Council

What the Specialist Apps Team do

• Deal with all applications for entry onto the Specialist Register or GP

• Certificate of Completion of Training (CCT)

• Certificate of Eligibility for Specialist Registration (CESR)

• Certificate of Eligibility for General Practice Registration

(CEGPR)

• Verifications and duplicates of certificates for GMC and previous

bodies responsible for Specialist training / registration

• Coordinate GMC’s response to appeals against SR / GPR

CCTs

• Following qualification and foundation years, doctors apply for entry into

specialist training

• Once appointed, they follow a GMC approved curriculum

• If they achieve all the competencies, they will be recommended to the GMC for

the award of a CCT.

• Fee is £390

Certificate of Eligibility for Specialist Registration (CESR)

Certificate of Eligibility for GP Registration (CEGPR)

For doctors who have not followed a full UK training

programme but can demonstrate that their:

knowledge

skills

and experience

are equivalent to the relevant curriculum.

Numbers of applications increasing

CESR / CEGPR applications

640

660

680

700

720

740

760

2012 2013 2014

Numbers of CESR / CEGPR apps received

JCST

26%

JRCPTB

19%RCPsych

11%

RCoA 6%

JCST

JRCPTB

RCPsych

RCGP

RCRad

RCoA

RCOG

RCOphth

RCPCH

CEM

RCPath

FSRH

FOM

FPH

Applications by specialties

Breakdown of CESR applications

Where applicants have had their most recent experience:

Type UK EEA Rest of the

World

Proportion by

region

CESR 82.0% 2.9% 15.1%

CEGPR 74.4% 4.7% 20.9%

All 81.5% 3.0% 15.5%

Documentary-based assessment – usually 800 – 1000

pages of evidence

Evidence has to be validated, authenticated and

anonymised

Assessed against the standards of the CCT curriculum

No two applications are the same

Often takes 6 – 9 months from start to end

CESR / CEGPR – evidence

Preparing for submission

Documentary evidence based on GMC’s Good Medical Practice Guide:

Domain 1: Knowledge, skills and performance Domain 2: Safety and quality Domain 3: Communication, partnership and teamwork Domain 4: Maintaining trust

CESR / CEGPR – the process

Structured Reports

You will be asked to provide six referees

These are used to triangulate your primary evidence

Verify work, training and experience

Details on your personal attributes, skills and competencies

First referee should be your current medical / clinical

director

A minimum of two other referees should be supervisory

consultants in the same specialty

Evidence - Validation

Every piece of evidence that relates to your training and

experience

Medical Supervisors who can confirm it is a true and

accurate record

Hospital Stamp

Name of person validating

Their job title

Their Signature

Incorrectly validated or authenticated evidence will not be

sent to the Royal College

A decision is made - Successful

Specialist Registration (and Full Registration) is automatically granted

A copy of the evaluation is sent to you

A decision is made - Unsuccessful

A letter confirming you have not been successful

A copy of the evaluation

Recommendations which will help in future applications

Review

You may wish to review our decision on an unsuccessful application if:

You have additional relevant documentary evidence

OR

You consider there has been a procedural error

You must apply within 12 months of the date on your decision letter

Success rates

0%

20%

40%

60%

80%

100%

120%

2012 2013 2014

Reject

Grant

Reasons applications are unsuccessful

• Common themes:• Lack of audit experience• Lack of WPBAs or assessment tools• Specialising in one area • Lack of evidence of research• Lack of management / leadership experience

47%

67%74%

43%51%

35%

74%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pass

Fail

Compliance with legal deadline

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

-10

10

30

50

70

90

110

130

150

170

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1

2012 2013 2014 2015

# Apps

% met SLA

Future of specialist registration

• GMC consulted on routes to the GP and specialist registers in

2012

• In September 2012 council approved a report regarding the

consultation and 13 resultant recommendations

• Short / medium term– publish an annual report regarding

outcomes, issues and learning points for CESR

• Longer term

• Doctors are required to work in the UK for 12 months prior

to application

• Test of knowledge to be introduced

• An evaluation of performance in practice required

13 recommendations

Rec 1• Acclimatisation

Rec 2• Knowledge test

Rec 3 • Workplace evaluation

Rec 4• GP legislation

Rec 5• Less documentary evidence

Rec 6• Applied to A or R applicants

Rec 7• International renown applicants

Rec 8• Reduce need for panels

Rec 9• Panel role defined

Rec 10

• Early mitigation

Rec 11

• Improve panel efficiency

Rec 12

• Publish TORs for panels

Rec 13

• Improve perceptions

Complicated ones still to do Straightforward ones done

For help from the Specialist Applications team

Website www.gmc-uk.org/doctors/SpecApps.asp

Phone0161 923 6002

Emailequivalence@gmc-uk.org

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©British Medical Association

Identifying facilitators and

local action planning -

table discussions

5 March 2015

Dr Amit KochharChair

BMA SAS Committee

©British Medical Association

1. Which facilitators can help overcome barriers to

professional development?

2. What are your 'take-home' messages from today's

workshop?

3. How do you intend to use what you have learnt

today to spread good practice within your own

trusts / areas?

Identifying facilitators and

local action planning

5 March 2015