the imt survey east midlands

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IMT Update Dr Dheya Biswas – Consultant in Acute and General Medicine & College Tutor University Hospitals of Leicester NHS Trust East Midlands New Consultant Forum July 2020

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IMT Update

Dr Dheya Biswas – Consultant in Acute and General Medicine

& College Tutor

University Hospitals of Leicester NHS Trust

East Midlands New Consultant Forum

July 2020

A “Who’s Who”• Royal Colleges

– SAC – Regional Offices

• HEE / Deanery– Head of School of Medicine– TPDs

• Hospital Trusts– Director of Clinical Education– Clinical Tutors– Education leads– Educational and clinical supervisors

Royal College TutorAssociate College Tutors

Why the change? Background and history

• Modernising Medical Careers 2007 (MMC and MTAS)

• Core Medical Training August 2007

• A syllabus and a spiral curriculum

• Competency based education

• Workplace based assessment

• Educational and clinical supervisors

Why the change? Drivers for change

• Shape of Training October 2013

• Future Hospital Commission Sept 2013

• Francis report Feb 2013

• GMC framework of Generic Professional Capabilities (GPCs)

– to be embedded in all curricula by 2020

• GMC 2016 standards for Medical Education and Training (including curriculum design)

• Trainee/Trainer feedback – “tick box exercise”

Key changes

Internal medicine stage 1 is a three year programme which will deliver the following improvements:• supported transition to the medical registrar role• a more structured programme with mandatory training in geriatric medicine, critical

care and outpatients• longer placements in internal medicine year 3 (IMY3) to provide more continuity in

training• simulation based learning• a programme of assessment which is more intuitive• additional time in which to gain MRCP(UK) if needed

What has not changed

• Good supervisory practice

• Annual Review of Competence Progression (ARCP) process

• Supervised learning events (SLEs) and workplace based assessment (WPBAs)

• MRCP(UK)

So what has changed?

2(3) years 5/6 years including GIM

Training pathway

• The specialties have been split into two groups which follow

different training pathways

Group 1

Dual training with Internal Medicine

Group 2

Single CCT

Group 1 specialties Acute Internal MedicineCardiologyClinical Pharmacology & TherapeuticsEndocrinology & Diabetes MellitusGastroenterologyGenitourinary MedicineGeriatric MedicineInfectious Diseases (except when dual with Medical Microbiology or Virology)NeurologyPalliative MedicineRenal MedicineRespiratory MedicineRheumatology

Group 2 specialties AllergyAudio vestibular MedicineAviation & Space MedicineClinical GeneticsClinical NeurophysiologyDermatologyHaematologyImmunologyInfectious Diseases (when dual with Medical Microbiology or Virology)Medical OncologyMedical OphthalmologyNuclear MedicinePaediatric CardiologyPharmaceutical MedicineRehabilitation MedicineSport and Exercise Medicine

What else is changing?

Staying the same Changing

Assessments i.e. ACATs/CBDs

MRCP

ARCP

Length of training

Rotations

Outpatients

Competencies

Curriculum

Eportfolio

Assessment

Yes

Yes

Yes

Yes

Yes – 3 years

Yes – Capabilities in Practice

Yes – 80 clinics

Yes?

Yes – “Clearer and easier”

Yes – ES & ?CS

What else is changing? - Rotations

Placement IMT 1-2 IMT 3

Geriatrics 4 months

Intensive Care 10 weeks

Acute Medicine 6 months

The IMT curriculum has six generic capabilities in practice (CiPs)

Internal Medicine Training (IM Stage 1) curriculum

The curriculum also has eight clinical CiPs

Internal Medicine Training (IM Stage 1) curriculum

What has changed about the curriculum?

What are the generic CiPs?

Clicking on the information icon will display the anchor statements used to rate the generic CiPs

Internal Medicine Training (IM Stage 1) curriculum

How is progress rated?

Educational Supervisor

And the Clinical CiPs?

Clicking on the information icon will display the level descriptors used for rating the clinical CiPs

Internal Medicine Training (IM Stage 1) curriculum

What are entrustment decisions?

Do entrustment decisions need to be certain level?

Multiple Consultant Report (MCR)

The IMT MCR is aligned to the 14 generic and clinical CiPs. Consultant supervisors should give feedback on CiPs they have observed using global ratings. A minimum of four MCRs are required each year from consultant supervisors

Is that it?

• Induction meetings

– Detailed meeting between trainees and supervisors (ES and CS)

• Local faculty groups

– Group of consultants feeding back on IMT trainees in their area

• Professional Development Meetings

– More frequent and regular meetings with ES

• Review of portfolio

• Discuss clinical cases and reflections

• Plan aims / objectives for the block

Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul

Placement 1 Placement 2 Placement 3

Professional Development

Meetings

Induction Meeting

Trust Induction

ProgrammeInduction

MSF

SLEs

CS Induction

CS appraisal

Placement Induction

LFG

MCR

ESR

ARCP

Biggest challenges

• IMTs getting to clinic and seeing patients

• Delivering the in-Trust weekly teaching programme

• Access to certain procedures

• Exam preparation

• Time for professional development and for supervision

What can you offer?

• Complete assessments (SLEs, DOPS) and MSF responses • Complete a consultant MCR at the end of a block• Become a clinical supervisor and/or educational supervisor• PLEASE get IMTs into your clinics and actively involved• Provide teaching in your local weekly IMT programme• Provide bedside teaching for IMT trainees preparing to take PACES• Support local simulation and procedural skills courses• Share QIP opportunities• Join an ARCP panel• Support IMT interviews

Thank you for listening!

• Questions?

https://www.jrcptb.org.uk/sites/default/files/IMT%20ARCP%20Decision%20Aid%202019.pdf