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JAG forms for DOPS, MSF and Mini-CEX (required for RITAs) can be found
at:
http://www.jrcptb.org.uk/forms/Pages/default.aspx
These notes are my own interpretation of what took place and do not reflect SAC position or policy.
Update, 10.6.10
The first round of ST3 recruitment has been completed. This has been successful with the majority of posts being filled. There were 6.8 applicants for every post with 20% of offers being rejected, due to several applications to different deaneries to different specialities. It is estimated that each applicant has an average of 4 other applications at any one time. 90% of applicants had MRCP. In 2011 MRCP will be an essential requirement.
The definition of an appointable candidate was a score of 36 or higher at interview. Concern was raised about the threshold of 36 points, with many deanery representatives feeling that this score was too low. The Royal College of Physicians feel that this is an acceptable standard for recruitment. Some deaneries have now chosen to opt out of the national scheme for the 2nd round. This will mean that any LAT posts that arise they will advertise independently. This led to further discussion about the situation where one deanery may deem a candidate unappointable, but despite this they reenter the national second round clearing system. The college will examine this process.
The clearing process is for candidates who scored above 36 and did not obtain a post. They will stay on a reserve list for posts that come up until mid August. Deaneries will approach candidates directly who then have 48 hours to accept or decline.
Assuming sufficient numbers of posts come up Round 2 will occur between Sept to October 2010 and will be posts that are available up until the end of January 2011. Any post that becomes available following this will go into the pool of posts for August 2011 recruitment.
The new 2010 Gastro curriculum will be published on line in August 2010. This will be for any candidates appointed from August 2010. It is unclear whether trainee’s on the 2007 curriculum will be allowed to change onto the new curriculum. The implementation of the new curriculum will be complex as one of the major changes is the development of the core nutrition and hepatology modules (6months each) and in addition the advanced Liver, Advanced Endoscopy, Nutrition and IBD modules. The modular posts will involve redefining existing posts and then advertised nationally. It is anticipated that 2010 appointee’s will do these posts in their 4th year (ST6) making it unlikely that they will be advertised until 2013. The speciality year will still include general internal medicine training.
Workforce planning continues to pose concerns. There has been an 8% increase in numbered posts in the last 12 months. Currently consultant posts are going unfilled but it is anticipated that this will not continue. It was made clear there must be a freeze on training posts and that there needs to be tighter regulation of numbers.
The 3rd knowledge based assessment is due to take place in September 2010. Discussion revolved around having 2 exams per year, but that this is not currently possible due to the relatively small bank to questions. I also raised the issue that may arise if a trainee has not passed the KBA by the time they reach their final year. The consensus was that the trainee would be allowed to pass their PAYE, but that obtaining it would become a mandatory requirement. It is not clear how long a trainee would continue to be employed for after completion of the training if they did not have the KBA.
JAG are due to publish new guidance on trainee certification, and this was reviewed. The main changes proposed are that learning is experiential and not absolute on numbers of procedure, there are changes to the assessor requirements in the summative assessment and new EUS accreditation guidelines. Although all trainees should be using the JETS system it is felt that only 40% of hospitals have this JETS up and running. It was raised that this involves some administration and that it is likely that trainee’s will have to lead this process. From July 2011 all applications for certification will be electronic.
Update, 10.2.10
Plans for ST3 recruitment in 2010 are now in place. Application will be online in a similar format to Foundation and CMT applications with self-selected scored components and two free text questions that will be scored by gastroenterologists. Dates have been agreed for applications, shortlisting and interviews. Interviews will consist of 3 stations – cv and career progression, 2 clinical scenarios, and presentation of a case or interesting development with associated discussion. There will be local and then national clearing to match appointable candidates to available posts. They will be allowed to appoint to any vacancy that is going to become available up to 31 Dec and keep a list of appointable candidates who could be offered a LAT or number if a vacancy came up in the 3 months following interviews.
The new 2010 Gastro curriculum will require slightly different implementation than has been the case to date. Rather than gastroenterologists in training rotating around and accumulating experience/competencies, posts will have to be mapped to the curriculum so it is clear which areas are being delivered in each post. This will be particularly important for the 6 months of ‘core’ nutrition and 6 months of ‘core’ hepatology. The ‘advanced’ modules in hepatology, nutrition, IBD and ERCP/EUS will be options for a minority and will be done in ST6. Regions have to decide to establish these posts which will have no G(I)M component and will use up an NTN. The posts need not necessarily be based in a single centre. Advanced modules will be offered in national competition (similar to sub-specialty hepatology posts now) and it may be necessary to move to a different region for the year.
Workforce remains a source of anxiety for those who do not yet have a CCT. The aim is to have 6 whole-time equivalent gastroenterologists per 250,000 population (already the case in the North East and London) which requires 850 more consultants nationally. There is the right number of trainees in post to meet this requirement but expansion will have to cease soon to avoid an overshoot with more CCT holders than jobs. To meet the target (and have all of us employed) requires an expansion in consultant posts of 7% per year. The actual figure has been 5% for the last few years and this might fall due to reduced health service spending. There is a ‘bulge’ of trainees reaching CCT in 2011-13 and it is hard to predict whether, where and how they will find employment.
The SCE Gastroenterology exam had 105 candidates in 2009 and 61% passed, lower than the expected 80% but similar to Cardiology and Renal. UK trainee UK graduates actually did slightly worse than overseas graduates and it was stressed that while the exam does test core gastroenterology knowledge this does include some fundamental science, histology, radiology and endoscopy images and rare conditions so book work and revision are important preparation. The SCE is still running at a considerable financial loss but it is predicted that the RCP and BSG will eventually recoup their investment.
The SAC will be interested to see the results of the current TiG/BSG Trainees Survey which will help assess provision of training opportunities across the UK, particularly in the areas of core nutrition and hepatology.
I raised the issue of individuals who had been told at ARCP that even though they had JAG certification they would have to attend a Basic Skills or Colonoscopy course because it is a mandatory requirement of the 2007 and later curricula. It was clarified that, although the courses are considered mandatory for those who started in 2008 or later (when the decision to make them mandatory was made), individuals who had already received JAG certification without attending the courses would not need to complete the courses just to receive a CCT.
I also raised the issue of trainees in ACF posts who have been told that because they are only in clinical work 50% of the time they will have to take twice as long to reach CCT. It was clarified that this is true if they are on the 2003 curriculum as ACF posts were not really designed to work with this time-based curriculum. ACFs on the 2007 curriculum or later have competency-based progression and so can reach CCT faster if they accumulate the necessary competencies. I would suggest that ACF/ACLs on the 2003 curriculum should seek advice from their supervisor, programme director and deanery and, if there are problems, from Prof David Thompson who is the Lead for Academic Training at the BSG, or from their local TiG rep.
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