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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, 10.2.10
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.
Update, 3.11.09
Plans for ST3 recruitment in 2010 are progressing and Gastro has joined with Cardiology, Geriatric Medicine, Diabetes/Endocrinology and Renal to produce a coordinated national recruitment programme for England and Wales with Scotland joining in for everything except Cardiology. The process is being facilitated by the RCP. Plans have yet to be finalised but it is likely candidates will be able to apply to any 2 deaneries within each specialty via an online portal similar to that used for CMT recruitment. Candidates applying for Gastro may get 1, 2 or 0 interviews depending on how their application form scores and on the competition for interview places in each deanery. After initial offers are made and accepted, there will be a clearing process to match appointable applicants to NTN vacancies in other deaneries and potentially some LAT posts offered after that. A very approximate timescale is likely to involve applications around April, interviews in May and decisions in June. Other specialties and Northern Ireland will have separate application processes and candidates will be at liberty to enter these as well as the coordinated scheme. Once the scheme is running it can be repeated three times a year so that vacancies are filled soon after they arise. It is worth noting that Dept of Health policy dictates that a commitment to supporting Equality and Diversity should underpin all NHS recruitment, so potential applicants for higher training might want to complete a relevant online training module as evidence of their commitment to this.
The new 2010 Gastro curriculum has reached its final draft and awaits approval from PMETB. The next stage will be some work on how to deliver the new curriculum with its more substantial elements of basic science, nutrition and hepatology, and the variety of options for endoscopic training available. The SAC is planning to work closely with the BSG Training Committee to ensure the curriculum can be delivered at a local level.
Workforce planning continues to be a challenge with SpR numbers having increased by 10% over the last year despite efforts to keep growth at 0%. It remains extremely difficult to predict how many consultant posts will be available in the future as acute trust employment practices are influenced largely by government targets and commissioning. The 18-week pathway seems responsible for a recent increase in new posts but harder times may lie ahead due to the economic climate.
There have been some problems with recruitment into advanced Hepatology training posts and I was asked what factors might be responsible. We identified that SpRs have been told that consultant jobs may become scarce and that acute medical posts may be an alternative route to a consultant post so some are reluctant to appear too ‘over-specialised’. Also, posts with relatively little endoscopy exposure can cause concern for those who are trying to keep up with colonoscopy numbers. Thirdly, the hepatology posts tend to be advertised relatively late and with little publicity and it can be difficult for applicants to arrange time out of programme in time. Furthermore, there has been little evidence of the hepatology year being necessary when applying for a DGH consultant post with a liver interest as it rarely appears as a requirement in job advertisements. It was suggested that it might help to advertise the posts earlier and with some coordinated publicity next year.
It was noted that some trainees are unsure which Gastro curriculum they are supposed to be following. This is largely a problem for those who were in LAT posts before the new curriculum was introduced in August 2007 but who received an NTN at that point or later. It was made absolutely clear that it is the NTN which determines the curriculum against which a trainee should be assessed, so if your NTN ends in a ‘C’ your CCT will depend on completion of the 2007 curriculum, even if you started as a LAT on the older 2003 curriculum. 2003 curriculum SpRs have an NTN ending in ‘N’. Academic trainees have an NTN ending in ‘A’; most will be on the 2007 curriculum but should check with JRCPTB if they are unsure.
There has also been some confusion about colonoscopy training for SpRs on the 2003 curriculum, some of whom have been told that they can stop training in colonoscopy as it is now optional. It was made clear that colonoscopy is an option for those on the 2007 curriculum (and colonoscopy and flexible sigmoidoscopy will be optional on the 2010 curriculum) but OGD, flexi sig and colonoscopy are all necessary for a CCT on the 2003 curriculum.
There was brief discussion about the constitution and terms of reference of the SAC. New guidelines from PTB suggest that an SAC could have up to 3 trainee representatives (1 each from England and Scotland and 1 from Northern Ireland or Wales) and that representatives are nominated or co-opted rather than elected. However, after discussion it was felt that as TiG includes all UK Gastro trainees regardless of geographic location or membership of colleges or specialist societies and as the TiG committee is elected by and accountable to its constituents, then a single representative from TiG could continue to represent the views of all UK Gastro trainees on the SAC.
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