A Guide to Specialist Registrar Tr a i n i n g Produced by the NHS Executive on behalf of: • The Department of Health • Welsh Office • DHSS - Northern Ireland • Scottish Office Department of Health February 1998 C o n t e n t s F o re w o rd - by Professor John Te m p l e I n t roduction S e c t i o n P a g e 1. The ro l es of the Sp eci a list Tra ining Auth ori ty, the CC ST 1 and the GMC's Sp eci a list Regis ter 2. App o in tm e n ts to the grad e 7 3. I n d ucti o n 43 4. Tra ining agree m e n ts 47 5. Sh ort - term and fixed - term app o in tm e n ts 69 6. F l exible tra inin g 77 7. Tra ining numb er s 83 8. Sub - s p eci a l ty tra inin g 9 9 9. Over s eas doctor s 103 10. Res earch 121 11. A s s essment of pro gres s 131 12. Record of In-tra ining A s s essment (RITA ) 139 13. Review and app eal pro ced ures 155 14. Movement between Dea n eri es, wi thin the UK, or abroad 165 15. Study leave 169 16. Leav ing the grad e 175 17. Eli gibili ty for co n s ul tant app o in tm e n ts 181 18. Terms and co n di tions of serv i ce and co n tract of empl oy m e n t 185 19. Sp eci a list regis trars in pub lic hea l th medi cin e 207 20. P l a nning numb ers and future career pro s p ects 217 G l o s s a r y 221 Appendices 1-4 225 F o re w o rd It is five years sin ce "Ho s pi tal Doctors Tra ining For The Future " , the rep ort of th e Working Gro up on Sp eci a list Medi cal Tra inin g, was first pub lis h ed in April 19 93. During this time much has been acco m plis h ed to im prove the qua li ty of hi gh er s p eci a list medi cal tra ining in the Uni ted Kin gd o m. The new speci a list regis trar tra ining pro gra mm es were first in tro d uced in two " va n g uard speci a l ti es" - General Sur gery and Di ag n o s tic Radi o l o gy - on 1 D ece mb er 19 95. B uil ding on the success of th ese speci a l ti es, a ro lling pro gra mme to in tro d uce the grade in all oth er speci a l ti es began on 1 April 19 96, w hi ch was kn own as th e G rade Com mi s sioning Date. This tra n s i tion pro cess was co m pl e ted on 31 March 19 97. This new edi tion of A Guide to Sp ecia list Regi s t rar Training re fl ects exp eri e n ce g a in ed from op era ting the speci a list regis trar grade over the last two years and has als o b een inform ed by a wide co n s ul ta tion exercise whi ch was co n d ucted last year. It covers all aspects of the speci a list regis trar grade from entry to exi t , and appli es to th e whole of the Uni ted Kin gdom as we ll as to all speci a l ti es. Cl earl y, this is still an evo lv i ng pro ces s, and alth o u gh this gui da n ce is very co m pre h e n s ive, it is likely th a t furth er modifi ca tion will be neces s ary over tim e. I am parti cul arly gra te ful for all the in d u s try and exp ertise of the memb ers of th e C a lman Impl e m e n ta tion Steering Gro up ba s ed in the NHS Executive in th e pro d uction of this Gui d e, and for the supp ort of those in the oth er UK Hea l th D epartm e n ts. We hope that tra in ees and all those invo lved in the management and delivery of hi gh er speci a list medi cal tra ining in the Uni ted Kin gdom will find that this Gui d e d e livers cl ear, h e l p ful and un a mbi g uous ad v i ce. Professor John Temple Special Adviser to the Chief Medical Officer Chairman, Calman Implementation Steering Group February 1998 I n t ro d u c t i o n Using the Guide 1. This Gui d e, w hi ch repl aces the March 19 96 edi tion of A guide to Sp ecia li s t Regi s t rar training, has been prepared for use by speci a list regis trars (Sp R s ), th o s e a s piring to enter the grad e, and by those who are invo lved in managing the grade and i ts tra ining pro gra mm es. All the sections will, of co ur s e, be of in terest to ca n di da tes for the Sp R grad e, s ucces sful entra n ts to tra ining pro gra mm es and future tra in ees. Some sections will be of more in terest to postgrad ua te dea n s, trust manager s, th e m edi cal Royal Coll eges and oth er re l e vant bodi es. It is im p ortant to note that th e Guide appli es eq ua lly to EEA and over s eas doctors (unl ess oth erwise sta ted ). 2. The aim of the Guide is to expl a in in a deta il ed but stra i gh t forward way exactl y what tra in ees can exp ect at various stages of th e ir Sp R tra ining pro gra mm es, f ro m e n tering the grad e, thro u gh the assessment pro cess to the co n clusion of tra ining and then leav ing the grad e. I n e v i ta b l y, the Guide ca nnot atte m pt to ad d ress all matter s re l a ting to postgrad ua te medi cal and dental ed uca ti o n. It is likely that furth er g ui da n ce may be req uired from time to tim e. A list of UK co n tact poin ts is at App e n dix1. 3. The Guide freq ue n tly re fers to the dis tin ctive ro l es of the various tra inin g p er s o nnel and oth er bodi es invo lved - postgrad ua te dea n s, m edi cal Royal Coll eges and th e ir Facul ti es, univer s i ti es, pro gra mme director s, s up erv is ing co n s ul ta n ts, Sp eci a l ty Tra ining Commi t tees, Sp eci a list Ad v is ory Commi t tees and so on. Po s t grad ua te dea n s are res p o n s ible for the management and delivery of postgrad ua te ed uca ti o n. It is im p orta n t , h owe ver, to emph a s ise that Coll eges and th e ir Facul ti es have a ce n tral ro l e, working both nati o n a lly and thro u gh local ad v is or s, by informing decisions in th e many areas of medi cal ed uca tion and tra inin g.No thing in this Guide gain s ays th e im p orta n t , in d ep e n d e n t , and co m pl e m e n tary pro ced ures un d erta ken by Coll eges and th e ir Facul ti es for vis i tin g, in s p ecting and approv ing Sp R tra ining pro gra mm es and, w h ere re l e va n t , in div i d ual tra ining pl ace m e n ts. I n t roduction of the specialist registrar grade in medicine 4. The tra n s i tion arra n ge m e n ts for in tro d ucing the Sp R grade were des crib ed in d e ta il in Section 2 of the March 19 96 edi tion of A Guide to Sp ecia list Regi s t rar t raining and this is repro d uced in full at App e n dix 2. The Guide has been re v is ed in li ght of the exp eri e n ce of op era ting the Sp R grade during the last 2 year s.