FAQs on Respiratory Training

This is a summary from the most recent STC meeting in May 2020 and Dr Bhowmik’s email.

This will be routinely updated with receipt of new information.

1. What is happening and new with regards to ARCP?

– will be done remotely and expected to take place in June/July (dates to be confirmed)

– please ensure all competencies signed off appropriate to stage of training

– A meeting will be done remotely to discuss evidence if there are concerns raised from ARCP

– In summary, the existing ARCP outcomes remain in place particularly for those whose training has not been massively affected. However, there is a new ARCP outcome 10 (10.1 and 10.2) if training/progression has been affected by the COVID-19 pandemic. There will be C codes used to further describe the reason for outcome 10.1 or 10.2. Please see this website for details of ARCP outcomes. https://www.copmed.org.uk/images/docs/Coding_for_ARCPs/Coding_for_ARCPs.pdf

• Outcome 10.1 – Progress is satisfactory but the acquisition of competencies/capabilities has been delayed by COVID-19 disruption. Trainee can progress.
• Outcome 10.2 – Progress is satisfactory but the acquisition of competencies/capabilities has been delayed by COVID-19 disruption. Trainee is at critical point and additional training time is required.

– Evidence required for each year of training include:

• 50% of SLEs expected for year
• ES report
• 2 MCRs
• MSF if there has not been one satisfactorily performed earlier in training
• DOPS (or continuing competence mentioned in ES report) for NIV and chest drain
• Ideally DOPS for bronchoscopy

2. Is PYA still going ahead?

– suspended at present

– this will be looked into at ARCP. Trainees who are expecting a PYA should go through the curriculum to ensure everything was done accordingly

– For any issues, please contact Dr Bhowmik. There may be some individual flexibility to combine with ARCP if this will delay CCT.

– To ensure you don’t get missed, it is safe to inform Dr Bhowmik that you are due your PYA.

3. What is happening and new with regards to SCE?

– mandatory for CCT

– expected to go ahead at the end of September

– if this is the only thing required for CCT, then people may be able to step up as consultant whilst waiting to do it and the usual 3-month limit is likely to be relaxed

4. Do I have to extend Resp/GIM training now that I have done more than 6 months of ITU?

– The extra ITU time should count towards Resp/GIM training (still awaiting formal notification). It may be like OOP where you can count some/all if you wish to.

– For those who want extra training in Resp/GIM, that can be considered and CCT date will be postponed.

– Individuals could discuss with Dr Bhowmik if they really want to rotate out of ITU if unwilling to spend extra time in ITU.

5. I was unable to gain adequate experience in some compulsory areas such as pulmonary hypertension, lung transplant, cystic fibrosis and occupational lung disease due to the COVID-19 pandemic required for ARCP/CCT.

– this should not delay CCT

– there is general agreement that some online modules may be considered as an alternative to the attachments.

– Dr Bhowmik has suggested some online modules below:

https://new.ersnet.org/cme-online/modules/how-to-diagnose-and-manage-pulmonary-vascular-disease

https://new.ersnet.org/cme-online/modules/pah-accurate-diagnosis-and-patient-assessment

https://new.ersnet.org/cme-online/modules/optimised-follow-up-for-paediatric-and-adult-cystic-fibrosis-patients

https://brit-thoracic.org.uk/education-and-events/elearning/lung-transplantation/

https://new.ersnet.org/cme-online/modules/indications-for-lung-transplantation

https://brit-thoracic.org.uk/education-and-events/elearning/occupational-asthma/

– Please check with Dr Bhowmik before doing other online modules to see if they are adequate

– Ideally the training plan created post ARCP would enable trainees to gain at least some of these external experiences. This could be completed in a period of grace, post CCT.

6. I was unable to rotate to an ITU post because of the COVID-19 pandemic.

– 3 months of ITU experience is required prior to CCT. CCT date may be postponed if you have less than 3 months left and you have not done your ITU rotation yet.

7. What is happening to training days?

– pan-London online training days are being planned. We are waiting technical solutions from HEE LASE.

– there will probably be online courses available from BTS especially to replace the cancelled SCE courses

8. How is OOP being affected by the pandemic?

– OOPs are gradually restarting. However it depends on whether the sponsors for research are able to restart work at the moment.

– For those who have returned from OOP, all clinical time will count towards training (except ad hoc bank/locum work).

– We are awaiting guidance if OOPs can be extended if needed.

9. What is happening to our rotations?

– This will happen in October. Please send your preferences form back to Dr Bhowmik if you haven’t done so.

10. I am looking for support during the COVID-19 outbreak.

– Professional Support Unit (PSU) has introduced Single Point of Contact (SPOC) which is a free, confidential and impartial service for trainee doctors. Trainees can sign up for a 45-minute conversation with a senior PSU lead. Calls can be arranged for same day, next day or next week to accommodate for last minute changes in rotas. Please see the COVID-19 Wellbeing Hub for further information.

11. I have questions about my ALS certification.

– ALS courses have all been suspended.

• All ALS certificates that expire in 2020 will be extended for 6 months unless for those who are returning to clinical practice and for those who feel that they no longer have capabilities related to leading a cardiac arrest team, they should follow the below guidance.
• ALS certificates that have lapsed within a year in 2019 and those that have lapsed over 12 months ago should discuss the need for a revision of ALS skills with the clinician who is supervising their day-to-day activities.
• If a trainee who does not hold active certification is inadvertently rostered to be part of the cardiac arrest team the trainee should alert the rota coordinator as soon as possible to ensure that either they receive the adequate training in advance of their shift, or, if this is not possible, a replacement is found for the cardiac arrest team.

12. What about quality improvement projects/audits?

– For an outcome 10, this is not required. However, if you are hoping to get an outcome 1 or 6, this remains essential.

13. Finally, what are the evidence required for GIM ARCP?

• Supportive reports from MSF from the first 2 years and last 2 years of training
• 3 MCRs
• Satisfactory Educational supervisor report

– Trainees should be allowed to progress if trainees who have been unable to acquire capabilities in their core programme due to the impact of Covid-19 be facilitated especially if specific components of the curriculum have been unfulfille but there should be generation of a PDP to ensure that trainees gain the necessary experiences defined in the curriculum.

– In terms of acting up, many capabilities can be gained during the period of grace post CCT. Management, training and leadership would be suitable in a grace period.