Contents

ARCP

PYA

Additional evidence

ARCP

The Annual Review of Competence Progression (ARCP) is the formal method by which a trainee’s progression through her/his training programme is monitored and recorded each year. ARCP is not an assessment – it is the review of evidence of training and assessment.

The ARCP decision is based on the ARCP decision aid (separate aids for Respiratory and GIM) so it is worth being very familiar with this grid: ARCP decision aid (Respiratory) and ARCP decision aid (GIM).

The curriculum states that, in addition to the components of the ePortfolio (meetings, workplace-based assessments, MSF, teaching observations, MCR and audit assessment), trainees should gather evidence of:

– An anonymised record of (see logbook):

• bronchoscopy experience, including details of exact techniques used as well as a record of the positive histology rate for visible tumour.
• pleural interventional experience.
• NIV experience.

– Formal sign off of:

• NIV competence (perhaps best done as DOPS, mini-CEX and relevant courses)
• Intensive Care Medicine experience (for the 6 month rotations in NCEL the educational supervisor report should do)

– Details of training in:

• appropriate specific subject areas within Respiratory Medicine, such as lung cancer and sleep breathing disorders (captured in clinic log and mini-CEX and CbD in specialist posts)
• special interest training, particularly in transplantation, pulmonary hypertension, adult cystic fibrosis, domiciliary NIV and occupational and environmental disease (see here for more info)

Please ensure that anything uploaded to the personal library section of your ePortfolio is clearly labelled. Anything that eases the job of the ARCP panel will be much appreciated!

The Multiple Consultant Report (MCR) is focused on the trainee’s clinical ability (rather than teamwork, communication etc that is gathered in the MSF). For everyone dual accrediting in GIM and Respiraotry, you need to cover GIM in your MCR if appropriate for your post. We advise ask all your Respiratory Consultants to complete an MCR and also 2 GIM Consultants, or ensure two of your Respiratory Consultants who have also seen you do GIM on calls comment on this aspect of your performance.

The required end of placement supervisor’s reports are:

• One for GIM (not required on ICU block or St. Bart’s specialist respiratory job)
• One for Respiratory

PYA – currently suspended due to Covid

In lieu of the formal PYA during Covid, the trainees should arrange a portfolio review (separate to ARCP) with Dr Bhowmik approximately 12 months before CCT date.

The penultimate year ARCP, known as the “PYA”, is undertaken 18 months or less prior to the anticipated CCT date, and will include an external assessor (JRCPTB and the deanery will coordinate this) from outside the training programme, often from the SAC. The PYA will include a face to face component. Its intention is to confirm the CCT date with the trainee and the local STC, and to decide further specific training requirements during the remaining time in training.

CCT date calculator and external assessor marking forms are available from JRPCTB. Trainees and their educational supervisors may find it instructive to review these forms ahead of the PYA. Remember that there will a separate Respiratory and GIM PYAs. To help you smoothly prepare for your PYAs, you can read the useful documents below from HEE:

• Letter to TPDs regarding GIM PYAs: Letter to TPDs regarding GIM (Sept 2016)
• GIM PYA FAQs 2016: GIM FAQs

Additional evidence

(with thanks to Dr Bhowmik for clarification)

GIM

• 186 clinics (may include General Respiratory clinics. Also Lung Cancer clinics where new GP referrals are seen, often in the nature of “Cough ?cause”)
• 1000 acute take patients – calculated by Firth Calculator rather than using a logbook of patients
• 6 ACATs per year (during attachments where GIM is a component e.g. not in ICU/St. Bart’s Hospital) which should include a minimum of 5 cases
• Record of 100 hours of GIM (not including Respiratory) CPD hours over the whole period of training – see training programme for more details
• A separate GIM Educational Supervisor Report, in addition to the one for Respiratory, in any post which includes GIM (even if written by the same supervisor). This is a common reason for trainees not getting an outcome 1.

Respiratory Medicine

In addition to the occupational lung disease, pulmonary hypertension, CF and lung transplant JRCPTB requirements (see here), here are some guidelines for additional experience to demonstrate (although these are guidelines rather than JRCPTB mandated requirements):

• Chemotherapy and Radiotherapy clinics – evidence of some experience. Arrange locally in appropriate posts
• Smoking cessation clinic experience (an online or BTS course is also beneficial, or formal level 1 training available at The Whittington)
• Pulmonary rehabilitation experience (arrange with your Respiratory Physio or community team (easy at the Whittington and Homerton). Why not give a patient education session and get it signed off as a Teaching Observation?)
• Integrated Respiratory Medicine experience (strict criteria not yet agreed: Dr Bhowmik suggests at least 3 MDTs and a home visit accompanying a specialist nurse with CbD afterwards. Easy to arrange at Whittington and Homerton)
• HIV clinic experience (available at UCLH and Royal Free)
• Respiratory allergy and immunology (available at Homerton)
• Thoracic surgical list (arrange locally through the surgeon at your Lung Cancer MDT)
• Safe sedation course (see courses). If necessary, the deanery may organise one on a training day similar to the one previously organised in Royal Free in 2015)
• Level 1 pleural US – see FAQs for further information
• Complete MSF with minimum of 12 responses including 3 consultants and several non-clinical staff once in first 1-2 years and one in final 2 years
• Audits or quality improvement projects including GIM
• Separate annual Respiratory and GIM supervisors report (end of placement) – incorporating MCRs (see above)

By the end of programme:

• Management course
• Teaching course
• Registration with RCP online CPD diary

A checklist written by LJ and Dr Bhowmik to make your ARCP go smoothly is available here: UCLP Respiratory Medicine ARCP checklist 2015 FINAL. You must still check the specific requirements for your year of training, in addition to this list, particularly with the new GIM ARCP decision aid:

• Individual sign off of emergency presentations and procedures by trainee and supervisor
• Other curriculum items – trainee to sign off all, supervisor to sign off 10% each year
• Record ratings at curriculum group level