New Guidance for Training

All doctors in training for a Certificate of Completion of Training (CCT) should register with the appropriate Royal College once they have decided upon their career speciality. For General Practice this will be the Certification Unit of the Royal College of General Practitioners.

The Foundation (F1 and F2) years do not count towards the full requirement of a 3 year GP training programme. This must still contain a minimum of 12 months GPR and up to 24 months in SHO posts.

The RCGP website contains guidance and all the forms needed to apply for registration with the Certification Unit. Current fee for this is a single payment of £350 and covers all advice, approval and gives entitlement to Associate Membership of the RCGP during the training years.

All trainees still in training should register with the RCGP and will be required to pay the registration fee. They should do so as soon as possible and new trainees should do so preferably at the start of a training programme.

The RCGP has already been passed any existing training files. Note: The RCGP Certification unit is currently still at the same address as the JCPTGP was.

The only trainees exempt from the RCGP registration fee will be those who had already submitted ALL the forms for a completed training programme for certification by the 29/9/05 to the JCPTGP.

Trainees who have completed or are part way through a training programme and still have forms to submit for training approval will be charged the full registration and approval fees.

The Postgraduate Medical Education and Training Board (PMETB) is responsible for issuing the Certificates of Completion of Training (CCT) in all specialities and will charge a £500 fee. All posts and programmes require prior formal approval for GP training by the RCGP.

GP Registrars will automatically be sent the PMETB application form for the CCT about 6 months before completion of their whole training programme. This form will not be available on the web.

The completed CCT form should normally be submitted 6 weeks prior to completion of training though it can be sent in earlier and will be held on file pending recommendation of certification by the RCGP.

To work as a General Practitioner either as a partner or sessional doctor requires both the CCT to have been issued and continued inclusion of the doctor on a Medical Performers List of a PCT. The CCT can not be back dated.

The newly qualified GP must notify the PCT of their change in status as it is the policy of some PCTs to remove the GPR’s name from the MPL automatically after their recorded date of programme completion.

The GP training programme remains as 3 years full time or the equivalent part-time following any Foundation years. If part-time training this must include at least 1 week full-time training and education in the 2-year hospital part and 1 week in the GPR part. The minimum part time training permitted by European regulations is 50% of the full time equivalent post.

Only the following List A and List B SHO posts will be recognised as counting towards future GP training programmes under Article 10 of the training regulations.

LIST A: The minimum required is 1 year in the A List posts below in a combination of 3, 4 or 6 month slots and the maximum allowed in any single post will be 12 months.

• Accident and emergency medicine
• Paediatrics or community paediatrics
• General medicine or geriatrics or dermatology or GU medicine or rehabilitation medicine
• Gynaecology or obstetrics / gynaecology
• Psychiatry or old age psychiatry
• Palliative medicine

LIST B: The maximum allowed is 6 months in each post listed below and in total no more than 2 posts or 12 months.

• Cardiology or medical oncology or clinical oncology or gastroenterology or endocrinology and diabetes mellitus or haematology or nephrology or respiratory medicine or rheumatology or neurology or infectious diseases
• Child and adolescent psychiatry or psychiatry of learning disability
• Ophthalmology or ENT or ENT surgery or General surgery or paediatric surgery or urology or trauma and orthopaedic surgery or trauma / orthopaedics
• Intensive therapy
• Public health medicine
  
   

LIST C (see RCGP website) is only for trainees who are already on existing GP Training Schemes prior to 30th September 2005.

PLUS a GPR post of 1 year or more to include satisfactory completion of Summative Assessment (or Joint modules of MRCGP) or in future the new MRCGP exam from 2007.

All training must be completed within a seven year period when applying for the CCT under Article 10 regulations.

The ideal is to undertake all or most of the SHO training in List A posts and to have 12-18 months as a GPR. It is important that the overall training programme is balanced across the full range of specialities and provides the trainee with a managed exposure to relevant specialties for GP.

Non-listed specialities are unlikely to be accepted and if approval is required will currently only be considered under Article 11 (Equivalent Experience) by PMETB. This is likely to cost the Trainee £950.

All components of a CCT training programme require prior formal approval by the RCGP. Any changes to a planned programme must be agreed with the Deanery and notified to the RCGP.

VTS existing programmes (check they are A List compliant) will only require the trainee to register with the RCGP at the start of training and to document progress by submission to the RCGP of each signed and stamped VTR2 or RITA C form upon satisfactory completion of each post. The CCT application form will automatically be sent 6 months before completion of the training programme.

The RCGP will acknowledge receipt of all VTR forms but will only respond in detail if a problem is identified. The forms must be correctly completed and any amendments will cause the forms to be returned to the trainee.

Self-construct trainees should register with the RCGP once they have committed to a GP career. The planned programme should be reviewed with a GP Educationalist where possible and must comply with RCGP/PMETB orders. Formal advice by the RCGP on prior experience will only be given if registered for GP training.

Overseas posts, training undertaken longer than 7 years previously or Non-approved training posts may currently only be approved under the Article 11 orders through PMETB. The trainee will need to apply to the PMETB for a Statement of Eligibility for Registration (SER) and will be charged £950 fee. They are not eligible to apply for a CCT (Article 10).

TAGPR, Electives and Innovative training posts all require Deanery approval and completion of the new ITP form. The ITP form and signed VTR1 should be submitted to the RCGP Certification Unit provided training is in the Listed A & B specialities and conforms to the guidance above otherwise application should be made under Article 11 orders to PMETB. We suggest you add the name of the GPR to it when sending in to the RCGP in the Reference number box.

Flexible SHO Training once approved for SHO flexible training and successfully applied for GP training through the National Recruitment Process the trainee should register with the RCGP. Detailed planning of the various posts and the learning plan should be undertaken with a GP Educationalist and approval will require submission of an ITP form. We suggest you add the name of the GPSHO to it when sending in to the RCGP in the Reference number box. SHO posts will require a signed and approved VTR2 on satisfactory completion of each post.

Training extensions due to sick, maternity leave or for other reasons will require submission of a supporting letter from the Deanery indicating the change in circumstances and giving support for the amendment.

Sick Leave regulations remain unchanged from previous advice and allow up to one week’s sick leave in any six-month GP Registrar post. Sickness in excess of this must be made up by extending the GPR post by the equivalent period.

The RCGP will not normally require less than one month’s sickness absence in a two-year hospital programme (pro rata for shorter training programmes) to be made up. Sickness in excess of this must be made up in full, but not necessarily in the specialty or post where the absence occurred.

Where the sickness absence exceeds these guidelines by a small amount, the GP director may exercise discretion and decide to endorse a VTR form attesting to the complete period of training. In exercising this discretion the GP director must be assured, after appropriate inquiry, that there has been no educational detriment to the programme resulting from the absence. Advice from the relevant educational supervisor(s) should be sought in every case

The RCGP policy is that training periods of less than one month in duration will not normally count towards a certificate. However, in cases where a GP in training has to make up time lost through sickness, the Committee may consider shorter training periods towards certification.

Trainees who have taken a lot of sick leave must confirm with the RCGP that their plans to make up lost time will mean that their programme of training conforms, on completion, to regulatory requirements.

The RCGP will allow time off from the training programme for maternity, paternity leave and jury service in the same amounts as is allowed for sick leave.

All individual GPR training periods require submission of separate VTR1 forms even if it was with the same GP trainer (i.e. TAGPR and GPR post or split times).

Where training problems have been identified or following a SA fail during the GPR section of training and the GPR moves to another practice for additional or extended training the GPR Trainer should complete a VTR1/RITA D form.

Application to PMETB for the CCT should be made from 6 weeks before completion of the training programme and will usually take no more than 2-4 weeks provided that all the documentation (VTR1 & 2 plus ITP forms etc.) has been correctly completed and previously sent to the RCGP Certification Unit.

The final VTR1 can not be signed by the Deanery until 6 weeks before completion of the full GPR training programme and a pass has been achieved in all components of Summative Assessment or equivalent modules.

All trainees should keep copies of any documentation submitted to the RCGP or PMETB. The Deanery should receive a copy of the trainee’s application for registration with the RCGP and copies of confirmation of programme approval.

Appointment to all training posts is via application twice a year through the National Recruitment process.