Answers to frequently asked questions about subspecialty training
You’ll need to discuss your suitability for subspecialty training with your Head of School, who’ll be able to advise on programmes and assess whether you’ve completed sufficient training to apply. You’ll need to have had a satisfactory ARCP before applying and should have completed as many (all if possible) of the advanced core curriculum competencies in the main O&G logbook that aren’t included in your subspecialty programme (this is a GMC requirement). You’ll complete the competencies that relate to your chosen field as part of the subspecialty training programme
Please see details on the Advanced Training registration fee and how to pay.
Before starting subspecialty training, you should have completed the intermediate and advanced core competences that lie outside your chosen subspecialist field.
If you haven’t managed this by the time of your appointment, your training should be targeted to achieving all outstanding competences before you take up your post. You’ll need to discuss with your Head of School how you can achieve the competences in a short space of time (there are typically 3–4 months between appointment and starting the subspecialty training programme). Your training placements will likely be adjusted to help you achieve this, provided there’s no adverse impact on other trainees and service delivery.
If you don’t achieve all the outstanding competences, your Head of School and Subspecialty Training Programme Supervisor will discuss how this can be achieved within your subspecialty training, or whether your start date should be delayed until the end of ST6. If you then don’t complete the outstanding competences by the end of ST6, the offer of subspecialty training may be withdrawn. You can reduce the likelihood of this by early and frequent discussion with your Head of School.
The Head of School of your home deanery will remain responsible for your training. All of your ARCPs (annual review of competence progression) will be undertaken in your home deanery. Remember that your ARCP will assess your progress in both subspecialty training and the core curriculum – the training matrix will help you identify what you need to ensure a satisfactory ARCP outcome.
If your ARCP identifies issues with your subspecialty training, in terms of either your progress or the department’s ability to provide training, your home deanery will be responsible. However, the Head of School in the deanery where you’re undertaking your training (host deanery) will work with your training unit to help you.
Subspecialty trainees following the pre-2019 core curriculum, you won’t need to provide evidence of continuing competence by undertaking workplace-based assessments (WPBAs) once you’ve had a competence that isn’t relevant to your subspecialty signed off in your core logbook. You will need to undertake WPBAs in subspecialty-specific skills, as outlined in your subspecialty curriculum. However, if you think there’s a chance you might take up a non-subspecialist consultant post in the future, you’ll need to ensure you keep all your skills up to date to enable you to take up the post.
Subspecialty trainees following the 2019 core curriculum, you will need to demonstrate ongoing competencies in cross specialty by providing evidence for the obstetric core CiPs 10 and 12 to ensure that you will receive a CCT in O&G in addition to your subspecialty accreditation at the end of your training. This applies to trainees undertaking the Gynaecological Oncology, Reproductive Medicine and Urogynaecology subspecialty training.
Subspecialty trainees following the 2019 core curriculum, you will need to demonstrate ongoing competencies in cross-specialty by providing evidence for the gynaecological core CiPs 9 and 11 to ensure that you will receive a CCT in O&G in addition to your subspecialty accreditation at the end of your training. This applies to trainees undertaking Maternal and Fetal Medicine subspecialty training.
Please read the guidance on how subspecialty training is assessed.
The annual RCOG subspecialty review assesses your progress against the subspecialty curriculum, and feeds in to the information collected for your ARCP (annual review of competence progression). For more information, please read the guidance on how subspecialty training is assessed.
If you are on the 2019 core curriculum, you need to demonstrate ongoing competencies in cross specialty core CiPs by providing evidence for the obstetric core CiPs 10 and 12. To achieve this it is recommended that you do some obstetrics on call to assist in the accumulation of evidence showing ongoing involvement and learning in obstetrics at advanced level. Other obstetric experience is likely to be necessary to satisfy the requirements of both CiP 10 and 12, and guidance from the RCOG will be available soon (when this is decided we can place a link). Pre CCT subspecialty trainees in Gynae oncology, Urogynaecology or Reproductive Medicine who are not part of an on call rota including obstetrics will need to formulate a plan with their supervisor, based on this guidance, as to how they will access appropriate learning opportunities in obstetrics so that entrustability level 5 can be reached in CiPs 10 and 12 by the time the trainee is completing training. Failure to do so may result in successful completion of the subspecialty training programme, but the need for additional general training time before an outcome 6 can be awarded in recognition of completion of the core 2019 curriculum.
If you are on the pre-2019 core curriculum, and you have all the core competencies signed off already, there is no requirement for you to evidence ongoing involvement in obstetrics. ARCP panels have been informed that you do not need OSATs showing ongoing competency in obstetric skills, provided you were signed off as being competent for them previously. The on-call component of each job depends on your trust and deanery and varies between hospitals depending on the funding for your post. There aren’t any specific requirements, but most trainees undertake on-call work in both parts of the specialty. Doctors who are planning to take up consultant posts with an obstetric component are reminded of GMC advice; they have a particular duty to their patients to ensure their obstetric skills remain equal to those of a general trainee being awarded CCT.
If you’re experiencing problems achieving your subspecialty or core curriculum objectives, an action plan will be developed at your ARCP (annual review of competence progression). This requires liaison between your Head of School and your Subspecialty Training Programme Supervisor.
RCOG review panels and your Subspecialty Training Programme Supervisor can recommend extending your training, but only your Head of School on behalf of the Postgraduate Dean can authorise this.
This is correct. Your placement post-CCT is at the discretion of your deanery. Some deaneries may wish to use your tertiary-level skills, but they aren’t obliged to do so. Priority will be given to those in pre-CCT training.
It may be possible to obtain approval for CCT before completion of subspecialty training. This issue can be complex and the individual circumstances require discussion. It is therefore important to seek advice from your Head of School and Postgraduate Dean as well as the Chairs of SEAC and Subspecialty Committees.
Trainees who are progressing well within the training programme and wish to bring forward their projected date of subspecialty training completion may now do so providing:
- This request is supported by the Subspecialty Training Programme supervisor and Head of School.
- This request must also be supported by the assessment panel during the subspecialty centralised assessment.
- Requests are made in a timely manner.
Requests to bring forward the subspecialty training projected completion dates must sent to the Subspecialty Committee via email email@example.com at least 6 weeks before the centralised assessment together with evidence of support of this request from the Subspecialty Training Programme Supervisors and the Head of School. This request, together with the new completion date, must be clearly documented on the Educational Supervisor Report for the assessment panels to review and assess training accordingly. Ultimately, the award and timing of the CCT is down to the home deanery and ARCP processes.
Yes. In general, the RCOG and Deaneries will support you if you want to complete an ATSM that you started before entering subspecialty training. You should discuss this with your subspecialty training programme supervisor and your deanery ATSM Director.
Owing to time constraints, subspecialty trainees are discouraged from undertaking ATSMs. ATSMs are primarily for trainees who wish to pursue special interest training rather than those aiming for a subspecialty career. Subspecialty trainees don’t need to complete two ATSMs to gain their CCT, as the GMC will recognise your subspecialty certificate instead of two ATSMs.
However, as a subspecialty trainee, when you register for your subspecialty programme you’ll be automatically registered for the ATSM that relates to your subspecialty interest. There’s no additional cost. You’ll need to demonstrate attainment of competences in the ATSM related to your subspecialty interest in addition to your subspecialty curriculum.
- If you’re undertaking subspecialty training in gynaecological oncology, you’ll be automatically registered for the oncology ATSM
- If you’re undertaking subspecialty training in maternal and fetal medicine, you’ll be automatically registered for the fetal medicine ATSM, or can choose to complete the maternal medicine ATSM
- If you’re undertaking subspecialty training in reproductive medicine, you’ll be automatically registered for the subfertility and reproductive health ATSM
- If you’re undertaking subspecialty training in urogynaecology, you’ll be automatically registered for the urogynaecology and vaginal surgery ATSM
In the unlikely event that you fail to fully complete your subspecialty training, this process of registering for your related ATSM will allow you to complete the module; you would then have to complete only one further ATSM to to gain your CCT. It would be expected that you would have sufficient training time to achieve this.
It’s not usual to start ATSMs during subspecialty training, owing to the time pressures of the subspecialty programme. However, there may be exceptions when your subspecialty training programme director will support you undertaking an ATSM as well. For example:
- If you’re doing subspecialty training in maternal and fetal medicine and are planning to undertake a leadership role on the delivery suite, you may wish to complete the labour ward lead ATSM
- If you’re doing subspecialty training in gynaecological oncology and are planning a leadership role in vulval disease, you may wish to complete the vulval disease ATSM
If you wish to undertake an ATSM during subspecialty training:
- Discuss the benefits with your subspecialty training programme director and ensure you have their full support
- Meet the Deanery ATSM Director to check whether it’s possible to undertake the ATSM locally
- Confirm when it would be possible to undertake the ATSM and who your ATSM Preceptor would be
- Ensure you have support from your Head of School or Deanery Specialist Training Committee Chair
Please bear in mind that the ATSM Director has overall responsibility for ensuring ATSMs are allocated equitably for all senior trainees – and in particular those for whom it’s mandatory to complete two ATSMs.
Once you have all the necessary support:
- Complete the ATSM registration form, available from How to register for an ATSM, which your ATSM Educational Supervisor, ATSM Preceptor and ATSM Director will need to sign
- Submit the completed form to the RCOG, together with a letter of support from your subspecialty training programme supervisor and the Head of School/Deanery Specialist Training Committee Chair and the appropriate registration fee
- The Chair of the RCOG’s Subspecialty Committee reviews all applications for ATSMs within subspecialty training
Find out more
If you need any help or advice, please email the Advanced Training Coordinator at firstname.lastname@example.org or call +44 20 7045 6789.