Assessment principles for subspecialty trainees

The subspecialty training assessment process coordinated by the RCOG ensures that all subspecialists are appropriately trainined. The primary purpose is to assess the clinical training of subspecialty trainees, underpinned by the following principles:

• Progress in clinical aspects of subspecialty training can be appropriately assessed only by specialists in that subspecialty
• Subspecialty assessment must inform the formally recognised Annual Review of Competence Progression (ARCP)
• Assessment of trainees’ skills and attitudes should be based on objective evidence and involve external assessment to ensure standards are met
• All assessments must be undertaken by individuals who’ve attended courses about current educational processes, e.g. courses that confer recognition as an Educational Supervisor
• Subspecialty assessment must comply with the GMC standards
• The quality assessment process for each unit is the responsibility of the deaneries, but the RCOG will define objective criteria to assist deaneries, linked to the GMC standards set out in The Trainee Doctor

The RCOG subspecialty training assessment is organised by the RCOG. The RCOG assessors need to receive completed paperwork 2 weeks before the assessment date.

RCOG assessments must be timed to allow information to be available for the ARCP. The number of assessments will be determined by the number of training years in the programme, as ARCPs are annual.

Timing of the RCOG subspecialty training assessment

The subspecialty training assessment needs to be aligned with the ARCP, taking place within 6 weeks of the ARCP.

The RCOG coordinates how the assessment outcome is communicated to the trainee, the training unit, the trainee’s deanery (Head of School) and the deanery delivering the subspecialty training programme, and will feed back to assessors.

On the day of the assessment visit

Any further objective evidence should be reviewed before meeting the trainee. The Educational Supervisor shouldn’t be present during the trainee interview.
The purposes of the meeting are to:

• Assess the trainee against the standards set out in the subspecialty matrix
• Meet with the trainee and Educational Supervisor after the assessment to discuss any training issues
• Clarify any support required for the trainee and set an educational plan
• Recommend an ARCP outcome (although the final ARCP outcome will be determined by the ARCP panel)

Possible outcomes of the annual assessment (not the final assessment)

• Progress is satisfactory when an educational plan is in place and no changes are required to complete the training. The subspecialty training assessors recommend an ARCP outcome 1.
• Progress is such that only minor changes to the educational plan are required to ensure training is completed in the allotted time. The subspecialty training assessors recommend an ARCP outcome 2. The advantage of an outcome 2 is that it’s easier to negotiate with the deanery to ensure that any study leave and short-term attachments in other departments can be facilitated.
• If additional time is required and the subspecialty training assessors recommend it, they should suggest an ARCP outcome 3.

Possible outcomes of the final assessment

• Subspecialty training has been completed. If a small number of achievable goals still need to be met, they can be listed and judged at the final ARCP before issuing the trainee with an outcome 6 (for CCT).
• Subspecialty training is not completed and additional training time is recommended; the panel recommends an ARCP outcome 3.

The deanery ARCP process is the only formally recognsed process for determing the progress of specialty trainees (StRs). However, the RCOG subspecialty training assessment provides signficant information to direct the ARCP panel’s decision. The RCOG subspecialty training assessment should:

• Assess the clinical training of the trainee and compile a report that informs the deanery ARCP process
• Help develop educational plans to ensure the trainee completes their training in the allotted plan
• Make recommendations about the ARCP outcome for review and final decision by the ARCP panel

The ARCP panel will take into account all evidence relating to progress of all training, including the achievement of core competencies and the RCOG subspecialty assessment report.

This section outlines the roles and responsibilities of all parties in the subspecialty training assessment process.

Trainee

• To fully engage in the RCOG subspecialty training assessment process
• To carefully collect and document the objective evidence of training progression against the subspecialty training curriculum
• To meet with their Educational Supervisor regularly and to agree a training plan which will be reviewed by the assessors

Subspecialty Training Programme Director

• To meet regularly with the trainee to set short- and long-term training goals using SMART criteria (specific, measurable, achievable, realistic, timely)
• To set a realistic educational plan in anticipation of the assessment and in negotiation with the trainee (this may require communication with other subspecialists within the department, or with collaborating departments)
• To complete the specific components of the assessment documentation required for the RCOG assessment process
• To liaise with Heads of School(s) in their own deanery (and the trainee’s deanery if the training is OOP) to make them aware of any issues in relation to progress
• To faciliate/allow training in the core competencies, if identified as a requirement for the trainee to achieve CCT (this should be an unusual occurrence if trainees are recruited to subspecialty training only when they’ve completed their non-subspecialty core competencies)

RCOG

• To set the subspecialty training curricula and any changes, and to gain GMC approval
• To ensure all assessors have an appropriate understanding of the role and remit of the RCOG assessment process
• To coordinate the process of subspecialty assessment and ensure deaneries (Heads of School) receive the subspecialty reports in acceptable timeframes

Deanery

• To be responsible to the GMC for the training of subspecialists following the RCOG-defined curriculum
• Head of School (or deputy): to be part of the appointment panel in recruiting subspecialty trainees, in order to review the applicant’s core competencies
• Head of School (or deputy) and Subspecialty Training Programme Supervisor: to undertake an educational meeting with the trainee at the start of the programme to review progress towards gaining the RCOG core curriculum advanced competencies and to review any previous experience within the subspecialty field. Information may be available from the donor deanery if the trainee is OOP. An educational plan should be devised to ensure aspects of training that aren’t directly related to subspecialty training are progressed as well as those of the subspecialty programme. Both the Subspecialty Training Programme Director and the Head of School should work towards this
• To attend the subspecialty assessment to ensure fairness and on-the-spot trainee feedback, and to obtain feedback from assessors
• Head of School: if appropriate and required, to work with the Subspecialty Training Programme Supervisor to develop an action plan to ensure any identified issues are addressed (if the trainee is OOP, liaise with the donor Head of School)

RCOG subspecialty training assessors

• Assessors must be or have been a Subspecialty Training Programme Supervisor, or be an RCOG-accredited subspecialist
• Assessors should understand educational assessment within the current postgraduate medical education context and have undertaken training at Educational Supervisor level
• Assessors should be aware of the remit of the ARCP process and outcomes, including the processes involved in managing a trainee in difficulty, and should ensure they have regular updates in educational supervision and assessments
• Assessors should review all objective evidence of training in clinical and non-clinical competencies
• Assessors should make an assessment of that information, weight against specific criteria, to determine whether the training progress is satisfactory, and then should make a recommendation about the ARCP outcome.