By Ahmed El-Medany
Disruption to training due to the COVID-19 pandemic has led to difficulties for some trainees in acquiring the competencies required to progress, or complete, their training.
However, where the acquisition of competencies has been delayed due to COVID-19 and there are no serious concerns about the trainee, one of the two new ARCP outcomes, Outcome 10.1 or Outcome 10.2 have been suggested by the Statutory Education Bodies (SEBs) of the 4 Nations.
The aim of introducing these new ARCP outcomes has been to enable trainees to progress or complete their training programme where possible. Of note TPDs, and the ARCP panels they lead, have the discretion to make ‘common sense’ decisions for trainees. The usual outcomes (1,2, and 3) will also be available and awarded as usual.
ARCP Outcome 10.1
Outcome 10.1 recognises that the trainee has been making progress in their training but there has been delay in the acquisition of competencies/capabilities due to COVID-19, and the trainee is likely to be able to acquire these capabilities without the need for extra training time. An Outcome 10.1 may be awarded at different stages of Cardiology training.
ARCP Outcome 10.2
Outcome 10.2 recognises that the trainee has been making progress in their training, and there is a delay in the acquisition of competencies due to COVID-19. Therefore, it either would not be safe or not possible for the trainee to progress in, or complete, their training programme and additional training time is required. For trainees approaching certification, trainees may be able to act up as a consultant (AUC) and acquire their missing capabilities during their additional training time where this facility exists in the curriculum.
We interviewed Dr. Alison Calver, JRCPTB Cardiology Specialist Advisory Committee Chair, BCS Vice-President for Training, and Consultant Interventional Cardiologist at University Hospital Southampton. She kindly provided us with the following information about modifications to the Cardiology ARCP decision aid, in the context of the COVID-19 pandemic:
Modifications to Cardiology ARCP decision aid in Covid 19 pandemic 2021
‘The Cardiology decision aid is very comprehensive. It should be used in conjunction with the ARCP guidance for the use of Covid outcomes (10.1, 10.2; Mike Jones slide) and the following recommendations:
- ST3s who are behind due to COVID at 2021 summer’s ARCP can probably catch up over 5 years.
- ST4s who are significantly behind due to COVID at 2021 summer’s ARCP may not be able to catch up without undue pressure being heaped on Trainee. Therefore, TPDs should consider 10.2.
- At ST5: Echo (BSE or curriculum tool) needs to be completed. They may need 10.2 if this is not the case. Near completion e.g. video cases only outstanding. TPD discretion is required whether this can be made up during Advanced Module 2 years
- At ST5: some latitude around level 3 angiography for those that do not wish to do PCI. Consider simulation if level 3 DOPS required.
- At ST5: some latitude if core ACHD, ICVD, MRI, CT, Nuclear not signed off, provided Advanced Module choice does not include these. No more than 3 of these should be outstanding otherwise the burden to make them up in Advanced Modular training will be too much for trainee.
- At ST7: temp pacing and pericardiocentesis – heavy reliance on simulation except for those pursuing cath lab based Advanced Modules e.g. PCI, EP, Devices.
- All patient surveys, teaching observations, audit assessments, MSFs, patient feedback, management course can be deferred. All can be done at any time during training (unless TPD feels there is a good reason that these need to be done now).
- ALS – to be done at first opportunity post-pandemic, should not hold up a CCT.
- Trainees on OOPR or academic trainees: all are likely to require 10.2 unless very close to finishing as all were re-deployed to clinical duties in pandemic.’
‘Moreover, it is impossible to predict every single scenario with which a trainee might present. However, the guidance is well understood by TPDs and will help trainees get a fair outcome for their personal situation. There is no ‘one size fits all’ and each trainee will get an individualised decision.’
For how long will outcomes 10.1 and 10.2 planned to be used?
No idea. Definitely for 2021.
What support mechanisms can supervisors direct their trainees to following an Outcome 10.1/10.2?
These will be personalised to individual trainees. Different solutions will work in different localities.
For trainees dual accrediting with GIM, that were redeployed to general medicine and completed their relevant competencies, is there a potential plan for allocating more training time to cardiology later in their training (i.e. ST7) and avoiding more GIM commitment?
Training skills of any sort (GIM, leadership, management etc) acquired during re-deployment can (and should) count towards CCT. It is important that trainees record it in e-portfolio and acquire the appropriate WPBA to provide evidence of their training. This advice was given to trainees via the SAC/BJCA in March 2020.
JRCPTB ARCP information hub: COVID-19 | JRCPTB