The law

1. The law The General and Specialist Medical Practice (Education, Training & Qualifications) Order 2003 Statutory Instrument 2003 No: 1250 [HMSO] http://www.opsi.gov.uk/si/si2003/20031250.htm Nicholas Grant

2. The Order, among other things: • Introduced new rules for direct entry in the Specialist Register. • Formerly called “Article 14” now called CESR – Certificate confirming Eligibility for Specialist Registration. Nicholas Grant

3. UK MMC Career Framework Proposal Continuing Professional Development Consultant and senior appointments Specialist and GP Registers CCT or CESR CESR Postgraduate Medical Training Specialty training inSpecialty/GP training “schools” Continuing Professional Development Career posts Specialist Training ST3+ Core Medical Training ST1 &B 2 Fixed term specialist training Foundation training in foundation schools F2 F1 Undergraduate medical training in medical school Nicholas Grant Arrows indicate competitive entry Medical school – 4-6 years

4. Equivalence CESR means that someone who has completed training and/or qualifications and who has knowledge or experience equivalent to that required for a CCT, may be entered in the Specialist Register. Nicholas Grant

5. How is this done? • Application is made to the PMETB • PMETB gathers all the evidence • PMETB confirms completion of application • Application passed to College • Evaluated by the relevant SAC(s) • Recommendation made to PMETB • PMETB decides and informs applicant Nicholas Grant

6. “Getting on the bus” PMETB has decided that either a Specialist Medical Qualificationorsix months of specialist training (from anywhere) will enable someone to eligibility for evaluation. Nicholas Grant

7. After which The evaluators must assess the persons complete portfolio of evidence to decide if all of her/his training, qualifications & knowledge and experience together can be accepted as equivalent to a CCT. Nicholas Grant

8. If the outcome is ‘yes’ The person can be recommended for specialist registration. Nicholas Grant

9. Recommendation & decision The College/Faculty advises the PMETB (on the PMETB’s form). The PMETB makes the decision and informs the applicant. Nicholas Grant

10. Non CCT specialties • Essentially the same except it applies to non-CCT specialties e.g. Dermatovenereology, Stroke Medicine, Diabetes etc but: • The ‘getting on the bus’ eligibility criteria must have been acquired outside the UK. Nicholas Grant

11. If the outcome is ‘NO’ Under 14[9] the PMETB shall give reasons for saying no and inform the person of two things: Nicholas Grant

12. 14[9][a] The period of additional training that the person must undertake, and the fields to be covered by it Nicholas Grant

13. 14[9][b] Any examination, assessment [including a specified period of assessment] or other test of competence that the person must complete to the Board’s satisfaction. Nicholas Grant

14. Criteria PMETB has set out high level & generic criteria for evaluations and these are set out in its “guidance for A14 applications” and “background information” document both of which are found on its website. www.pmetb.org.uk Nicholas Grant

15. Colleges and Faculties • Were asked to create specialty specific guidance [SSGs]. These are the specialty ‘spin’ on the PMETB criteria. • New SSGs are to be written in parallel with the re-writing of the curriculum. • Applicants must refer to these during the creation of their applications. Nicholas Grant

16. SSG The SSG built on the PMETB criteria through providing standards set against the current curricula and suggested evidence. There is a single set of criteria for all the specialties. Nicholas Grant

17. New SSG will be written as a single grid for each specialty containing both the generic and specialty specific guidance and cross referenced to the revised curricula. Nicholas Grant

18. When finally agreed • The SSGs are published on the PMETB website – applicants are directed to these by the PMETB. • They are also published, with some further advice, on the JCHMT website. www.jchmt.org.uk Nicholas Grant

19. Application process • The applicant downloads the form from the PMETB website. • And submits it to the PMETB administration with sufficient/appropriate evidence selected from that suggested in the Specialty Specific Guidance [SSG]. • PMETB gathers in all the evidence and the referees reports. Nicholas Grant

20. PMETB • decides when the application is complete [in dialogue with the applicant]. During this time • Applicants may approach the College [us] or you[!] for advice and guidance. Nicholas Grant

21. When the application is complete to its satisfaction The PMETB notifies the College/Faculty that the application is ready via email and access to its dbase, into which all the evidence will have been scanned. Nicholas Grant

22. The evaluation is conducted by mail and must be completed within seven weeks. There is no further dialogue with the applicant. Nicholas Grant

23. The recommendation is made on the PMETB’s form. We use the form as an evaluators’ guide and subsequently as the recommendation. Much of it can be pre-populated with relevant information. Nicholas Grant

24. If the recommendation is ‘no’ [plus requirements] The applicant has recourse to an appeal system: • A review by the College/Faculty. • An oral or written appeal to an independent appeal panel. Nicholas Grant

25. PMETB’s mandatory best practice College/Faculty evaluators will: • Provide an evaluation for all applicants • Provide a recommendation for each one • Apply PMETB best practice when conducting evaluations • Provide a recommendation for additional training etc • Provide recommendations using PMETB admin arrangements Nicholas Grant

26. PMETB recommended best practice Colleges/Faculties: • Should use three evaluators • Evaluators should complete their evaluations independently • Evaluators should record outcomes separately • Evaluators should record recommendations for additional training etc, separately Nicholas Grant

27. Fees • The PMETB levies a £950 fee for each application. Of this the JCHMT will receive £500 on making the recommendation. • From 1st April 2007, the PMETB proposes to raise the fee to £1250. We suspect that our £500 will remain the same. Nicholas Grant

28. Fees • Fee for a review is £600 • Fees for appeal are currently £1400 for a written hearing, and £2100 for an oral hearing. Nicholas Grant

29. In the pipeline • The PMETB has not been able to give us any clear indication of the number applications from Physicians waiting to be forwarded to us. • We have evaluated about 140 – 80 positive and 60 negative. Nicholas Grant