SSAC Chairman Martin M Brown

1. Update on MMC: Report from the Stroke Medicine SSACBASP AGM7 Dec 2006Updated 6 Jan 2007 to include presentation re proposed new full specialty curriculum to National Stroke Strategy Workforce Group SSAC Chairman Martin M Brown

2. Sub-Specialty Advisory Committee Topics to report • Change in SSAC membership • Post approval • Numbers approved • Funding issues • Revised forms • Specialty Year Assessments • Feedback from Trainees • Revised Curriculum: PMETB Approval • Plans for MMC and new ‘full’ specialty

3. SSAC: Membership • Chairman: Martin Brown • Sec: Margaret Roberts replaced Gary Ford • Ron MacWalter replaced Ken Lees (BASP) • Ruth Kent replaced Chris Ward (BSRM) • Ian Hastie replaced Alan Sinclair (SAC Ger) • John Bamford left (ABN) • Kath Pascoe joined as Trainee Rep • Other members: Bill Burr (Lead Dean), Christine Collin, Alastair Doward, Jane Flint, Tim Hendra, JCHMT staff

4. New SSAC Constitution:Proposed membership • Regional Specialty Advisors (or Heads of Specialty Training when appointed) • London, South West, Midlands, Northern, Scotland, Wales, Northern Ireland • Representatives from relevant parent specialty societies if not already included • Geriatric Medicine, Neurology, Rehab Medicine • Trainee representative • Lay member x 1 • Lead Dean and JCHMT representatives • Chairman appointed after advertisement

5. Current training numbers in Stroke Medicine • 47 posts approved/pending by PMETB • Not all posts provide all 3 modules – hence less programmes than posts • Only 17 trainees currently in post

6. Training post funding • Funding remains an issue • MMC provides an opportunity to create new Stroke Medicine posts • RSAs and others encouraged to approach their local dean to discuss funding • New forms have been designed for training post approval – these can be obtained from JCHMT

7. Specialty year assessments • Every enrolled trainee requires a specialty year assessment, ideally 3 months prior to proposed completion of stroke post • Usually replaces RITA interview or incorporated into PYA • Requires representative nominated by Stroke Medicine SSAC • Should be arranged with JCHMT & Deanery informed • From 2007, proposed that SYA should take place for several trainees on fixed dates at RCP London

8. Feedback from trainees • Specialty specific visits by JCHMT to inspect individual training posts abolished • SSAC replacement • Generic Questionnaires to trainees • Meeting with trainees at annual Stroke Forum* and BASP trainees meeting *All current and past trainees in approved posts invitedto stay on at end of AGM

9. Revised curriculum • Revised curriculum presented to PMETB in September: Approved December • Learning objectives and modular topic grids unchanged • New • Background to development • Education methods to be used • Methods to update curriculum • Still to be developed: Assessment methods

10. 12 months subspecialty training Current subspecialty run through training for stroke medicine approved by PMETB

11. MMC Run through training:Proposal to establish Stroke Medicine as a “Full” speciality • Background • Increasing numbers of consultants practicing as full time stroke physicians • Current one year stand-alone subspecialty training posts provide insufficient experience to become fully competent in stroke medicine • Requirement to make appointments in open competition and for trainees to move out of programme unsatisfactory e.g. on-call • Proposal to develop a curriculum designed to provide the competencies needed to practice as a full time stroke physician supported by PMETB

12. “Full” specialty training in stroke medicine: proposed model • Trainees selected after minimum 2 year core stem training in medicine • 4 year minimum period of higher specialty training in a stroke medicine programme • Posts would include • Neurology • Care of the Elderly • Neurological rehabilitation • Neuroradiology • Cardiovascular medicine

13. “Full” specialty training in stroke medicine: proposed model • Years 1 & 2 could incorporate existing SpR posts in General Neurology/Geriatric Medicine with attachments to Neuroradiology and Cardiovascular Medicine • Years 4 & 5 could incorporate existing and new stroke medicine sub-specialty training posts based on comprehensive stroke services

14. “Full” specialty training in stroke medicine: possible parallel schemes leading to limited competencies • Existing geriatric/neurology SpRs could move across to full stroke medicine training • Existing one-year subspecialty posts could remain but specify that only penultimate or final year SpRs could apply • Training posts could be developed in single modules e.g. acute stroke leading to a certificate of competency e.g. for emergency physicians

15. “Full” speciality training in stroke medicineRun through training 2 years training in neurology/geriatrics/neuroradiology/cardiology 2 years training in stroke services

16. “Full” specialty training in stroke medicine: preconditions • Deans willing to develop the training programmes • Neurologists and geriatricians willing to transfer existing training posts to stroke medicine training programmes • But they would not necessarily lose an SpR or need to find someone else to do the on-call • Funding for the additional training posts for years 4 & 5 based in comprehensive stroke services • Commitment by Department of Health to fund FT consultant posts in stroke medicine • Trainees willing to commit to a new specialty without existing consultant posts • Trainees willing to give up option of work in parent specialty

17. SSAC Contacts • SSAC Chairman • m.brown@ion.ucl.ac.uk • Kirstin Barnett, Specialty Co-ordinator • kirstin.barnett@rcplondon.ac.uk • JCHMT Website • http://www.jchmt.org.uk/