UNSPECIFIED (Ed). (2020) Guidance for flexibility in postgraduate training and changing specialties. Academy of Medical Royal Colleges: London, UK.

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Abstract

Encouraging and improving flexibility in postgraduate medical training is a key recommendation from the General Medical Council (GMC) report Adapting for the future (2017). The Academy of Medical Royal Colleges (the Academy) Accreditation of Transferable Competences Framework (ATCF) in 2014 described how doctors in training could transfer between specialties and obtain recognition of knowledge and skills gained in their original specialty without the need to repeat them. An Academy and GMC Working Group was convened to review the ATCF in the context of the new standards for curricula and the GMC’s 2017 Generic Professional Capabilities framework. In addition, the group considered Heath Education England's (HEE) developing Out of Programme Pause (OOPP) pilot which would enable doctors in training to 'step off' for a period and to have the opportunity for skills developed during Out of Programme (OOP) recognised when returning to the training programme. Two scenarios in which flexibility would be appropriate for further consideration for doctors in training were identified: 1. Doctors in training who realise their current programme is not the right one for them and wish to change to train in another specialty 2. Doctors in training who take some time out of their programme for other experience and later return. A further two aspirational scenarios, in which the principles of flexibility may be applicable for doctors not in training, were also identified: 3. Doctors not in training or trust / health board doctors who may not have decided on their career path but plan to join a training programme 4. Staff Grade, Associate Specialist and Specialty (SAS) doctors working in a particular specialty who wish to enter a training programme. This guidance describes how doctors in training who wish to train in another specialty can receive recognition towards the Certificate of Completion of Training (CCT) in the new specialty of capabilities gained in their existing specialty. The guidance also suggests how flexibility in training could work in practice for both doctors in training who wish to take time out of training and doctors not in training who wish to join or return to training programmes. Implementation of this guidance will need to address both general and specialty-specific principles, which individual royal colleges and faculties will need to develop in the context of the new curricula standards. However, it is anticipated that these principles will enhance training not only in terms of the quality of the training experience, but also, crucially, for the safety and quality of care for patients, by maintaining the breadth of professional and clinical capabilities. The recommendations have been developed in the context of the recent GMC regulatory changes Executive summary 5 Academy of Medical Royal Colleges Flexibility in postgraduate training and changing speciality to support flexible working and training across postgraduate medical education. The GMC remains supportive in principle of trainees 'stepping out' of UK training and for any subsequent skills gained while away to be fully considered upon their return. Results from the ongoing HEE pilots are awaited and the GMC will be looking for the necessary safeguards to be in place to protect both doctors in training and the service.

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