Annual Review of Competence Progression and Penultimate Year Assessment

ARCP

The annual review of competence progression (ARCP) is the process by which medical trainees are reviewed to assess progression against standard criteria; there are separate ARCPs for respiratory and general internal medicine. These criteria are set out in separate decision aids for respiratory and general internal medicine (GIM) which highlight the specific targets to be achieved for a satisfactory ARCP outcome for each training year. Remember, you will need an Educational Supervisor (ES) report each year for both Respiratory Medicine and GIM.

For respiratory medicine, trainees must also record practical procedures including bronchoscopies, pleural procedures and NIV experience in the respiratory logbook. This logbook also contains a tab to record patients seen on acute medical take; at GIM PYA you are expected to demonstrate evidence of 1000 patients seen. It would be wise to add tabs for outpatient clinics and external GIM continuing professional development (CPD); at your GIM penultimate year assessment (PYA) you are also expected to demonstrate evidence of 186 general medicine clinics and 100 hours of external GIM CPD.

Penultimate Year Assessment

The penultimate year assessment takes place 12-18 months prior to your expected training completion date. It is intended to set a certificate of completion date (CCT) date, which once set cannot be changed, and identify outstanding targets to ensure requirements of the curriculum are met prior to this date. JRCPTB have published guidance on preparing for the PYA. Once again there are separate respiratory and GIM PYAs.

Respiratory PYA

In addition to the criteria set out in the respiratory decision aid, there are specific requirements for the respiratory PYA to demonstrate the curriculum has been achieved. These include:

• Minimum training requirements for lung transplantation, pulmonary hypertension and cystic fibrosis.
• Evidence of experience in integrated respiratory medicine, occupational lung disease, HIV medicine and genetic and developmental lung disease (currently no formal requirements – attendance at training days, CBDs/mini-CEX and reflective practice will suffice).
• Evidence of training in safe sedation (a course plus DOPS).

GIM PYA

Similarly, there are additional specific requirements for the GIM PYA to demonstrate the curriculum has been achieved.

These include:

• Registration with the RCP CPD online diary
• Evidence of 100 hours external GIM CPD (regional GIM training days, courses from bodies such as RCP, RSM and BMA, online CPD (up to 15 hours)).
• Evidence of 1000 patients seen on acute medical take.
• Evidence of 186 general medicine clinics (general, but not subspecialty, respiratory clinics can count towards this in addition to ambulatory care and ‘hot’ clinics).
• Specific GIM paperwork: summary of clinical experience (SOCE) form, summary of training calculator, power-point presentation summarising training experience, goals and outstanding issues (6 slides, 5-10 minutes) – an example will be sent with your PYA invitation.

The above can seem quite daunting however, it is very achievable; the best advice is to familiarise yourself with the decision aids and guidance early on and collect evidence throughout the year in preparation for your ARCP/PYA rather than panicking at the end. It will make for a much smoother and less stressful training process. Good luck!

Author: Dr Neelu Kumar