The 2020 foundation competency (CREST) form explained
The link to the 2020 foundation competency (CREST) form is mentioned here:
https://www.oriel.nhs.uk/Web/ResourceBank/Edit/MTA3NA%3D%3D
If you are interested in applying for a training post, please see the person specifications here:
https://specialtytraining.hee.nhs.uk/Recruitment/Person-specifications
I am going to discuss each point and highlight the important parts.
The points highlighted in blue are my personal opinions and advice. Please note that this is my personal interpretation based on my experience of 18 months as a non trainee SHO, core medical trainee for 2 years and now trainee registrar ( since August, 2019). Despite this, the information here may not be 100% accurate in which case, you should always talk to your supervisor or the recruitment team.
PAGE 1:
This certificate can only be signed by a Consultant or equivalent. For the purposes of this documentation, Consultant includes General Practitioners, Clinical Directors, Medical Superintendents, Academic Professors, and locum Consultants with a CCT/CESR.
Consultants are only eligible to sign this certificate if they have worked with you for a minimum continuous period of three months whole-time equivalent wholly within the 3.5 years prior to the advertised post start date for which you are applying. They may rely on evidence you have given them that comes from posts before that date.
If your signatory is registered with any medical regulatory authority other than the GMC, then you should also make sure they submit current evidence of their registration with that authority. A certified translation should be included if this is not in English. Historic registration with the GMC will not be accepted. Failure to provide this will result in you, the applicant, being rejected.
You must be rated as demonstrated for each and every professional capability listed on this certificate. If you cannot demonstrate that you have achieved all your professional capabilities in one post, you may submit additional evidence to the signatory who, if they agree that it demonstrates capability may accept it in lieu of direct observation. If you cannot demonstrate each and every professional capability, you will not be eligible for Specialty Training at ST1 or CT1 level.
If you have ever started but not satisfactorily completed a UKFPO-appointed 2-year Foundation programme or FY2 standalone post, then you should not use this form. Instead, you should approach the Foundation School Director where your previous training took place and either request to return to complete that training or provide such evidence as they request then ask the Dean of that area to complete and sign the proforma available on the resource bank ( Third document here: https://www.oriel.nhs.uk/Web/ResourceBank/Edit/MTA3NA%3D%3D. )
The certificate MUST be complete in every detail, including details about the person completing it for you. Incomplete certificates may lead to your application being deemed ineligible for that recruitment round. It is strongly recommended that you check the form after your signatory has completed it using the attached checklist.
Because of changes to the process, only the 2020 version of this form will be accepted.
You should attach your Advanced Life Support Certificate from the Resuscitation Council UK or equivalent to this form and sign the declaration below
Read these posts as well:
My guideline for on calls:
http://omarsguidelines.blogspot.co.uk/2017/05/guideline-for-on-calls.html
My experience of working on AMU:
https://omarsguidelines.blogspot.com/2019/07/my-experience-of-working-in-amu.html
How to clerk patients safely and efficiently :https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
Night shifts in medicine:
https://omarsguidelines.blogspot.com/2019/09/how-to-work-on-nights-medicine.html
Teamwork and leadership in the NHS:
https://www.oriel.nhs.uk/Web/ResourceBank/Edit/MTA3NA%3D%3D
If you are interested in applying for a training post, please see the person specifications here:
https://specialtytraining.hee.nhs.uk/Recruitment/Person-specifications
I am going to discuss each point and highlight the important parts.
The points highlighted in blue are my personal opinions and advice. Please note that this is my personal interpretation based on my experience of 18 months as a non trainee SHO, core medical trainee for 2 years and now trainee registrar ( since August, 2019). Despite this, the information here may not be 100% accurate in which case, you should always talk to your supervisor or the recruitment team.
PAGE 1:
This certificate can only be signed by a Consultant or equivalent. For the purposes of this documentation, Consultant includes General Practitioners, Clinical Directors, Medical Superintendents, Academic Professors, and locum Consultants with a CCT/CESR.
Consultants are only eligible to sign this certificate if they have worked with you for a minimum continuous period of three months whole-time equivalent wholly within the 3.5 years prior to the advertised post start date for which you are applying. They may rely on evidence you have given them that comes from posts before that date.
You should not use a signatory with
whom you have a close personal relationship.
If you have ever started but not satisfactorily completed a UKFPO-appointed 2-year Foundation programme or FY2 standalone post, then you should not use this form. Instead, you should approach the Foundation School Director where your previous training took place and either request to return to complete that training or provide such evidence as they request then ask the Dean of that area to complete and sign the proforma available on the resource bank ( Third document here: https://www.oriel.nhs.uk/Web/ResourceBank/Edit/MTA3NA%3D%3D. )
PAGE 2:
I confirm that the attached Advanced Life Support Certificate is either (please tick relevant box):
from the Resuscitation Council UK OR
from an equivalent course that assessed my ability in all of: ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock I have attached a course outline and confirmation of booking for a course that meets the requirements and I will provide a certificate of completion prior to commencing a training post.
I confirm that the attached Advanced Life Support Certificate is either (please tick relevant box):
from the Resuscitation Council UK OR
from an equivalent course that assessed my ability in all of: ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock I have attached a course outline and confirmation of booking for a course that meets the requirements and I will provide a certificate of completion prior to commencing a training post.
These are the courses resus, UK accepts:
https://www.resus.org.uk/information-on-courses/faqs-for-candidates/
HOWEVER, this form DOES NOT specify if the course you have done SHOULD BE acceptable by RESUS, UK PROVIDED the course MEETS the following requirements:
ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock.
https://www.resus.org.uk/information-on-courses/faqs-for-candidates/
HOWEVER, this form DOES NOT specify if the course you have done SHOULD BE acceptable by RESUS, UK PROVIDED the course MEETS the following requirements:
ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock.
PAGE 2, SECTION 1
1.1 Professional behaviour
Acts in accordance with GMC guidance (or equivalent) in all interactions with patients, relatives/carers and colleagues; acts as a role model for other healthcare workers; acts as a responsible employee; AND complies with local and national requirements e.g. completing mandatory training, engaging in appraisal and assessment.
Acts in accordance with GMC guidance (or equivalent) in all interactions with patients, relatives/carers and colleagues; acts as a role model for other healthcare workers; acts as a responsible employee; AND complies with local and national requirements e.g. completing mandatory training, engaging in appraisal and assessment.
We do this everyday in the NHS. We are expected to do mandatory training, get our appraisals done and get assessments wherever possible. This IS NOT something we routinely do in our home countries. Read this to understand how appraisals are done:
http://omarsguidelines.blogspot.com/2017/06/my-guideline-on-appraisals-in-nhs.html
http://omarsguidelines.blogspot.com/2017/06/my-guideline-on-appraisals-in-nhs.html
1.2 Personal organisation
Attends on time for all duties, clinical commitments and teaching sessions; supervises, supports and organises others to ensure appropriate prioritisation, timely delivery of care and completion of work, including handover of care; AND delegates or seeks assistance when required to ensure that all tasks are completed.
We do this everyday in the NHS.Attends on time for all duties, clinical commitments and teaching sessions; supervises, supports and organises others to ensure appropriate prioritisation, timely delivery of care and completion of work, including handover of care; AND delegates or seeks assistance when required to ensure that all tasks are completed.
Read these posts as well:
My guideline for on calls:
http://omarsguidelines.blogspot.co.uk/2017/05/guideline-for-on-calls.html
My experience of working on AMU:
https://omarsguidelines.blogspot.com/2019/07/my-experience-of-working-in-amu.html
How to clerk patients safely and efficiently :https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
Night shifts in medicine:
https://omarsguidelines.blogspot.com/2019/09/how-to-work-on-nights-medicine.html
Teamwork and leadership in the NHS:
https://omarsguidelines.blogspot.com/2018/12/teamwork-and-leadership-in-nhs.html
1.3 Personal responsibility
Takes personal responsibility for clinical decisions, is able to justify actions, accepts responsibility for any personal errors and takes suitable action e.g: seeking senior advice, apologising, making appropriate records and notifications.
We do this everyday in the NHS.https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/outcomes-for-graduates/outcomes-1---professional-values-and-behaviours
Takes personal responsibility for clinical decisions, is able to justify actions, accepts responsibility for any personal errors and takes suitable action e.g: seeking senior advice, apologising, making appropriate records and notifications.
We do this everyday in the NHS.https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/outcomes-for-graduates/outcomes-1---professional-values-and-behaviours
1.4 Patient centred care
Considers the patient as a whole, respecting their personal circumstances, dignity, autonomy, individual healthcare decisions, and right to privacy; works with patients and colleagues to develop individual care plans; respects patients’ right to refuse treatment and/or to decline involvement in research projects.
We do this everyday in the NHS.
It is explained in more detail here: https://www.gmc-uk.org/ethical-guidance
We do this everyday in the NHS.
It is explained in more detail here: https://www.gmc-uk.org/ethical-guidance
1.5 Trust
Acts with empathy, honesty and sensitivity in a non-confrontational manner; discusses management options with patients; responds to patient’s ideas, concerns and expectations; encourages patients to make informed decisions; AND recognises patients’ expertise and helps them to acquire knowledge of their condition.
We do this everyday in the NHS.
1.6 Consent
Competently performs the core procedures, as mandated by the GMC (http://www.gmc-uk.org/education/postgraduate/F1_outcomes_core_skills.asp); obtains valid consent for those procedures by giving each patient the information they want and need in a way they can understand; demonstrates understanding of the principle of involving children in the decision-making process when they are able to understand and consider the options
Competently performs the core procedures, as mandated by the GMC (http://www.gmc-uk.org/education/postgraduate/F1_outcomes_core_skills.asp); obtains valid consent for those procedures by giving each patient the information they want and need in a way they can understand; demonstrates understanding of the principle of involving children in the decision-making process when they are able to understand and consider the options
Click on the link to read more about this. Again, we do this everyday in the NHS.https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/consent
PAGE 3
1.7 Ethical and legal requirements
Practises in accordance with guidance from the GMC or equivalent, relevant legislation and national and local guidelines; demonstrates understanding of the risks of legal and disciplinary action if a doctor fails to achieve the necessary standards of practice and care; AND completes statutory documentation correctly e.g. death certificates
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors
Practises in accordance with guidance from the GMC or equivalent, relevant legislation and national and local guidelines; demonstrates understanding of the risks of legal and disciplinary action if a doctor fails to achieve the necessary standards of practice and care; AND completes statutory documentation correctly e.g. death certificates
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors
1.8 Confidentiality
Describes and applies the principles of confidentiality in accordance with GMC guidance or equivalent and local information governance standards; follows GMC (or equivalent) guidance on the use of social media; AND describes when confidential information may be shared with appropriate third parties e.g. police
This is explained here in more detail:
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/confidentiality
Describes and applies the principles of confidentiality in accordance with GMC guidance or equivalent and local information governance standards; follows GMC (or equivalent) guidance on the use of social media; AND describes when confidential information may be shared with appropriate third parties e.g. police
This is explained here in more detail:
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/confidentiality
We do this on a regular basis in the NHS and sometimes, it is not followed in our home countries.
1.9 Mental capacity
Performs mental state examination and assessment of cognition and capacity where appropriate; demonstrates understanding that there are situations when it is appropriate for others to make decisions on behalf of patients; AND demonstrates understanding that treatment may be provided against a patient’s expressed wishes in certain defined circumstances.
Please read this:
https://www.gmc-uk.org/ethical-guidance/ethical-hub/mental-capacity
Performs mental state examination and assessment of cognition and capacity where appropriate; demonstrates understanding that there are situations when it is appropriate for others to make decisions on behalf of patients; AND demonstrates understanding that treatment may be provided against a patient’s expressed wishes in certain defined circumstances.
Please read this:
https://www.gmc-uk.org/ethical-guidance/ethical-hub/mental-capacity
1.10 Protection of vulnerable groups
Demonstrates understanding of the principles of safeguarding children and vulnerable adults; AND manages situations where safeguarding concerns may exist
Please read this:
https://www.gmc-uk.org/ethical-guidance/ethical-hub/adult-safeguarding
Demonstrates understanding of the principles of safeguarding children and vulnerable adults; AND manages situations where safeguarding concerns may exist
Please read this:
https://www.gmc-uk.org/ethical-guidance/ethical-hub/adult-safeguarding
1.11 Self-directed learning
Acts to keep abreast of educational / training requirements; demonstrates change and improvement in practice as a result of reflection on personal experience and feedback; AND Identifies and addresses own learning needs
Acts to keep abreast of educational / training requirements; demonstrates change and improvement in practice as a result of reflection on personal experience and feedback; AND Identifies and addresses own learning needs
We do this on a regular basis in the NHS.
1.12 Teaching and assessment
Demonstrates improvement in teaching skills as a result of seeking, accepting and reflecting on feedback from learners and supervisors; AND provides constructive feedback to other health professionals
Demonstrates improvement in teaching skills as a result of seeking, accepting and reflecting on feedback from learners and supervisors; AND provides constructive feedback to other health professionals
We do this on a regular basis in the NHS.
Section 2: Communication, team-working and leadership
2.1 Communication with patients, relatives + carers
Introduces themselves to patient/carer/relative stating name and role; communicates clearly, politely, considerately, with understanding and empathy; ensures sufficient time and appropriate environment for communication; provides the necessary / desired information; AND communicates complex information clearly.
Introduces themselves to patient/carer/relative stating name and role; communicates clearly, politely, considerately, with understanding and empathy; ensures sufficient time and appropriate environment for communication; provides the necessary / desired information; AND communicates complex information clearly.
We do this on a regular basis in the NHS.
2.2 Communication with patients
Checks patients’ understanding of options and supports patients in interpreting information and evidence relevant to their condition; AND responds to patients’ queries or concerns
Checks patients’ understanding of options and supports patients in interpreting information and evidence relevant to their condition; AND responds to patients’ queries or concerns
2.3 Communication in challenging circumstances Uses appropriate styles of communication; breaks bad news compassionately and supportively; AND manages three-way consultations e.g. with an interpreter, using sign language, or with a child patient and their family/carers
We do this on a regular basis in the NHS.https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-3---communication-partnership-and-teamwork
2.4 Complaints
Acts to prevent/mitigate and minimise distress in situations which might lead to complaint or dissatisfaction; AND deals appropriately with angry/distressed/dissatisfied patients/carers and seeks assistance as appropriate
https://www.nhs.uk/common-health-questions/nhs-services-and-treatments/what-is-pals-patient-advice-and-liaison-service/
Acts to prevent/mitigate and minimise distress in situations which might lead to complaint or dissatisfaction; AND deals appropriately with angry/distressed/dissatisfied patients/carers and seeks assistance as appropriate
https://www.nhs.uk/common-health-questions/nhs-services-and-treatments/what-is-pals-patient-advice-and-liaison-service/
2.5 Patient Records
Maintains accurate, legible and contemporaneous patient records AND ensures that entries are signed and dated
Maintains accurate, legible and contemporaneous patient records AND ensures that entries are signed and dated
We do this on a regular basis in the NHS.
PAGE 4
2.6 Working with other healthcare professionals
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/leadership-and-management-for-all-doctors/working-with-colleagues
Works effectively within the wider healthcare team for the benefit of patient care; makes clear, concise and timely written and oral referrals to other healthcare professionals; AND produces timely, legible discharge summaries or outpatient letters that identify principle diagnoses, key treatments/interventions, medication and follow-up arrangements.
Works effectively within the wider healthcare team for the benefit of patient care; makes clear, concise and timely written and oral referrals to other healthcare professionals; AND produces timely, legible discharge summaries or outpatient letters that identify principle diagnoses, key treatments/interventions, medication and follow-up arrangements.
We do this on a regular basis in the NHS.
2.7 Continuity of care
Allocates and prioritises tasks during handover; anticipates and identifies problems for the next clinical team/shift; AND takes pre-emptive action where required
We do this on a regular basis in the NHS.
2.8 Interaction with colleagues
Demonstrates initiative e.g. by recognising work pressures on others, providing support and organising / allocating work to optimise effectiveness within the clinical team
We do this on a regular basis in the NHS.
2.9 Leadership
Knows the organisational structures and chains of responsibility and principles of line management in medical and non-medical staff; demonstrates extended leadership role within the team by making decisions and taking responsibility for managing complex situations across a range of clinical and non-clinical situations; AND supervises and supports team members, delegating tasks appropriately, directing patient review, organising handover
We do this on a regular basis in the NHS.
Section 3: Clinical Care
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice
3.1 Recognition of acute illness
Responds promptly to notification of deterioration or concern regarding a patient’s condition; prioritises tasks according to clinical urgency AND reviews / reassesses patients in a timely manner
We do this on a regular basis in the NHS.
3.2 Assessment of the acutely unwell patient
Performs rapid, focused assessment of illness severity including physiological monitoring and considering mental health aspects; AND performs prompt, rapid, focused assessment of the patient who presents an acute risk to themselves or to others in the context of mental disorder, incapacity or incompetence
We do this on a regular basis in the NHS.https://www.gmc-uk.org/ethical-guidance/ethical-hub/mental-capacity
3.3 Immediate management of the acutely unwell patient
Initiates prompt appropriate management to stabilise/prevent further deterioration in patients with common acute presentations (including mental health) and seeks timely senior help with the further management; identifies electrolyte imbalance and, with senior advice, delivers a safe and effective method of correction; AND recognises when a patient should be moved to a higher level of care and seeks appropriate assistance with review and management
We do this on a regular basis in the NHS.
We do this on a regular basis in the NHS.
3.4 Managing of long-term conditions in the acutely unwell patient
Performs primary review of new referrals within the hospital or outpatient clinic; cares for patients with long-term diseases during their in-patient stay, as outpatients or in the community; reviews long-term drug regimes and, with senior advice, considers modifying dosage, timing and treatment assesses; AND manages the impact of long-term mental disorder on the presentation and course of acute physical illness, and vice versa
We do this on a regular basis in the NHS.
We do this on a regular basis in the NHS.
3.5 The frail patient
Formulates individual patient management plans based on assessment of frailty as well as clinical need; prescribes with an understanding of the impact of increasing age, weight loss and frailty on drug pharmacokinetics and pharmacodynamics; performs a comprehensive geriatric assessment including consideration of dementia or delirium; describes the impact of activities of daily living on long-term conditions; AND provides information / discusses these with the patients and carers
We do this on a regular basis in the NHS.http://omarsguidelines.blogspot.com/2018/08/managing-elderly-patients.html
PAGE 5
3.6 Supports patients with long term conditions
Encourages and assists patients to make realistic decisions about their care and helps them to construct and review advance/long-term care plans; AND arranges appropriate assessment for specialist rehabilitation, care home placement and respite care.
We do this on a regular basis in the NHS.http://omarsguidelines.blogspot.com/2018/08/managing-elderly-patients.html
3.6 Nutrition
Works with other healthcare professionals to address nutritional needs and communicate these during care planning; recognises eating disorders, seeks senior input and refers to local specialist service; AND formulates a plan for investigation and management of weight loss or weight gain
We do this on a regular basis in the NHS by liaising with dietitians.
3.7 History
Obtains relevant history, including mental health and collateral history, in time limited and sometimes difficult circumstances
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.8 Physical and mental state examination
Performs competent physical and mental state examination in a timely manner; uses a chaperone, where appropriate; AND performs focused physical/mental state examination in time limited environments e.g. outpatients, general practice or emergency department
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.9 Diagnosis
Formulates appropriate physical/mental health differential diagnoses, based on history, examination and immediate investigations; AND takes account of probabilities in ranking differential diagnoses
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.10 Clinical management
Refines problem lists and management plans; AND develops appropriate strategies for further investigation and management
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.11 Clinical review
Undertakes regular reviews, amends differential diagnosis and expedites patient investigation and management in light of developing symptoms and in response to therapeutic interventions; AND reprioritises problems and refines strategies for investigation and management
We do this on a regular basis in the NHS when we are on the ward.
http://omarsguidelines.blogspot.com/2017/05/guideline-for-junior-doctors-working-in.html
3.12 Discharge planning
Anticipates clinical evolution and starts planning discharge and ongoing care from the time of admission; liaises and communicates with the patient, family and carers and supporting teams to arrange appropriate follow up; recognises and records when patients are medically, including mentally, fit for discharge; AND prescribes discharge or outpatient medication in a timely fashion
We do this on a regular basis in the NHS when we are on the ward.
http://omarsguidelines.blogspot.com/2017/05/guideline-for-junior-doctors-working-in.html
3.13 Investigations
Ensures correct identification of patients when collecting and labelling samples, reviewing results and planning consequent management; explains to patients the risks, possible outcomes and implications of investigation results; AND obtains informed consent.
We do this on a regular basis in the NHS when we are on the ward and on call.
3.14 Interpreting investigations
Seeks, interprets, records and relays/acts on results of complex investigations, e.g. ECG, laboratory tests, basic radiographs and other investigations; AND explains these effectively to patients
We do this on a regular basis in the NHS when we are on the ward and on call.
3.15 Correct prescription
Prescribes medicines correctly, accurately and unambiguously in accordance with GMC or other guidance using correct documentation to ensure patients receive the correct drug via the correct route at the correct frequency at the correct time; demonstrates understanding of responsibilities and restrictions with regard to prescribing high risk medicines including anticoagulation, insulin, chemotherapy and immunotherapy; performs dosage calculations accurately and verifies that the dose calculated is of the right order; prescribes controlled drugs using appropriate legal framework or describes the management and prescribing of controlled drugs in the community; AND describes the importance of security issues in respect of prescriptions
We do this on a regular basis in the NHS when we are on the ward and on call.
PAGE 6
3.16 Prescribing for relatives
Follows the guidance in Good Medical Practice (or equivalent) relating to prescribing for self, friends or family
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/prescribing-and-managing-medicines-and-devices/need-and-objectivity#paragraph-17
3.17 Clinically effective prescription
Prescribes and administers for common important indications including medicines required urgently in the management of medical emergencies; can assess the need for fluid replacement therapy and choose and prescribe appropriate intravenous fluids and calculate the correct volume and flow rates or can describe how to do so; AND can prescribe and administer blood products safely in accordance with guidelines/protocols on safe cross matching and the use of blood and blood products or can describe how to do so.
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/prescribing-and-managing-medicines-and-devices
3.18 Discussion of medication with patients
Discusses drug treatment and administration with patients/carers, including duration of treatment, unwanted effects and interactions; AND obtains an accurate drug history, including allergy, self-medication, use of complementary healthcare products and enquiry about allergic and other adverse reactions
We do this on a regular basis in the NHS
3.19 Guidance on prescription
Prescribes using support, including local and national formularies, pharmacists and more experienced prescribers to ensure accurate, safe and effective error-free prescribing, whilst recognising that legal responsibility remains with the prescriber
We do this on a regular basis in the NHS
3.20 Prescribing antimicrobials
Prescribes according to relevant national and local guidance on antimicrobial therapy, recognising the link between antimicrobial prescribing and the development of antimicrobial resistance
We do this on a regular basis in the NHS by following the local anitmicrobial guidleines and liaising with the microbiology team where appropriate.
3.21 Review of prescriptions
Reviews prescriptions regularly for effectiveness and safety taking account of patient response, adverse reactions and drug level monitoring; recognises and initiates action for common adverse effects of drugs; AND communicates these to patients, including potential effects on work and driving
We do this on a regular basis in the NHS
3.22 Performs procedures safely
Competently performs the core procedures, as mandated by the GMC (http://www.gmc-uk.org/education/postgraduate/F1_outcomes_core_skills.asp); knows the indications and contraindications of each procedure; AND performs some more complex procedures / in more challenging circumstances
3.23 Cardiac and respiratory arrest
Trained to perform immediate adult life support comprising cardiopulmonary resuscitation, simple airway management and safe defibrillation or basic paediatric life support and to adapt resuscitation when appropriate; demonstrates the performance of advanced life support including cardiopulmonary resuscitation, manual defibrillation and management of life-threatening arrhythmias; AND is able to lead the resuscitation team where necessary
Please note: The applicant is expected to provide an Advanced Life Support Certificate from the Resuscitation Council UK or equivalent with this certificate. Any equivalent certificate should relate to a course where the applicant has been assessed and the course has covered:
• ECG and pulse interpretation of aberrant rhythms
• Use of defibrillator
• Use of drugs such as adrenaline/atropine
• Assessing and treating for shockThese are the courses resus, UK accepts:
https://www.resus.org.uk/information-on-courses/faqs-for-candidates/
HOWEVER, this form DOES NOT specify if the course you have done SHOULD BE acceptable by RESUS, UK PROVIDED the course MEETS the following requirements:
ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock.
3.24 “Do not resuscitate” orders
Able to discuss decisions not to resuscitate with the multidisciplinary team, the patient, long term carers (both medical and non-medical) and relatives and then records the outcome of that discussion.
We do this on a regular basis in the NHS https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr
3.25 Understands the principles of health promotion
Explains to patients the possible effects of lifestyle, including the effects of diet, nutrition, inactivity, smoking, alcohol and substance abuse; AND advises on preventative measures with reference to local and national guidelines.
We do this on a regular basis in the NHS when we clerk patients - we ask about smoking, alcohol and any substance abuse and give them advice. We also discuss this when we see patients in the outpatient clinic or when they are admitted to the cardiology ward. https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/generic-professional-capabilities-framework
PAGE 7
3.26 End of Life Care
Recognises that palliative care requires attention to physical, psychological, emotional, social and spiritual aspects of the patient’s experience, and those close to them; helps patient to access this if required; participates in discussions regarding personalised care planning including symptom management and advance care plans with patients, family and carers; AND discusses the patients’ needs and preferences regarding care in the last days of life, including preferred place of care and death, treatment escalation plans, do not attempt cardiopulmonary resuscitation (DNACPR) decisions.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life
3.27 Care after death
Confirms death by conducting appropriate physical examination, documenting findings in the patient record; follows the law and statutory codes of practice governing completion of Medical Certificate of Cause of Death; demonstrates understanding of circumstances requiring reporting death to coroner/procurator fiscal or equivalent; discusses the benefits of post mortem examination AND explains the process to relatives/carers.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life
3.28 Infection control
Demonstrates consistently high standard of practice in infection control techniques in patient contact and treatment including hand hygiene and use of personal protective equipment (PPE); demonstrates safe aseptic technique and correctly disposes of sharps and clinical waste; requests screening for any disorder which could put other patients or staff at risk by cross contamination, e.g. Clostridium.Difficile; informs the competent authority of notifiable diseases; challenges and corrects poor practice in others who are not observing best practice in infection control; recognises the need for immunisations and ensures own are up to date in accordance with local/national policy; AND recognises the risks to patients from transmission of blood-borne infection
We do this on a regular basis in the NHS. https://www.nice.org.uk/guidance/qs61
Section 4: Safety and Quality
4.1 Personal competence
Recognises and works within limits of competency; calls for senior help and advice in a timely manner and communicates concerns/expected response clearly; uses clinical guidelines and protocols, care pathways and bundles; AND takes part in activities to maintain and develop competence e.g. seeking opportunities to do structured learning and attending simulation training; demonstrates evidence of reflection on practice and how this has led to personal development.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-1---knowledge-skills-and-performance
4.2 Patient safety
Delivers healthcare within clinical governance frameworks under senior/consultant direction; discusses the limitations of clinical pathways and seeks advice regarding deviating from these in certain individual patient circumstances; AND undertakes appropriate pre-theatre/procedure checks including World Health Organisations (WHO) safe surgery checklist; describes the mechanisms to report critical incidents/near misses, device related adverse events and adverse drug reactions
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-2----safety-and-quality
4.3 Causes of impaired performance, error or suboptimal patient care
Can describe the risks to patients if personal performance is compromised, why health problems of the practitioner must not compromise patient care or expose colleagues or patients to harm, the need to report personal health problems in a timely manner and an awareness of the support services available; seeks support appropriately (e.g. GP, occupational health, support services) regarding health or emotional concerns that might impact personal performance; describes the role of human factors in medical errors and takes steps to minimise these; AND describes ways of identifying poor performance in colleagues and how to support them
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/raising-and-acting-on-concerns
PAGE 8
4.4 Patient identification
Ensures patient safety by positive identification of the patient at each encounter, in case notes, when prescribing/administering drugs and before consent for surgery/procedures; uses appropriate 2 or 3 point checks (e.g.name, date of birth, hospital number, address) in accordance with local protocols and national guidance; AND crosschecks identification immediately before procedures/administration of blood products/IV drugs
We do this on a regular basis in the NHS.
4.5 Usage of technology
Demonstrates ability to operate common medical devices and interpret non-invasive monitoring correctly and safely after appropriate training; accesses and uses IT systems including local computing systems appropriately; AND demonstrates good information governance in use of electronic records.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/confidentiality/managing-and-protecting-personal-information
4.6 Quality Improvement
Contributes significantly to at least one patient safety quality improvement project, including data collection, analysis and/or presentation of findings and implementation of recommendations; AND makes quality improvement link to learning/professional development.
http://omarsguidelines.blogspot.com/2018/02/all-about-quality-improvement-projects.html
https://improvement.nhs.uk/resources/pdsa-cycles/
4.7 Healthcare resource management
Demonstrates understanding of the organisational structure of the healthcare and their role in the wider health and social care landscape; recognises the resource implications of personal actions; AND minimises unnecessary or wasteful use of resources e.g. repeat investigations, delayed discharge
We do this on a regular basis in the NHS.http://omarsguidelines.blogspot.com/2018/08/managing-elderly-patients.html
PAGE 5
3.6 Supports patients with long term conditions
Encourages and assists patients to make realistic decisions about their care and helps them to construct and review advance/long-term care plans; AND arranges appropriate assessment for specialist rehabilitation, care home placement and respite care.
We do this on a regular basis in the NHS.http://omarsguidelines.blogspot.com/2018/08/managing-elderly-patients.html
3.6 Nutrition
Works with other healthcare professionals to address nutritional needs and communicate these during care planning; recognises eating disorders, seeks senior input and refers to local specialist service; AND formulates a plan for investigation and management of weight loss or weight gain
We do this on a regular basis in the NHS by liaising with dietitians.
3.7 History
Obtains relevant history, including mental health and collateral history, in time limited and sometimes difficult circumstances
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.8 Physical and mental state examination
Performs competent physical and mental state examination in a timely manner; uses a chaperone, where appropriate; AND performs focused physical/mental state examination in time limited environments e.g. outpatients, general practice or emergency department
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.9 Diagnosis
Formulates appropriate physical/mental health differential diagnoses, based on history, examination and immediate investigations; AND takes account of probabilities in ranking differential diagnoses
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.10 Clinical management
Refines problem lists and management plans; AND develops appropriate strategies for further investigation and management
We do this on a regular basis in the NHS when we are on call.https://omarsguidelines.blogspot.com/2019/08/how-to-clerk-medial-patients-safely-and.html
3.11 Clinical review
Undertakes regular reviews, amends differential diagnosis and expedites patient investigation and management in light of developing symptoms and in response to therapeutic interventions; AND reprioritises problems and refines strategies for investigation and management
We do this on a regular basis in the NHS when we are on the ward.
http://omarsguidelines.blogspot.com/2017/05/guideline-for-junior-doctors-working-in.html
3.12 Discharge planning
Anticipates clinical evolution and starts planning discharge and ongoing care from the time of admission; liaises and communicates with the patient, family and carers and supporting teams to arrange appropriate follow up; recognises and records when patients are medically, including mentally, fit for discharge; AND prescribes discharge or outpatient medication in a timely fashion
We do this on a regular basis in the NHS when we are on the ward.
http://omarsguidelines.blogspot.com/2017/05/guideline-for-junior-doctors-working-in.html
3.13 Investigations
Ensures correct identification of patients when collecting and labelling samples, reviewing results and planning consequent management; explains to patients the risks, possible outcomes and implications of investigation results; AND obtains informed consent.
We do this on a regular basis in the NHS when we are on the ward and on call.
3.14 Interpreting investigations
Seeks, interprets, records and relays/acts on results of complex investigations, e.g. ECG, laboratory tests, basic radiographs and other investigations; AND explains these effectively to patients
We do this on a regular basis in the NHS when we are on the ward and on call.
Prescribes medicines correctly, accurately and unambiguously in accordance with GMC or other guidance using correct documentation to ensure patients receive the correct drug via the correct route at the correct frequency at the correct time; demonstrates understanding of responsibilities and restrictions with regard to prescribing high risk medicines including anticoagulation, insulin, chemotherapy and immunotherapy; performs dosage calculations accurately and verifies that the dose calculated is of the right order; prescribes controlled drugs using appropriate legal framework or describes the management and prescribing of controlled drugs in the community; AND describes the importance of security issues in respect of prescriptions
We do this on a regular basis in the NHS when we are on the ward and on call.
PAGE 6
3.16 Prescribing for relatives
Follows the guidance in Good Medical Practice (or equivalent) relating to prescribing for self, friends or family
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/prescribing-and-managing-medicines-and-devices/need-and-objectivity#paragraph-17
3.17 Clinically effective prescription
Prescribes and administers for common important indications including medicines required urgently in the management of medical emergencies; can assess the need for fluid replacement therapy and choose and prescribe appropriate intravenous fluids and calculate the correct volume and flow rates or can describe how to do so; AND can prescribe and administer blood products safely in accordance with guidelines/protocols on safe cross matching and the use of blood and blood products or can describe how to do so.
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/prescribing-and-managing-medicines-and-devices
3.18 Discussion of medication with patients
Discusses drug treatment and administration with patients/carers, including duration of treatment, unwanted effects and interactions; AND obtains an accurate drug history, including allergy, self-medication, use of complementary healthcare products and enquiry about allergic and other adverse reactions
We do this on a regular basis in the NHS
3.19 Guidance on prescription
Prescribes using support, including local and national formularies, pharmacists and more experienced prescribers to ensure accurate, safe and effective error-free prescribing, whilst recognising that legal responsibility remains with the prescriber
We do this on a regular basis in the NHS
3.20 Prescribing antimicrobials
Prescribes according to relevant national and local guidance on antimicrobial therapy, recognising the link between antimicrobial prescribing and the development of antimicrobial resistance
We do this on a regular basis in the NHS by following the local anitmicrobial guidleines and liaising with the microbiology team where appropriate.
3.21 Review of prescriptions
Reviews prescriptions regularly for effectiveness and safety taking account of patient response, adverse reactions and drug level monitoring; recognises and initiates action for common adverse effects of drugs; AND communicates these to patients, including potential effects on work and driving
We do this on a regular basis in the NHS
3.22 Performs procedures safely
Competently performs the core procedures, as mandated by the GMC (http://www.gmc-uk.org/education/postgraduate/F1_outcomes_core_skills.asp); knows the indications and contraindications of each procedure; AND performs some more complex procedures / in more challenging circumstances
3.23 Cardiac and respiratory arrest
Trained to perform immediate adult life support comprising cardiopulmonary resuscitation, simple airway management and safe defibrillation or basic paediatric life support and to adapt resuscitation when appropriate; demonstrates the performance of advanced life support including cardiopulmonary resuscitation, manual defibrillation and management of life-threatening arrhythmias; AND is able to lead the resuscitation team where necessary
Please note: The applicant is expected to provide an Advanced Life Support Certificate from the Resuscitation Council UK or equivalent with this certificate. Any equivalent certificate should relate to a course where the applicant has been assessed and the course has covered:
• ECG and pulse interpretation of aberrant rhythms
• Use of defibrillator
• Use of drugs such as adrenaline/atropine
• Assessing and treating for shockThese are the courses resus, UK accepts:
https://www.resus.org.uk/information-on-courses/faqs-for-candidates/
HOWEVER, this form DOES NOT specify if the course you have done SHOULD BE acceptable by RESUS, UK PROVIDED the course MEETS the following requirements:
ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock.
3.24 “Do not resuscitate” orders
Able to discuss decisions not to resuscitate with the multidisciplinary team, the patient, long term carers (both medical and non-medical) and relatives and then records the outcome of that discussion.
We do this on a regular basis in the NHS https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr
3.25 Understands the principles of health promotion
Explains to patients the possible effects of lifestyle, including the effects of diet, nutrition, inactivity, smoking, alcohol and substance abuse; AND advises on preventative measures with reference to local and national guidelines.
We do this on a regular basis in the NHS when we clerk patients - we ask about smoking, alcohol and any substance abuse and give them advice. We also discuss this when we see patients in the outpatient clinic or when they are admitted to the cardiology ward. https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/generic-professional-capabilities-framework
PAGE 7
3.26 End of Life Care
Recognises that palliative care requires attention to physical, psychological, emotional, social and spiritual aspects of the patient’s experience, and those close to them; helps patient to access this if required; participates in discussions regarding personalised care planning including symptom management and advance care plans with patients, family and carers; AND discusses the patients’ needs and preferences regarding care in the last days of life, including preferred place of care and death, treatment escalation plans, do not attempt cardiopulmonary resuscitation (DNACPR) decisions.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life
3.27 Care after death
Confirms death by conducting appropriate physical examination, documenting findings in the patient record; follows the law and statutory codes of practice governing completion of Medical Certificate of Cause of Death; demonstrates understanding of circumstances requiring reporting death to coroner/procurator fiscal or equivalent; discusses the benefits of post mortem examination AND explains the process to relatives/carers.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life
3.28 Infection control
Demonstrates consistently high standard of practice in infection control techniques in patient contact and treatment including hand hygiene and use of personal protective equipment (PPE); demonstrates safe aseptic technique and correctly disposes of sharps and clinical waste; requests screening for any disorder which could put other patients or staff at risk by cross contamination, e.g. Clostridium.Difficile; informs the competent authority of notifiable diseases; challenges and corrects poor practice in others who are not observing best practice in infection control; recognises the need for immunisations and ensures own are up to date in accordance with local/national policy; AND recognises the risks to patients from transmission of blood-borne infection
We do this on a regular basis in the NHS. https://www.nice.org.uk/guidance/qs61
Section 4: Safety and Quality
4.1 Personal competence
Recognises and works within limits of competency; calls for senior help and advice in a timely manner and communicates concerns/expected response clearly; uses clinical guidelines and protocols, care pathways and bundles; AND takes part in activities to maintain and develop competence e.g. seeking opportunities to do structured learning and attending simulation training; demonstrates evidence of reflection on practice and how this has led to personal development.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-1---knowledge-skills-and-performance
4.2 Patient safety
Delivers healthcare within clinical governance frameworks under senior/consultant direction; discusses the limitations of clinical pathways and seeks advice regarding deviating from these in certain individual patient circumstances; AND undertakes appropriate pre-theatre/procedure checks including World Health Organisations (WHO) safe surgery checklist; describes the mechanisms to report critical incidents/near misses, device related adverse events and adverse drug reactions
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-2----safety-and-quality
4.3 Causes of impaired performance, error or suboptimal patient care
Can describe the risks to patients if personal performance is compromised, why health problems of the practitioner must not compromise patient care or expose colleagues or patients to harm, the need to report personal health problems in a timely manner and an awareness of the support services available; seeks support appropriately (e.g. GP, occupational health, support services) regarding health or emotional concerns that might impact personal performance; describes the role of human factors in medical errors and takes steps to minimise these; AND describes ways of identifying poor performance in colleagues and how to support them
https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/raising-and-acting-on-concerns
PAGE 8
4.4 Patient identification
Ensures patient safety by positive identification of the patient at each encounter, in case notes, when prescribing/administering drugs and before consent for surgery/procedures; uses appropriate 2 or 3 point checks (e.g.name, date of birth, hospital number, address) in accordance with local protocols and national guidance; AND crosschecks identification immediately before procedures/administration of blood products/IV drugs
We do this on a regular basis in the NHS.
4.5 Usage of technology
Demonstrates ability to operate common medical devices and interpret non-invasive monitoring correctly and safely after appropriate training; accesses and uses IT systems including local computing systems appropriately; AND demonstrates good information governance in use of electronic records.
We do this on a regular basis in the NHS. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/confidentiality/managing-and-protecting-personal-information
4.6 Quality Improvement
Contributes significantly to at least one patient safety quality improvement project, including data collection, analysis and/or presentation of findings and implementation of recommendations; AND makes quality improvement link to learning/professional development.
http://omarsguidelines.blogspot.com/2018/02/all-about-quality-improvement-projects.html
https://improvement.nhs.uk/resources/pdsa-cycles/
4.7 Healthcare resource management
Demonstrates understanding of the organisational structure of the healthcare and their role in the wider health and social care landscape; recognises the resource implications of personal actions; AND minimises unnecessary or wasteful use of resources e.g. repeat investigations, delayed discharge
We do this on a regular basis in the NHS.
FAQS
Can I get this form signed from my home country?
No, it will be difficult to get it signed as we do not do all the aforementioned things in our home countries.
Well, my consultant is happy to sign it.
Just imagine this- You have got it signed and you have gone through the trouble to apply for a training post which requires this form and you have submitted it. Later on, you find out that you have been deemed ineligible because the recruitment team has checked the details your consultant has ticked as "witnessed" and you do not have those.
Like what?
Quality improvement projects (QIP), for example.
I can do a QIP in my home country.
It is very unlikely that you will be able to do it as the QIP framework is not routinely followed in our home country:
https://improvement.nhs.uk/resources/pdsa-cycles/
What are the other points in the form you think that we cannot achieve in our home country?
Page 3- point 1.9 : Mental capacity
Page 3, point 1.10 : protection of vulnerable groups.
Page 3- point 2.4 : Complaints
Page 4- point 3.5: The Frail patient
Page 5- point 3.12: Discharge planning
Page 6- point 3.16: Prescribing for relatives.
Page 6- point 3.24- Do not resuscitate orders ( Some hospitals abroad have this but most do not).
Page 7- point 3.26 - Managing end of life care.
Page 8- Point 4.6- Quality improvement.
There are more, this is just an example.
I have noticed that you have not mentioned ALS here.
I am going to copy paste what I have mentioned above:
"The applicant is expected to provide an Advanced Life Support Certificate from the Resuscitation Council UK or equivalent with this certificate. Any equivalent certificate should relate to a course where the applicant has been assessed and the course has covered:
• ECG and pulse interpretation of aberrant rhythms
• Use of defibrillator
• Use of drugs such as adrenaline/atropine
• Assessing and treating for shockThese are the courses resus, UK accepts:
https://www.resus.org.uk/information-on-courses/faqs-for-candidates/
HOWEVER, this form DOES NOT specify if the course you have done SHOULD BE acceptable by RESUS, UK PROVIDED the course MEETS the following requirements:
ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock. "
So what does this mean?
You need an ALS or equivalent certificate.
Does this mean that I can use an ACLS ( American Heart Association) certificate?
I am going to copy paste the relevant information again:
"Any equivalent certificate should relate to a course where the applicant has been assessed and the course has covered:
• ECG and pulse interpretation of aberrant rhythms
• Use of defibrillator
• Use of drugs such as adrenaline/atropine
• Assessing and treating for shock"
Can I use my ACLS certificate: Yes or No?
My interpretation of the above information is that yes, you can. However given that you need to get the competency form signed from within the UK and will need an ALS certificate when you start your training ( or in some training posts, when you apply for the training post), it is best to sort this out when you start working in the NHS.
The criteria are mentioned here:
https://specialtytraining.hee.nhs.uk/Recruitment/Person-specifications
What if I get it signed from my home country and manage to get a training post as well?
My personal opinion is that they have introduced this form to ensure a doctor works in the UK before applying for a training post which requires this competency form. The reason behind it is to avoid mistakes and have basic knowledge to apply for a training post and be able to work in it without any hiccups.
If, let's say during the interview of a training post, they want you to describe the QIP your form states you have completed and you are unable to describe it ( or do not have evidence ) that you have done it, this will NOT go in your favor.
Similarly they may ask about DNAR discussions and so on.
So what would your advice be?
I would suggest that you do the following:
1. Get registered with the GMC
2. Start in a non training post
3. Use the points in this competency form as your personal development plan ( http://omarsguidelines.blogspot.com/2017/06/your-personal-development-plan.html )
4. Once your consultant has observed you for a few months and you have achieved everything in this form, you can apply for a training post.
What is your personal opinion about this form?
I personally really like the eligibility criteria they have set in it. As a registrar ( and former core medical trainee), I have witnessed some IMG trainees make mistakes which could have been avoided had they spent more time working in their non training posts and getting used to the NHS system. This competency form will allow them more time to get used to the system. Plus, some points like QIPs will encourage them to actively participate in them and polish their CV even further.
What about those IMGs who have been working in the NHS for a few months , got their previous competency forms signed just a few weeks ago and were about to apply for training posts in a few months? I feel you are being very selfish here by saying that you agree with what is going on.
I understand your frustration and my colleagues and I can personally help you achieve whatever you are deficient in.
Here is my advice.
1. Talk to your supervisor in the NHS and show him/her your previous signed form and alspo show the new 2020 competency form.
2. Inform him/her that you need the current form to apply for training posts.
What if (s)he is not willing to sign it?
Ask what deficiencies you have and meet them.
(S)He has said that I do not have a QIP.
It takes 2 weeks to 1 month to do a QIP. Some consultants may be happy to sign the section even if you have not fully completed it- it depends on the consultant. However they all understand how important this is for you.
My colleagues and I can personally help you meet the deficiencies your supervisor has identified if you join this Facebook group and post here:
https://www.facebook.com/groups/IMGs.in.the.UK/
Can I get this form signed from my home country?
No, it will be difficult to get it signed as we do not do all the aforementioned things in our home countries.
Well, my consultant is happy to sign it.
Just imagine this- You have got it signed and you have gone through the trouble to apply for a training post which requires this form and you have submitted it. Later on, you find out that you have been deemed ineligible because the recruitment team has checked the details your consultant has ticked as "witnessed" and you do not have those.
Like what?
Quality improvement projects (QIP), for example.
I can do a QIP in my home country.
It is very unlikely that you will be able to do it as the QIP framework is not routinely followed in our home country:
https://improvement.nhs.uk/resources/pdsa-cycles/
What are the other points in the form you think that we cannot achieve in our home country?
Page 3- point 1.9 : Mental capacity
Page 3, point 1.10 : protection of vulnerable groups.
Page 3- point 2.4 : Complaints
Page 4- point 3.5: The Frail patient
Page 5- point 3.12: Discharge planning
Page 6- point 3.16: Prescribing for relatives.
Page 6- point 3.24- Do not resuscitate orders ( Some hospitals abroad have this but most do not).
Page 7- point 3.26 - Managing end of life care.
Page 8- Point 4.6- Quality improvement.
There are more, this is just an example.
I have noticed that you have not mentioned ALS here.
I am going to copy paste what I have mentioned above:
"The applicant is expected to provide an Advanced Life Support Certificate from the Resuscitation Council UK or equivalent with this certificate. Any equivalent certificate should relate to a course where the applicant has been assessed and the course has covered:
• ECG and pulse interpretation of aberrant rhythms
• Use of defibrillator
• Use of drugs such as adrenaline/atropine
• Assessing and treating for shockThese are the courses resus, UK accepts:
https://www.resus.org.uk/information-on-courses/faqs-for-candidates/
HOWEVER, this form DOES NOT specify if the course you have done SHOULD BE acceptable by RESUS, UK PROVIDED the course MEETS the following requirements:
ECG and pulse interpretation of aberrant rhythms, defibrillator use, use of drugs such as adrenaline/atropine and assessing and treating for shock. "
So what does this mean?
You need an ALS or equivalent certificate.
Does this mean that I can use an ACLS ( American Heart Association) certificate?
I am going to copy paste the relevant information again:
"Any equivalent certificate should relate to a course where the applicant has been assessed and the course has covered:
• ECG and pulse interpretation of aberrant rhythms
• Use of defibrillator
• Use of drugs such as adrenaline/atropine
• Assessing and treating for shock"
Can I use my ACLS certificate: Yes or No?
My interpretation of the above information is that yes, you can. However given that you need to get the competency form signed from within the UK and will need an ALS certificate when you start your training ( or in some training posts, when you apply for the training post), it is best to sort this out when you start working in the NHS.
The criteria are mentioned here:
https://specialtytraining.hee.nhs.uk/Recruitment/Person-specifications
What if I get it signed from my home country and manage to get a training post as well?
My personal opinion is that they have introduced this form to ensure a doctor works in the UK before applying for a training post which requires this competency form. The reason behind it is to avoid mistakes and have basic knowledge to apply for a training post and be able to work in it without any hiccups.
If, let's say during the interview of a training post, they want you to describe the QIP your form states you have completed and you are unable to describe it ( or do not have evidence ) that you have done it, this will NOT go in your favor.
Similarly they may ask about DNAR discussions and so on.
So what would your advice be?
I would suggest that you do the following:
1. Get registered with the GMC
2. Start in a non training post
3. Use the points in this competency form as your personal development plan ( http://omarsguidelines.blogspot.com/2017/06/your-personal-development-plan.html )
4. Once your consultant has observed you for a few months and you have achieved everything in this form, you can apply for a training post.
What is your personal opinion about this form?
I personally really like the eligibility criteria they have set in it. As a registrar ( and former core medical trainee), I have witnessed some IMG trainees make mistakes which could have been avoided had they spent more time working in their non training posts and getting used to the NHS system. This competency form will allow them more time to get used to the system. Plus, some points like QIPs will encourage them to actively participate in them and polish their CV even further.
What about those IMGs who have been working in the NHS for a few months , got their previous competency forms signed just a few weeks ago and were about to apply for training posts in a few months? I feel you are being very selfish here by saying that you agree with what is going on.
I understand your frustration and my colleagues and I can personally help you achieve whatever you are deficient in.
Here is my advice.
1. Talk to your supervisor in the NHS and show him/her your previous signed form and alspo show the new 2020 competency form.
2. Inform him/her that you need the current form to apply for training posts.
What if (s)he is not willing to sign it?
Ask what deficiencies you have and meet them.
(S)He has said that I do not have a QIP.
It takes 2 weeks to 1 month to do a QIP. Some consultants may be happy to sign the section even if you have not fully completed it- it depends on the consultant. However they all understand how important this is for you.
My colleagues and I can personally help you meet the deficiencies your supervisor has identified if you join this Facebook group and post here:
https://www.facebook.com/groups/IMGs.in.the.UK/
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