Speacialist Training Programme

Details

Mersey region consists of 3 teaching hospitals, 4 regional centres and 6 district general hospitals. It stretches from Southport and Ormskirk in the north to Crewe in the South. The deanery is relatively compact so all the hospitals are commutable from central Liverpool.

Hospitals on the rotation include:

Teaching Hospitals

• Royal Liverpool University Hospital
• University Hospital Aintree
• Wirral University Teaching Hospital

Specialist Centres

• Walton Centre for Neurology & Neurosurgery
• Liverpool Women’s Hospital
• Liverpool Heart and Chest Hospital
• Alder Hey Children’s Hospital

District General Hospitals

• Whiston Hospital (St Helens)
• Countess of Chester Hospital
• Warrington and Halton Hospitals
• Leighton Hospital (Crewe)
• Southport and Ormskirk Hospital
• Macclesfield District Hospital

Intermediate Years (ST3/4)

In the first 2 years (or intermediate years), trainees will spend 12 months in the teaching centres where they will do the first of two 3 month blocks of intensive care medicine (usually the Royal Liverpool with a further 3m in theatres), 3 months at the Walton Centre (for neuro-anaesthesia), 3 months at the Women’s hospital and a further year in two separate district hospitals. Trainees will spend a two week attachment to the Liverpool Heart and Chest hospital for cardiothoracic anaesthesia usually in the ST3 year. By the end of intermediate training, they should have the seven essential units signed off on their intermediate training certificate. Progression into the higher years is dependent on these competencies being achieved. Full details of these are found in the new curriculum (2010) documents which can be downloaded from the College website (www.rcoa.ac.uk).

As well as having all the competencies signed off by the end of year ST4, a trainee must also have passed the Final FRCA exam to progress into the higher years of training. All relevant exam courses can be found at the MSA website (www.msoa.org.uk)

Higher and Advanced Years (ST5-7)

All trainees will have different career aspirations and the higher years allow some flexibility to pursue these goals. However, there are essential areas of higher and advanced training that must be achieved. All trainees must have completed a further 3 months ICM on top of their 3 months in the intermediate years. They will do a minimum of 3 months paediatrics at Alder Hey (normally 6 months), 3 months at the Cardiothoracic Centre, a further module in neuro-anaesthesia as well as a minimum of 6 months of general duties.

In the final year (ST7), trainees, who intend to obtain a consultant post in a non-specialist hospital without a commitment to ICM, will complete six months to a year of advanced general duties incorporating the appropriate units of training to suit their aspirations for independent consultant practice. There will be opportunities to spend the final 6 months at centres pursuing advanced competency in specialist areas.

Advanced Level Training posts and Out of Programme Training (OOPT)

To allow trainees to develop a specific specialist interest in the final year of training and post-CCT, there are many opportunities to apply for advanced level training posts within the region. These include paediatric (4 at Alder Hey), cardiothoracic (4 at Liverpool Heart and Chest Hospital), neuro (4 at the Walton Centre), obstetric (2 at Liverpool Women’s), pain (1 at the Royal Liverpool), airway (1 at Aintree) and research (1 each at Aintree and the Royal Liverpool).

In principle, the Deanery is also supportive of trainees taking up advanced level training posts and other similar posts outside the region however unpaid leave (UPL) / out of programme training (OOPT) must be considered by the trainee as a privilege and not a right. There are also other conditions attached to these posts and it is expected that such posts will occur in ST6/7 with a maximum duration of 6 months and will not be undertaken out of the region in the final 6 months leading up to CCT.

Firstly, the TPD must approve all applications for OOPT and has the right to turn these requests down although he/she must consult the Head of School, Regional Advisor and deputy Post Graduate Dean before doing so and there is an appeals process to the Post Graduate Dean.

Each trainee should have only one period of UPL or OOPT. Any period which does not count for training (i.e. in a post that is not recognised by PMETB) will not be considered for UPL. There is a limit of 15-20 trainees absent at a time (with some flexibility for the TPD to consider other factors operating at the time) so requests will be considered by the TPD on a first-come-first-served basis.

Therefore the first thing to do, particularly for any post outside the region, is to inform the TPD of your wish. Once you have been successful in obtaining the post, you will have to apply to have time off the rotation and get GMC approval for your post. The application form for time out of the rotation can be obtained from the Deanery. The recognition of the time for training starts with the College OOPT form (www.rcoa.ac.uk). Once you have obtained College approval, it must be copied to the Deanery so that approval can be applied for from GMC. The Deanery is required to submit specific documentation to GMC to seek prospective approval for any such post.

For any advanced level training post outside the Deanery, the following completed documentation will be required:

• A request for unpaid leave
• A timetable for the post
• A statement of the educational goals to be achieved
• A statement of how the assessment will be carried out
• Confirmation from the hospital where the post is to be carried out regarding the educational governance structures (e.g. is it recognised for training by local training authorities)
• Confirmation from the relevant UK College / Specialty association that the proposed training would provide the appropriate experience for the stage of training.

For posts within the Deanery, this is a well worn path and should therefore be relatively straightforward. Almost all advanced level training posts are already recognised for training by the GMC and the minimum requirement is the submission of an OOPT form downloadable from the Deanery website. It all takes time and should be done as far ahead of the OOPT as possible with a minimum notice period of 3 months being required.

ARCP Process

Just as in the early years of training, you will go through the Annual Record of Competence Progression (ARCP) process. The three key elements which support trainees in this process are appraisal, assessment and annual planning. You will be required to submit documents which include a range of evidence to indicate satisfactory assessments during the preceding year. This will include an upto date CV, a record of workplace based assessments; a log book; a record of educational activities, an NHS appraisal and personal development plan and a report from your College Tutor / Educational Supervisor and are all available on the Mersey Deanery website. These will be reviewed by the panel and the outcome will be determined prior to the interview to plan the subsequent year’s training. Full details are available in the Gold Guide (www.mmc.nhs.uk)