General Tips

Every year many of us tell ourselves we won't leave ARCP preparation until the last minute, and every year many of us do so anyway. It is boring to think about, but trying to get as much done in the first 3 or 4 months will make the rest of your year so much less stressful.

New trainees should be aware that ARCP can come very early within the training year (as early as May) so hitting the ground running with your assessments in the first few months is essential.

If you are in a speciality where your GIM commitment is consolidated into blocks of pure GIM away from your parent speciality, be sure to plan how you are going to acquire your GIM competences in those compressed training periods.

Use the Summary of Progress page on your ePortfolio to monitor your progress as it centralises all the information about what you have and what you still need. You can find it under Progression — Summary of Progress

If you have not had significant GIM exposure during your training year, you should fill out a Supplemental Information for ARCP form and upload it to your ePortfolio, so that the ARCP panel are aware.

A Guide to Outcomes

• Outcome 1: Achieving progress & capabilities at the expected rate

  This is what you want!

• Outcome 2: Development of specific capabilities required – Additional training time not required

  There are a few areas where you are not quite on track and need to catch up, but the panel do not feel it will extend your training

• Outcome 3: Development of specific capabilities required – Additional training time required

  There are areas where you are not on track and need to catch up. The panel feel this will require your training to be extended

• Outcome 4: Released from training programme with or without specified capabilities

  You have not been able to meet your educational objectives despite additional support, and the panel have recommended you are released from the training programme

• Outcome 5: Incomplete evidence presented – An assessment of progression cannot be made

  You forgot to upload the Form R didn't you?

• Outcome 6: Achieved all required capabilities for completion of the programme

  "It always seems impossible until it's done"

• Outcome 8: Out of programme for clinical experience, research, career break or pause (OOPE/OOPR/OOPC/OOPP)

  You are enjoying a year without any night shifts. Good for you.

Reviews & Appeals

Reviews:

If you have received an Outcome 2, you have the right to request a review. This involves the same ARCP panel reviewing your case

To request a review you must write to the Chair of your ARCP panel within 10 working days of being notified of their decision. If you have extra evidence at this time (eg. evidence of mitigating circumstances or other evidence relevant to the original panel’s decision) you must include this in your written review request. Please note that reviews do not typically take into account extra evidence from assessments obtained after the date of the original ARCP

The panel should review your case within 15 working days. The decision of the review is final and there are no further appeals possible

Appeals:

If you have received an Outcome 3 or 4, you have the right to request an appeal. This involves a different panel reviewing your case

To request an appeal you must write to the Postgraduate Dean within 10 working days of being notified of the original ARCP decision. The request must explicitly state the grounds for appeal. Initially, the Postgraduate Dean will arrange for a review as above. If this changes the outcome of your ARCP then the process is complete. If it does not, then the Postgraduate Dean will confirm that you wish to go forwards to an appeal hearing. Appeals may take into account extra evidence from assessments obtained after the date of the original ARCP

Once again, the decision of the appeal is final and there are no further appeals possible

Please see the Gold Guide (p91 onwards) for more information

Basic Reports & Forms

Prior to ARCP please make sure that you have the following uploaded to your ePortfolio:

Educational Supervisor (ES) Report:

• If your speciality ES is also supervising you for GIM (eg. in Respiratory Medicine) then only 1 report is required, which covers both your parent speciality and GIM. If you have a separate GIM ES (eg. in Neurology) then a separate ES report is required for GIM.

• If you have done little to no IM in that year, your ES can acknowledge that little IM has been undertaken and suggest priorities for the following year

• You may need to upload an ES report for ARCP even if you are out of programme at the time. See our OOP page for more information

Form R:

• Forgetting this is the easiest way to ensure an Outcome 5 at ARCP. The forms can be completed through the TIS Self-Service here. Remember to upload these to ePortfolio once you have completed them

CCT Calculator:

• This can be downloaded here

Other Forms

Some trainees will have additional forms they need to fill out

Academic Supervisor's Report:

• This must be completed in Out of Programme Research (OOPR) years and can be found within ePortfolio under Progression — Supervisor's Report

OOP Update Form:

• The OOP Update form must be filled out if you are out of programme at the time of your ARCP. It can be found here

Capabilities in Practice (CIPs)

Each year you need to rate yourself against the Generic and Clinical CIPs on ePortfolio, and you should link an assessment to the CIP to evidence your rating. Be sure to reference the ARCP Decision Aid to ensure you are progressing at the expected pace.

Your ES will then have the thrilling task of rating you against the same CIPs. Please be sure that they do this rating before they complete the ES report as otherwise their ratings will not pull through to the Summary of Progress page in your ePortfolio

Multiple Consultant Report (MCR)

Each year, at least 2 of your MCRs must be from consultants who have supervised you in a GIM context unless you have done fewer than 2 weeks of GIM in that training year

Final year trainees beware: in your last year of training you need 3 MCRs from consultants who have supervised you in GIM

Multisource Feedback (MSF)

A minimum of 4 respondents in your MSF should have worked with you in a GIM context unless you have done fewer than 2 weeks of GIM in that training year.

To be considered valid, an MSF must include at least 12 raters (including 3 consultants) and be completed within a 3 month period

Patient Survey

After all that complexity so far you'll be glad to hear there are no GIM-specific requirements for a patient survey, you just need one by the end of your training. This means a patient survey you do within your parent speciality will also count for GIM.

JRCPTB guidance on carrying out a patient survey can be found here.

You can also download:

• Patient Survey Form

• Patient Survey Cover Letter

• Patient Survey Summary Form

Please be aware that some specialities require more than 1 patient survey throughout higher speciality training so check your speciality decision aid here.

ACAT

You require 4 ACATs during any year where you do at least 2 weeks of IM, and these should be from consultants supervising you in the acute take / post take setting.

You must have 4 IM ACATs during your final year of training.

Be sure to include enough information with your ACATs that the ARCP panel can see that these are not patients from your own speciality.

CBD/Mini-CEX

You require 3 IM CBDs/Mini-CEXs during any year where you do at least 2 weeks of IM, and these should be from consultants supervising you in the acute take / post take setting.

You must have 3 IM CBDs/Mini-CEXs during your final year of training.

Outpatient Clinics and Acute Unselected Take

You require a total of 20 clinics in specialities other than your parent speciality by the end of training. Please note this does not need to be 5 clinics in each year as is sometimes erroneously stated. Your logbook must clarify the speciality of each of these clinics. Please note that ambulatory care does count towards this number, unless you are an Acute Internal Medicine trainee.

You also require active involvement in the care of 750 patients presenting with GIM problems on the acute unselected take, including 100 patients in your last year of training. Active involvement means enough involvement to write in the patient's notes (eg. clerking, post-take, ad hoc review).

We recommend using the IMT JRCPTB calculator here

Continuing Ward Care

You should have 12 months of experience looking after ward inpatients with GIM problems by the end of your training, including 3 months in your final year. This can include patients in your parent speciality and most of you will acquire this automatically.

For those of you in specialities that are more outpatient focused you may need to discuss with your TPD to ensure that your rotations meet this requirement.

Practical Procedures

Competent to perform unsupervised:

• Advanced CPR

• Ascitic Tap

• Direct Current (DC) Cardioversion

• Lumbar Puncture

• Nasogastric Tube

• Pleural Aspiration for Fluid (Diagnostic)

Skills Lab / Satisfactory Supervised Practice:

• Abdominal Paracentesis

• Access to Circulation for Resuscitation (femoral or intraosseous)

• Central venous Cannulation

• Intercostal Drain for Effusion

• Intercostal Drain for Pneumothorax

• Temporary Cardiac Pacing

Note that when you have been signed off at the appropriate level earlier in training (even prior to higher speciality training) you do not need a further DOPS to prove your competence is maintained unless you or your ES feel otherwise.

Note that for Pleural Procedures the assessment is for your ability to perform the procedure itself excluding the ultrasound. If you are not pleural ultrasound trained as per British Thoracic Society Guidelines (see table 1 and figure 1) a pleural ultrasound trained individual should perform the ultrasound for you.

Final Requirements

Study Leave:

• You need 75 hours of GIM recognised study leave by the end of training including 20 hours in the final year of training

Simulation:

• At least 12 hours of human factors simulation training by the end of training, including at least 4 hours in the final year of training

• Until August 2024 ALS could count towards this due to lack of availability of simulation courses, but this is no longer the case as more courses are becoming available

Quality Improvement Project (QIP):

• At least 1 QIP specifically in a GIM project by the end of training

• For example, a Respiratory trainee could not use a QIP on ambulatory management of PE but a Renal trainee could

• You should complete the QIP assessment tool (QIPAT) on ePortfolio

Teaching:

• At least one Teaching Observation by the end of training, with the form completed on ePortfolio

• You do not need to have a GIM-specific Teaching Observation form; it can be from your parent speciality

Advanced Life Support:

• Valid ALS certificate