Severn School of Paediatrics Guidance on exiting training levels early

This guidance provides clarity as to the circumstances and process by which trainees may complete levels of their training early. Training is competency based, although there are specific minimum time periods within each level, and some sub-specialty training programmes have additional time based elements.

The RCPCH have specified the minimum training time at each level as follows:

Level 1 (ST1-3): 24 months whole time equivalent (WTE)

Level 2 (ST4-5): 12 months (WTE)

Level 3 (ST6-8): 24 months (WTE)

Most trainees complete their training in around 8 years, but there are circumstances in which training periods can be shorter. Guidance about each period is dealt with separately as below. The RCPCH has produced advice on exiting training levels early (see link to RCPCH website); this guidance compliments this advice and sets out our own School process.

 

Level 1

Trainees must complete all of the competencies at level 1 to progress to level 2, and have all parts of the MRCPCH examination. Trainees who wish to move to level 2 training earlier than at the end of their ST3 year should contact the ST1-3 Training Programme Director (TPD) to make their intention known and seek further advice. There should be liaison between the trainee, their supervisor and the ST4-8 TPD to establish whether an early move to level 2 training is appropriate and when this might take place, and what placement can be offered. Trainees will need to have completed at least the minimum number of Supervised Learning Events (SLEs) for each fullly completed ST year. When a trainee has spent less than 12 months at ST3, then a pro-rata minimum number of SLEs would be expected. RCPCH guidance states that trainees who have spent 6 to 12 months at ST3 will need a MSF and a safeguarding CBD for that year. At ARCP, their trainer’s report must comment specifically on whether they are ready to move to level 2 training. Appropriate annotation of the curriculum on ePortfolio may help to show that an early move is appropriate.

 

Level 2

Trainees in level 2 must complete all of the competencies within general paediatrics, neonatal medicine and community child health. As trainees usually rotate between placements in these areas, it is difficult to gain appropriate experience and competences in a significantly shorter time than 24 months WTE. Trainees who wish to move to level 3 training earlier than 24 months should contact the ST4-8 Training Programme Director (TPD) to make their intention known and seek further advice. There should be liaison between the trainee, their supervisor and the ST4-8 TPD to establish whether an early move to level 3 training is appropriate and when this might take place, and what placement can be offered. We would usually expect two years of SLEs as a minimum number during training at level 2. At ARCP, their trainer’s report must comment specifically on whether they are ready to move to level 3 training. Appropriate annotation of the curriculum on ePortfolio may help to show that an early move is appropriate.

 

Level 3

Trainees who are considering requesting an early exit from training should contact the Head of School (HoS) for further advice. The majority of trainees will complete their full ST8 year, but some trainees who are clearly performing well may be able to leave training earlier at some point within their ST8 year. Trainees in grid sub-specialty training programmer are often subject to time-based elements within their programme, and should also seek early advice from their CSAC chairs.

At the point of request, there would be liaison between the trainee, Head of School, TPD and their supervisor to consider whether an early exit to training would be appropriate for that trainee. The minimum notice period for brining forward a nominal CCT date is 6 months from the date at which a trainee requests consideration from the HoS.

To exit from training, trainees must be able to demonstrate the following:

- clear attainment of progress in prior ST years

- support from their current educational supervisor that they will be competent to leave training early in the suggested time frame

- have undertaken the START assessment, with clear evidence of having addressed all of the areas identified as needing development

If an early exit from training is deemed appropriate, a nominal CCT date is given.  If required, the Head of School will write a letter confirming support for this CCT date. A trainee can use this as supportive evidence of this CCT date if they have an upcoming consultant interview (trainees can be interviewed for a consultant post if on the day of the interview they are within 6 months of their CCT date).

A face to face ARCP will be then set up to formally assess the evidence for progression. At ARCP, the trainer’s report must comment specifically on whether they have achieved all competencies and are ready to exit training. A pro-rata minimum number of SLEs would be expected for periods spent in ST8. Appropriate annotation of the curriculum on ePortfolio may help to show that an early move is appropriate. Where possible, it is recommended that a trainee undertakes a period of acting up as a consultant (see RCPCH guidance) before they complete their training as this will support their transition to being a consultant. Grid trainees on sub-specialty training programs must have sought early advice from their CSAC; for grid trainees to leave training early they must have CSAC approval and evidence that they have been showing appropriate progression, and at their final ARCP, will have met the required sub-specialty competencies.

At ARCP, if the panel agree that it is appropriate for the trainee to exit training, then this CCT date will be set and an outcome 6 awarded. This CCT date cannot be subsequently changed or the trainee to re-enter training; however they will be eligible for up to 6 months grace placement dependent upon availability of posts within the programme.