I attended the annual BOA/SAC/TPD forum this year and was involved in the programme. The meeting was organised by the BOA Ed Board with the SAC Chair (David Large) and myself (as BOTA President) helping on the day. It was attended by around one third of TPDs in the UK, with a further third providing apologies for absence. It was announced that a review of CCT indicative numbers would be performed by the SAC as it has been 3 years since their introduction.
Based on the work that BOTA conducted in the Linkmen Roadshow, we had considerable input in shaping 4 standards based on good practice seen across the UK. These standards formed the basis for a lively and extensive discussion. Please see below these standards and the discussion points from each group.
Standard 1: Training Programme Directors should allocate trainees to specific trainers in order to best match their training needs.
There are obvious obstacles due to the variation of training posts available in different rotations and the different approaches to accessing feedback from trainees.
Trainees should in most cases only be allocated to specific trainers in the later years of their programme or to fulfil specific training needs leading up to exams.
There should be a focus on the importance of developing a relationship between TPDs and trainees, which forms a strong basis for decisions on allocation to posts.
The allocation would also be informed by strong links with educational leads in each training centre.
Suggested standard: “TPDs should develop strong relationships with all education leads to enable appropriate allocation of trainees to trainers, especially in their early years. In later years TPDs should encourage input from trainees in terms of their placement choice.”
Standard 2: Regional programmes should have a process to quality assure each training post occupied by their trainees on a regular rolling basis.
There should be a process in place to quality assure all training posts.
Differing ways in which the assessment of the quality of training can be sought.
The onus should be put on the trainee to prove their ability and their engagement with the programme; the trainer should recognise this commitment.
Underpinning this there must be a trust between trainees and trainers to ensure that there is honest feedback.
Action should be taken to improve posts failing to meet quality standards.
Standard 3: Out of Programme Placements for Training (OOPTs) should be considered when:
The trainee has successful passed the FRCS exam (both parts) The trainee has an outcome 1 at the last ARCP given:
The OPPT is within the UK
The TPD supports the application
Efforts are made by the trainee to find another trainee from the host region to fill the post they are leaving
There needs to be a level playing field for placements: either they are allowed pre CCT or they are not. There is a varying level of placement opportunities across specialities and regions.
The general consensus is that trainees should not be allowed to undertake fellowships or placements pre CCT. The few TPD’s who allow them create problems for the majority who do not.
If pre CCT fellowships are allowed then the posts would require full quality assurance – who would do this?
Interface fellowships should remain.
In terms of trainees sourcing other trainees to fill the post in their absence, this doesn’t seem feasible as it’s unlikely that a suitable transfer opportunity will coincidentally be available.
Standard 4: Regional training programmes should have a structure of complimentary roles occupied by consultant trainers that assist the TPD in teaching and training delivery e.g. deputy TPD/education TPD
This standard was generally supported.
The complimentary roles would provide the opportunity for current TPDs to facilitate succession planning of future TPDs and for future TPDs to develop the skills necessary to be a TPD.
Roles could potentially form part of an executive/management committee and would be particularly useful for larger training programmes.
It is important to note that there is no one size fits all structure for these additional roles and there will be variation between programmes.
These complimentary roles may be difficult to establish, however once a structure is in place they should be easily maintained.