All Postgraduate Deans
26 November 2007
Dear Postgraduate Dean,
Re: PMETB prospective approval of Out-of-Programme
Within the last few months, PMETB has clarified its policies on out-of-programme training and experience for postgraduates, and a system is emerging for those who wish to train outside of their normal rotation. However, it is apparent that there is still some confusion about the process and who needs prospective approval from PMETB.
We thought it might be helpful to list some types of surgical posts with explanations regarding prospective approval.
Acting up as a consultant: The JCST regards ‘acting up’ as a valuable if not essential part of training and would be seen as the final step to independent practice and consultant appointment. The technical, clinical, and professional competencies achieved during an acting up post would normally be embedded within the surgical curriculum; ‘acting up’ can be seen as a strategy for meeting those competencies. These types of posts require a named consultant supervisor, are subject to the usual assessments, and upon completion the SAC must ensure that the required educational competencies are met before the time can formally be counted towards the CCT. PMETB prospective approval is not required.
Approved clinical fellowships in the UK (including Training Interface Fellowships)
These posts are usually undertaken in the final years of training in special interest areas. There are a number of Training Interface Fellowships in Head and Neck Surgical Oncology, Breast Surgery, Cleft Lip and Palate Surgery, and Hand Surgery which are endorsed specifically by the JCST. These posts are national fellowships and a trainee is sometimes based at a centre outside of the home deanery. There may also be other popular fellowships in the UK which are educationally approved, but outside of the home deanery. Nevertheless, these posts are part of approved training programmes and part of the PMETB-approved curriculum. Prior to undertaking such a post, the SAC must give support for the post to ensure it meets curriculum requirements. Upon completion of the post, the trainee must also apply to the SAC to ensure that they have met educational standards. However, PMETB prospective approval is not required.
Un-approved clinical fellowships in the UK
Please note that some national fellowships may not be in educationally approved training slot; if this is the case, both SAC support and PMETB prospective approval is required. PMETB insists that evidence of College support is submitted with the deanery application. While the medical Royal Colleges may have different mechanisms for offering this support, the surgical Colleges only
recognise the SACs for this purpose. PMETB is aware of this, and it will not accept applications with support only from regional surgical College representatives such as regional advisors or surgical tutors. Trainees must apply to the SACs directly in good time, prior to their un-approved fellowship.
Upon completion of the post, the trainee must also apply to the SAC to ensure they have met educational standards. Evidence of PMETB prospective approval should be submitted by the trainee at this stage, along with the usual documentation.
Out of programme research (OOPR)
Research forms an explicit component of the Calman Specialist Registrar (SpR) curriculum and as such, OOPR is supported for SpRs. These posts are not educationally approved and PMETB prospective approval is required. As is the case with un-approved fellowships outlined above, SACs are the only bodies who can offer College support for the PMETB application and trainees must apply to them directly, well before the start of their OOPR post.
The new specialty training curriculum does not have an explicit research component (apart from those with academic training numbers) and currently, OOPR for Specialty Registrars (StRs) will not be supported by the SACs to count towards the CCT. However, research is strongly encouraged and any time out of programme for research may be counted as a career break.
Out of programme training (OOPT) in an EEA member state or Switzerland
As PMETB recognises training approved by the competent authorities in other EEA states, these types of posts can be recognised towards a CCT without PMETB prospective approval, as long as there is written confirmation that the competent authority approves the post (note: the JCST is the competent authority in the Republic of Ireland). However, the SAC must still give its support for the post to ensure it meets curriculum requirements. Upon completion of the post, the trainee must also apply to the SAC to ensure that they have met educational standards. PMETB prospective approval is not required. Please note that if a letter from the competent authority can not be provided, PMETB prospective appoval is needed.
OOPT outside the EEA or Switzerland
These posts are not educationally approved and PMETB prospective approval is required. As is the case with other un-approved posts, SACs are the only College bodies who can offer College support for the PMETB application and trainees must apply to them directly, well before the start of their OOPT post.
The JCST website provides guidance on how to apply for SAC support for each of the above categories. I do hope that the above information is helpful. The new processes are starting to become more efficient and I am sure the systems will work well in the future
Yours sincerely,
Jessica Lichtenstein
Deputy Head of JCST
0207 869 6252
cc: All Postgraduate Deans
Patricia LeRolland, PMETB
Gabrielle Shaw, PMETB