This programme has been developed in response to the clear need for the NHS to train physicians in the specialist expertise of stroke medicine. Stroke is the most common cause of hospital death and severe acquired disability in the UK, and accounts for over 5% of NHS resources. Stroke encompasses elements of neurology, cardiovascular disease, ageing and rehabilitation. Until now there has been no formal training structure for those who wish to pursue a career in Stroke Medicine and it has been difficult for trainees to obtain the full range of relevant skills.
The primary purpose of sub-specialist training in stroke medicine is to promote the development of physicians with the knowledge, skills and attitudes to function as an expert consultant resource within specialist stroke services. The detailed role of a stroke physician will vary depending on the type of service within which they are practising. The training programme recognises this, but expects all stroke specialists to have core knowledge and skills in all areas of diagnosis, investigation and treatment relevant to the care of stroke patients. Furthermore, stroke physicians will require skills in service development, team working, teaching, critical appraisal and service evaluation. They should be familiar with stroke research methods and keep up to date with relevant research findings.
This programme is open to all trainees holding MRCP (UK) or equivalent and an NTN in a relevant medical specialty, namely Geriatric Medicine, Neurology, Rehabilitation Medicine, Cardiology, Clinical Pharmacology and Therapeutics, or General Internal Medicine. The background specialty of such clinicians is considered to be less important than the possession of those competencies needed to provide a specialist stroke service. After satisfactory completion of Subspecialty training in Stroke Medicine, trainees would be eligible to have the Subspecialty of Stroke Medicine included in their entry in the GMC's Specialist Register, after the award of a CCT in their parent specialty.
Given that that there is a recognised need for stroke specialists it is expected that training posts for Stroke Medicine will be created in all Deaneries.
The programme has been designed to be adaptable to meet the needs of trainees from a variety of backgrounds, and the impact of sub-specialties on the duration of the parent specialty will be a matter for the parent specialty.
Competence Based Curricula and Assessment – StRs (for trainees who commenced training from 1 August 2007 to present)
There are two versions of curricula for this training period:
StRs who commenced training between 1st August 2007 and 3rd August 2010 will follow the 2007 version of their specialty curriculum and the 2007 Generic curriculum. Please see the 2007 Curriculum section of this webpage.
StRs who commenced training from 4th August 2010 onwards will use the 2010 version of their specialty curriculum. There is no need to follow the previously known ‘Generic curriculum’ as this has now been embedded into the specialty curriculum. Please see the 2010 Curriculum section of this webpage.
The Joint Royal Colleges of Physicians Training Board (JRCPTB) is pleased to announce the 2010 Sub-Speciality Stroke Medicine curriculum which has been reviewed and rewritten to:
- meet the GMC’s 6 new standards as detailed in their Standards for Curricula and Assessment systems
- keep up to date with medical advances and changes in the service and training
- incorporate the framework documents produced by the Academy of Medical Royal Colleges (AoMRC) detailing Common, Medical Leadership and Health Inequality competencies
- include 5 new assessment methods (Acute Care Assessment Tool, Case based Discussion, Patient Survey, Teaching Observation and Audit Assessment).
This new curriculum has improved content, design and usability compared to its predecessors, and reflects a great deal of hard work and time expended by specialty curriculum groups. This curriculum will become the training manual for all trainees entering ST3 from 4th August 2010.
Stroke Medicine sub-specialty accreditation is an additional qualification (involving a minimum ONE year period in an approved training post) for the ‘Advanced Year' of the Stroke Medicine curriculum.
This ‘Advanced Year' is usually undertaken in the penultimate or final year of the trainee's parent specialty training and whilst still retaining an NTN in their parent specialty. This will enable the trainee to complete sub-specialty certification in Stroke Medicine.
It is recommended that trainees who are interested in Stroke Medicine accreditation should discuss this with a Stroke Medicine training programme director as soon as possible. The training programme director for the trainee's parent specialty will also be able to offer advice. This will ensure that the Stroke Medicine competencies acquired in the parent specialty during the ‘basic year' of Stroke Medicine training will be reviewed at an appropriate parent specialty ARCP.
Please refer to the Frequently Asked Questions for Trainees 2011 for further guidance.
For further information on the 2010 curriculum it is recommended that you read the Quick Start Curriculum Guide.
If you have any queries or problems regarding the 2010 curriculum please email ptb@jrcptb.org.uk.
Core Training Programmes
Entry into Stroke Medicine training is possible following successful completion of both a foundation programme and a core training programme.
There are 2 core training programmes for Stroke Medicine training:
This programme is open to all trainees in the relevant specialties of medicine who hold MRCP (UK) or equivalent qualification and have been accepted as a specialist trainee in one of the recognised specialties i.e. they must be holders of a National Training Number (NTN). Trainees may come from specialty training posts in Geriatric Medicine, Neurology, Rehabilitation Medicine, Clinical Pharmacology and Therapeutics, Cardiology, General (Internal) Medicine or Acute Internal Medicine. This curriculum should therefore be read in conjunction with that of the main specialty. Training in Stroke Medicine will take place after entry to specialty training. Stroke Medicine sub-specialty training may take place at any stage after appointment to the specialty training post, either on a full time basis or a time-equivalent modular basis. To achieve all the competencies at an appropriate level it is expected that 2 years experience orientated to the Stroke Medicine curriculum will be required.
Assessment
The following methods are used as part of the integrated assessment system:
- NIH Stroke Scale Certificate of Training
- International Conference on Harmonisation – Good Clinical Practice – Certificate of Learning (ICH GCP)
- Workplace-based assessments (WPBAs)
The assessment blueprint, which is embedded in the clinical syllabus, shows the possible methods that can be used to assess each of the competencies in the curriculum. Trainees and trainers should refer to the blueprint for guidance on the appropriate assessment methods for each aspect of the curriculum, and so plan the training programme according to the criteria set by the ARCP Decision Aid. It is not expected that all competencies will be assessed by all methods, rather that there will be a sampling of competencies within a variety of settings, both within formal and workplace-based assessment, from which overall competence acquisition has to be determined.
Please view the 2010 curriculum for the Stroke Medicine for full details on the training routes, selection criteria and assessments.
Entry into Stroke Medicine training is possible following successful completion of both a foundation Programme and a core training programme.
Please view the 2007 curriculum for Stroke Medicine for full details on the training routes and selection criteria.
Assessment
The assessment blueprints show the possible methods that can be used to assess each of the competencies in the curriculum. Trainees and trainers should refer to the blueprints for guidance on the appropriate assessment methods for each aspect of the curriculum, and so plan the training programme according to the criteria set by the ARCP/RITA Decision Aid. It is not expected that all competencies will be assessed by all methods, rather that there will be a sampling of competencies within a variety of settings, both within formal and workplace-based assessment, from which overall competence acquisition has to be determined.
Further information on the various methods of assessment can be viewed in the Assessment section of this website.
The diagram below describes the training pathways in general terms
Competence Based Curricula - SpR (for trainees who commenced training between 1 Jan 2003 and 31 July 2007)
The JCHMT introduced revised curricula for all the medical specialties together with a generic curriculum that applied to all trainees back in 2003. These are competence-based and set out the knowledge, skills and attitudes to be acquired by trainees before they may be awarded a CCT.
Curricula - SpR (for trainees who commenced training before 1 Jan 2003)
The curricula for trainees enrolling pre 01/01/03 are no longer available on the website but can be obtained by request to ptb@jrcptb.org.uk.