Quality criteria for GIM/AIM Registrars

Background

In 2015 we published a set of quality criteria for Core Medical Training (CMT) designed to enhance educational experience of trainees. The criteria were produced in response to concerns that heavy service demands had led to a loss of training opportunities and had also encroached on valuable supervisor feedback that helped trainees develop the competence and confidence required to perform the role of General Internal Medicine (GIM) and Acute Internal Medicine (AIM) Registrars.

Purpose of the new quality criteria

In 2016 the three UK Royal Colleges of Physicians (London, Edinburgh and Glasgow) asked that a similar approach be developed to support the educational experience of doctors undertaking the demanding role of either GIM or AIM Registrar. The difficulties faced by Registrars involved in the unselected acute medical take were already well documented, however it was felt that specific and measurable quality criteria would help set a practical vision outlining how doctors might be better assisted and educationally supported to perform this role, which could also be monitored UK-wide via the General Medical Council’s National Training Surveys.

Development of the new quality criteria

A wide range of stakeholders, including those responsible for monitoring and running the NHS as well as the postgraduate training system, contributed to the development of the new quality criteria. As both GIM and AIM Registrars interact with many areas of the hospital, it was felt that establishing clear boundaries and effective ways of working with other colleagues at the interface with acute medical services was essential to the success of the initiative, as well as providing clear benefits for patient safety and experience. Input from trainees, via their College committees, ensured improvements were focused on areas of high importance to trainees.

The way forward

We will progress this initiative from 2018 onwards, on behalf of the three UK Royal Colleges of Physicians, in partnership with its major stakeholders in the postgraduate training system and wider NHS.

There is an expectation that all organisations and individuals responsible for delivering UK postgraduate medical education and training will begin to integrate these criteria into GIM and AIM training programmes from 1 August 2018. The criteria are designed to augment other relevant national guidance, such as the Gold Guide requirements for core or specialty training programmes, relevant employment guidance6 and General Medical Council standards for education and training. The criteria were primarily developed for the role of GIM Registrar but there is broad agreement they are relevant to AIM Registrar roles and their use here is encouraged. Work to support fully embedding these quality criteria into wider acute medicine posts, including rotas, and to monitor their implementation will continue in 2018.

We intend to monitor the implementation of the quality criteria for both GIM and AIM Registrars and Core Medical Trainees for the foreseeable future and to discuss the findings with its training partners. It is anticipated that, in time, a set of quality criteria drawing on the learning from existing quality criteria will be developed to assist the implementation of the new Internal Medicine curriculum.