Currently the Core Medical Training (CMT) programme takes a period of 24 months whole time equivalent (WTE) to complete, giving the trainee doctor appropriate competence and experience to progress into ST3 level of a medical specialty. However, in light of the fact that the curriculum is competency rather than time-based, there are certain circumstances in which it may be appropriate for a trainee to complete CMT in less than 24 months.
Who does this guidance apply to?
This guidance applies to trainees who have acquired an amount of acute medical experience prior to entering CMT that they wish to be considered to reduce the time they need to undertake in CMT training. This may or may not have been in a UK setting. The trainee will still need to evidence the required CMT competences to meet the end of programme requirements.
IMPORTANT: This guidance only applies to trainees who have gained appropriate experience outside of a UK-approved training programme. This is separate to the Accreditation of Transferrable Competences Framework, details of which can be found in the CMT curriculum.
Is there a minimum amount of time that must be spent in CMT?
Irrespective of the duration of previously acquired commensurate experience, under no circumstances will a trainee be permitted to complete CMT in less than 18 months whole time equivalent (WTE). Given that CMT requires both competence and experience, this is the minimum amount of time considered appropriate by the Core Medical Training Advisory Committee (CMTAC).
Academic Clinical Fellows
The guidance does not apply to trainees on a recognised Academic Clinical Fellow (ACF) programme, who ordinarily complete the clinical requirements of their training programme in 18 to 24 months.
European minimum time for CCT
Trainees should be reminded of the EU minimum training time for the award of CCT (currently 60 months). In medical specialties this includes both core and higher training. In the event a trainee does complete CMT in less than 24 months they should be aware that this may mean they are unlikely to be eligible for any accelerated completion of their specialty training.
Process for considering approval for completion of CMT between 18-24 months
The trainee and educational supervisor should have an evidence-based discussion to consider whether completion in less than 24 months is appropriate. Useful evidence to inform this discussion may include previous supervisor reports and workplace based assessments (WPBAs). The trainee must state clearly their reasons for wanting to complete CMT in less than 24 months. This, together with educational supervisor support, should be recorded in the ePortfolio and must take place before the trainee’s CT1 ARCP.
A request for a trainee to complete CMT in less than 24 months must be approved by the Training Programme Director (TPD) and ratified by the Head of School/Associate Dean. The Educational Supervisor should make the request to the TPD in writing at least 6 weeks before the CT1 ARCP. The TPD will then make a recommendation in writing to the ARCP Panel
Guidance for TPDs on considering a request
When approving a recommendation for early completion of CMT the TPD should consider the quality, duration and content of all post-foundation experience being offered as appropriate by the trainee. The TPD should also consider whether the trainee’s reasons for completing early are reasonable and to the benefit of their overall training. The previous experience must include adequate experience of unselected medical on-call. The recommendation of the TPD will need to be ratified by the Head of School/Associate Dean (as appropriate per local governance arrangements) before being considered by the ARCP panel. The ARCP panel shall be responsible for the final decision regarding CMT completion date.
Recording a decision at ARCP
Upon the issuance of an Outcome 1 at the CT1 ARCP, any targeted training needs or conditions for early completion must also be reflected in the ARCP paperwork and shared with the trainee and TPD/Educational Supervisor prior to the trainee entering CT2.
Final sign off for early completion
An interim review should be completed by the TPD at Month 3 of CT2. An early ARCP should be organised ahead of the expected early completion date. The trainee must get an Outcome 6 at that ARCP i.e. they must have met all of the requirements ordinarily expected at month 23 as outlined in the CMT ARCP Decision Aid.
Early completion does not exempt the trainee from their usual contractual notice period. The trainee must give the required notice to their employer in the event they expect to complete the CMT programme in less than 24 months.
Trainees that are unable to demonstrate competences at early ARCP
In the event that a trainee is unable to demonstrate all competencies at their final (month 18) ARCP then they should be awarded an outcome 3 but have it noted in the ePortfolio and ARCP documentation that additional training time has not been awarded but that they have merely reverted to their original CMT completion date. In the event that the trainee is still unable to demonstrate full competencies at the end of 24 months then they should be managed in accordance with the usual ARCP process.
Published 21 October 2016