Transition to new curricula in the JRCPTB specialties

Concern has been expressed about progression of trainees on to the new curricula, both by those already in Internal Medicine training (IMT) and for those in transition from either existing dual curricula or from a single specialty training programme to a dual programme with internal medicine. We have produced guidance on progression and curricular transition in physician training which is available via this link. Please also see below.

The guidance has been updated to clarify guidance for trainees in Cardiology training - 14 July 2021 

The GMC's updated policy statement on the transition of learners to a new curriculum sets out the requirements for doctors in training who are working towards a CCT to move to the most recent GMC approved curriculum and programme of assessment. The transition should be completed as soon as it is feasibly possible, taking account of patient and trainee safety whilst also balancing the needs of the service. Some cohorts of trainees may experience a greater impact than others and require longer to prepare for the transition. As a guide, the GMC considers two years from the implementation date to be a reasonable transition period for all trainees to have moved to new curricula. Doctors in their final year of training (pro rata for less than full time trainees), or for whom it would not be in the interests of patient safety or impractical to support to move to a new curriculum, will normally remain on the curriculum in place prior to the new approval.

Due to the significant change to some curricula the GMC has allowed greater flexibility for a number of JRCPTB specialties. The principles below have been agreed with the GMC. 

Trainees in GUM, Palliative Medicine or Neurology training prior to August 2021

Trainees in new dual training specialties of GUM, Palliative Medicine and Neurology who started training prior to August 2021 will not be mandated to transfer from single to dual CCT training programmes but should be strongly encouraged to do so. This should be discussed with, and supported by, the educational supervisor and training programme director. Trainees who have entered training in Palliative Medicine from General Practice or Anaesthetics will not be required to transfer to the new curriculum and dual train with IM.

Trainees in Cardiology only training prior to August 2021

Trainees in cardiology who started training in that specialty alone prior to August 2021 will not be mandated to transfer from single to dual CCT training programmes but should be strongly encouraged to do so. Trainees appointed to dual Cardiology and GIM training in 2020 should not drop GIM; only those in more advanced training may be supported in moving to single accreditation and this must have the approval of the Postgraduate Dean. Please see the joint statement by the JRCPTB and Cardiology SAC.

Trainees who start training in GUM, Palliative Medicine, Neurology between August 2021 - August 2022

Doctors who start training in GUM, Neurology and Palliative Medicine between August 2021 and August 2022 have been given notice that they will be expected to transfer to the new curriculum and advised to maintain and develop general medical capabilities, including managing the acute take. It is expected that trainees starting training in these specialties in August 2021 will be able to transfer to the new curricula in August 2022 and dual accredit in specialty and IM, except those entering Palliative Medicine from non-physician core training routes,

If it would not be in the interests of patient safety or impractical to support a trainee to move to a new curriculum the trainee may remain on the curriculum in place prior to the new approval. This must be discussed with and approved by the postgraduate dean and the reasons for not transferring must be documented. 

Trainees in all other group 1 specialty training prior to August 2022

Trainees in group 1 specialties other than those listed above will be required to transfer to the new curricula unless in their final year of training (pro rata for less than full time trainees). Trainees should transfer to the new curriculum at the earliest opportunity. Wherever possible this should be at the point at which they progress into the next training grade/level. For most group 1 trainees this will be August 2022, however for some it may be later if their ARCP is later in the year. 

Doctors may be expected to contribute to the acute take from the point in time when they transfer to the new curriculum / training structure. For this reason, they are advised to maintain experience in internal medicine from the start of their training programme if this is before the time of transition. They may need support to return to this area of practice and ideally, they should have a GIM educational supervisor to help prepare the trainee for curriculum transition.

If it would not be in the interests of patient safety or impractical to support a trainee to move to a new curriculum (for example, where a trainee has had to stop training in GIM or working on the acute take) the trainee may remain on the curriculum in place prior to the new approval . The postgraduate dean should be consulted to decide whether the trainee can remain on the curriculum in place prior to the new approval and the decision documented.

A small number of trainees in Clinical Pharmacology and Therapeutics (CPT) may be in dual CCT programmes with non-GIM specialties at the time the new curriculum is introduced and may not be able to transfer to the new curriculum. They should be considered on a case by case basis.

Trainees in group 2 specialty training prior to August 2021

Trainees in group 2 specialties will transfer to the new curricula unless in their final year of training (pro rata for less than full time trainees). Trainees should transfer to the new curriculum at the earliest opportunity. Wherever possible this should be at the point at which they progress into the next training grade/level. For most group 2 trainees this will be August 2021, however for some it may be later if their ARCP is later in the year. 

If a trainee is given an extension to training (e.g. outcome 3/outcome 10.2) they should continue on the current curriculum and transfer to the new curriculum when they progress to the next training grade, provided that this is by August 2022. In exceptional circumstances, this could be extended to August 2023.

Final year trainees who have had an extension to training due to COVID-19 (outcome 10.2) that delays their CCT date beyond August 2022 (full time trainees) or February 2023 (less than full time), do not need to transfer to the new curriculum provided that they CCT by August 2023 at the latest.

A longer transition period will be allowed for Allergy trainees (two years) to take into account the development of a new examination for the Allergy and Immunology pathways. 

Requirements of transferring curriculum

  • Educational supervisors should agree individual transition plans with their trainees, with training programme directors providing guidance for this. The educational supervisor and trainee should review the new curriculum learning outcomes - 'capabilities in practice' - and identify any gaps that need to be addressed. This 'gap analysis' will help deaneries to tailor the training programme to ensure the trainee encounters relevant learning experiences. Any additional training time and change to the CCT date should be agreed by the first ARCP.
  • For some specialties there will be little difference between the current and new curriculum and the transition will only need to be 'light touch'.
  • A form will be provided on the ePortfolio to facilitate and record the curriculum transfer and gap analysis discussion.
  • Training programme directors should notify the JRCPTB which trainees have transferred and the new curriculum will be added to their ePortfolio accounts.
  • Trainees will not be required to re-link or transfer evidence from the previous curriculum and should start using the new curriculum in their ePortfolio account.