A review of the legality of exams taken outside approved training posts has been announced by the GMC following uproar from trainees concerned that their qualifications may no longer be valid.
Anxiety was sparked among trainees last month when the GMC published a note clarifying legislation which states that exams must be taken within an approved training post in order to count towards a CCT (certificate of completion of training).
This ruling affects doctors who passed exams when they were not on training programmes and those who took exams during periods of unapproved training or work experience overseas.
In a bid to calm nerves, the GMC says that it will not be reviewing any CCTs which may already have been erroneously awarded.
It has also clarified that trainees who are not affected are those who sit exams during the foundation programme, are undertaking research, on maternity leave or working overseas - providing they maintain their training status.
Doctors who fall foul of the new ruling can gain entry to the specialist register via one of the equivalence routes and most can do the CP (combined programme) which is more straightforward and lower in cost than a CESR (certificate of eligibility for specialist registration), says the GMC.
The regulator says it will now explore whether it is possible to amend the legislation to provide greater flexibility around the timing of exams.
But in a letter to trainees GMC chair Professor Peter Rubin says the bottom line is that the integrity and educational coherence of approved training programmes must be maintained.
The GMC plans to meet with the royal colleges, the deaneries, the BMA and the four UK health departments to develop a “pragmatic approach” to resolving this issue.
Professor Bill Burr, medical director of the Joint Royal Colleges of Physicians Training Board described the GMC ruling as “counter-intuitive, illogical and inconsistent” with the way training has been conducted in the UK.
“It is not sufficient to tell trainees that they are eligible for CESR (CP). In spite of claims to the contrary this continues to be viewed as an inferior qualification to CCT and in practice is a lesser qualification since it has no European recognition,” he said.
The ruling is causing problems for deaneries who are now having to gear themselves up to deal with doctors needing remediation in order to complete the MRCP. Problems could be massively compounded by doctors who decide to retake all or part of the MRCP to qualify for CCT, claimed Burr.
Royal College of Surgeons president Mr John Black said the The Joint Committee on Surgical Training was concerned that those responsible for administering programmes may face logistical problems trying to keep trainees in training posts until they pass exams. “We hope further discussions with the GMC will help unravel these issues,” he said.
The BMA’s junior doctors committee said the issue has caused “great anxiety “ among juniors. Committee chair Dr Shree Datta insisted that no additional juniors should be affected by any changes and action must be taken to reverse the negative effects of the GMC’s advice.
This reminds me of the comedy films of Laurel and Hardy “What a mess you have gotten us into”!
Why is it that Acts of Parliament (usually drafted by lawyers) are open to different ‘interpretations’ by lawyers? Why can they not draft them clearly and concisely? Have they forgotten how to use English properly? Or is it because those who draw them up have little actual knowledge of the practicalities of the issues involved?
It would seem to me, a ’simple surgeon’ (retired), that an ‘examination’ is usually a test of knowledge - so it should not matter when it is taken. Annual assessments (or appraisals) are supposed to signify ‘competence’ in a particular area of practice, so should also apply towards ’specialty recognition’ provided it is relevant to that specialty when it comes to awarding a CCT. Sadly, the two have become intermingled with ‘recognised training posts’ - which, according to the medical press, are often failing to provide the training expected of them!
Mr Morrison should remember his Dickens…’interpretation’ will often require expensive legal assistance.
To put it another way, Ambrose Bierce defined a lawyer, in his ‘Devil’s dictionary, as like a die designed to lie on any side.
I completed a 3 year SHO programme, applying to sit the final MRCPsych whilst on the programme.
I took & passed the exam (first time) a couple of months later, having moved into a staff grade post at the end of the SHO programme, as was permitted under the rules at the time.
I have completed 3 years in higher training.
I am now not eligible for a CCT.
I was eligible to apply for a CESR before I entered higher training.
Why train?