Paediatric Subspecialty Training Grid 2016
Reference Request
Dear Referee,
Please complete the following reference to the best of your knowledge to provide a professional assessment of
his/her achievements and track record.
When you have completed the reference, please return the form to the applicant in a sealed envelope. All
applicants must bring their references with them on the day of their interview in sealed envelopes.
The grid matching process seeks clearly to identify the characteristics required for sub-specialty training, with an
understanding that many of these individuals will become tertiary level NHS paediatric consultants in the future. This
is reflected in the person specification at the end of this document which describes in detail the essential and
desirable criteria being assessed and the point in the matching process when evaluation takes place (AF = application
form; i/v = interview; ref = reference), which may help to inform your comments. References will be reviewed at
interview, although will not contribute to scoring, therefore we would appreciate if a copy of your reference is with us
by the interview date wherever possible.
This reference form has been designed to ask you for specific information about the candidate which can only be
obtained by asking your views. Some of the characteristics are difficult to assess, but if you do have any concerns
about the candidate’s abilities, we would be grateful if you would describe these. We would also appreciate your
professional view of the suitability of the candidate for the sub-specialty programme. Please note that completed
reference forms should be made available to all candidates on request.
Thank you very much for participating in this process.
Yours sincerely,
Alison Williams
Sub-specialty Recruitment Coordinator
Email: ntngrid@rcpch.ac.uk
Telephone: 020 7092 6139
Structured Reference form for Grid Training post candidates
Please state the dates the candidate worked with you:
Candidate Name:
Date started:
Date finished:
Position held:
Location:
Educational supervisor
Other (specify below)
Your relationship to
candidate:
Clinical supervisor / employer
Recommendation of candidate for this post:
Strongly without reservation
Could recommend as competent
Would have some reservations
Could not recommend for this post
This reference is based upon:
General Impression
Close observation
Collective opinion of consultants
Employers views
Would you be happy to work with this doctor again?
YES
NO
Are there any issues with the applicant’s attendance/timekeeping?
YES
NO
If Yes, please give details
Are you aware of any health issues which may affect the candidates’ ability to undertake this post?
YES
NO
If Yes, please give details:
Was the applicant subject to any disciplinary procedure, formal or otherwise, during their time with you?
YES
NO
If Yes, please give details:
This post is exempt from the provision of section 4 (2) of the Rehabilitation of Offenders Act 1974 (exceptions
order 1975). Under this order are you aware of any criminal convictions or cautions which may affect the
applicant’s suitability for the post?*
YES
NO
If Yes, please give details:
*It is contrary to the Act for referees not to reveal any information they may have, concerning convictions which
may otherwise be considered “spent” in relation to this application which you consider relevant to the applicant’s
suitability for employment
Please give your opinion regarding the candidate’s present knowledge, skills and personal attributes (taking account
of the level that would be expected for grid training) by ticking the appropriate boxes below. Statements are provided
to give examples of behaviours that would constitute different levels of performance, though this is not intended to be
an exhaustive list.
Please use the space provided to give examples of the candidate’s behaviour that support the rating you have given
them in each area; this is essential if you have given a rating of 1 or 2.
Clinical knowledge & expertise: Capacity to apply sound clinical knowledge and awareness to full investigation of
problems. Makes clear, sound and proactive decisions, reflecting good clinical judgement.
1
Cause for concern
2
Weak
3
Satisfactory
4
Good to excellent
Comments / evidence:
Communication skills: Capacity to adjust behaviour and language (written / spoken) as appropriate to needs of
differing situations. Actively and clearly engages patient (and colleagues) in equal/open dialogue.
1
2
Uses technical language
that patients do not
understand, ignores what
they have to say
Can be lacking in clarity
and coherence when
speaking to patients
3
Often uses lay language to
help patients understand
4
Always speaks clearly, give
patients time and checks
that they understand
Comments / evidence:
Empathy and sensitivity: Capacity and motivation to take in patient / colleague perspective, and sense
associated feelings. Generates safe / understanding atmosphere. The understanding approach.
1
Is not sensitive to the
feelings of patients and
treats them in an
impersonal manner
2
Shows some interest in the
individual and occasionally
reassures patients
3
Usually demonstrates
empathy towards patients
4
Always shows empathy
and sensitivity, gives
reassurance to the patient
Comments / evidence:
Professional integrity: Capacity and motivation to take responsibility for own actions (and thus mistakes).
Respects/defends contribution and needs of all. (Respect for “position, patients and protocol”).
1
Does not take
responsibility for their
actions or show
enthusiasm for job
2
Sometimes seeks to blame
others for their actions
3
Often shows respect to
patients and enthusiasm
for their job
4
Puts patients needs before
their own and takes full
responsibility for their own
actions
Comments / evidence:
Problem-solving & decision-making skills: Capacity to think/see beyond the obvious, analytical but flexible mind.
Maximises information and time efficiently, and creatively.
1
2
3
Misses minimal cues and
symptoms, lets
Often relies on surface
information and doesn’t
Usually thinks beyond
surface information, picks
4
Thinks beyond surface
information and gets to the
assumptions guide
diagnosis
probe deeper
up on cues/minimal
symptoms
root cause
Comments / evidence:
Organisation and planning: Capacity to organise information in a structured and planned manner, think ahead,
prioritise conflicting demands, and build contingencies. Delivers on time.
1
2
3
4
Is always late for
meetings/deadlines and
unable to prioritise tasks
Is often late for meetings
and deadlines and
disorganised with
paperwork etc
Usually able to prioritise
tasks and organise
paperwork
Excellent at managing time
and prioritising tasks
Comments / evidence:
Learning and Development: Ability to identify own learning and development needs, commits time and resources
to appropriate training and development activities.
1
Reacts badly to
constructive criticism or
feedback, not interested
own development
2
3
Needs assistance in
identifying own training
needs/developing personal
targets
4
Often learns from
experience, generally
reacts well to constructive
criticism
Actively seeks out and
welcomes constructive
criticism/feedback
Comments / evidence:
Managing others & Team involvement: Collaborative style, works with colleagues in partnership, able to
compromise. Assumes role of leader when necessary, provides support and views self as part of larger
organisation.
1
Sticks rigidly to their own
agenda and doesn’t
negotiate
2
3
Tends to take a ‘back seat’
rather than participating
4
Good at negotiating and
usually able to compromise
Is excellent at supporting
and motivating others and
at negotiating
Comments / evidence:
Ability to deal with pressure: Capacity to put difficulties into perspective, retaining control over events. Is aware
of own strengths/limitations, able to “share the load”.
1
2
3
Loses temper easily and
refuses to share workload
Finds it difficult to share
workload with others or to
switch off after work
4
Often recognises when to
share workload with others,
usually remains calm under
pressure
Remains calm under
pressure at all times,
recognises when to share
work load
Comments / evidence:
Commitment, enthusiasm and drive for the sub-specialty: Showing motivation to complete training in the subspecialty and has pursued opportunities related to the sub-specialty.
1
Shows no
commitment or
enthusiasm for the
2
Weak interest
3
Has a keen interest in
the sub-specialty and
is motivated to pursue
4
Has a high drive and commitment for the
sub-specialty and has gone beyond what
would normally be expected of a trainee to
sub-specialty.
the sub-specialty
seek experiences associated with the subspecialty
Comments / evidence:
SIGNATURE
(mandatory for hard copy responses)
NAME (print in block capitals)
POSITION HELD
Name of Trust, deanery, training practice or
employing organisation
Full postal address
CONTACT TELEPHONE NO
DATE (dd/mm/yyyy)
Your UK GMC number
For authentication purposes. It is essential when returning the form by post the reference is stamped with an
official deanery, hospital or organisation stamp. If no stamp is available, please attach a compliment slip or letter
headed paper.
Official stamp (Trust, deanery, training practice or employing organisations)
Thank you for taking the time to complete this reference.
When you have completed the reference, please return the form to the applicant in a sealed envelope. All
applicants must bring their references with them on the day of their interview in sealed envelopes.
2016 Person Specification
Application to enter Paediatric Sub-specialty (NTN Grid post)
Qualifications
Essential
When Evaluated1
 MBBS or equivalent medical qualification
Application form
Interview
Reference
 MRCPCH via MRCPCH examination – no equivalent*
 The NTN grid is only open to UK trainees holding an NTN and those in
an equivalent training programme within the EEA
 Eligible for full registration with the GMC at time of appointment and
hold a current licence to practise
 Eligibility to work in the UK
Eligibility
 Evidence of achievement of Level 1 competences as outlined in
‘Curriculum for Paediatric Training, General Paediatrics, Level 1, 2 and
3 Training’2 *
Application form
Interview
Reference
 Applicants may make a maximum of two NTN Grid round applications
unless they meet the eligibility criteria to submit a third round
application**
Fitness to
Practise
 Is up to date and fit to practise safely
Language
Skills
 All applicants to have demonstrable skills in written and spoken English
that are adequate to enable effective communication about medical
topics with patients and colleagues which could be demonstrated by
one of the following: a) that applicants have undertaken undergraduate
medical training in English; or b) have evidence of adequate
communication skills, including outcomes of any IELTS sittings
Health
Career
Progression
Application
Completion
 Meets professional health requirements (in line with GMC standards /
Good Medical Practise)
 For Type 1 Trainees (SpRs): minimum of 24 months General
Professional Training and satisfactory completion of core SpR training.
Evidence of competitive entry to Type 1 training programme (UK or
EU).
 For Run Through trainees (ST): completion or expected completion of
Level 2 Training by the time of entry to the Grid Programme*
 Satisfactory completion of 24 months core paediatric
specialist/specialty registrar training by Grid entry date for SpR/StR
trainees (those who may have switched) *
 For those in post core (SpR) or post Level 2 (ST) training; must be able
to complete sub-specialty training by anticipated CCT date and if
needed have the relevant CSAC approval for any completed subspecialty posts
ALL sections of application form completed FULLY according to written
guidelines
1
‘when evaluated’ is indicative, but may be carried out at any time throughout the selection process
2
Curriculum for Paediatric Training, General Paediatrics, Level 1, 2 and 3 Training, RCPCH, September 2010.
Application Form
Reference
Application Form
Interview / Selection
Centre
Application Form
Pre-employment
health screening
Application form
Interview
Reference
Application form
Interview
* Anaesthetic trainees who wish to apply for Paediatric Intensive Care are not required to have MRPCH or the paediatric competences listed above. You must
have FRCA and have completed ST4 by the time of entry into the Grid.
** For guidance on third round application eligibility, please refer to the NTN Grid webpages – www.rcpch.ac.uk/ntngrid
Career
Progression
Essential
Desirable
When Evaluated3
As above
 Experience of paediatric
sub-specialty applied to at
any level
Application form
Interview
Reference
 Has the clinical knowledge, skills
and attributes to complete training
in the sub-specialty and function as
a tertiary consultant in the future
 Shows commitment to the
specialty
Clinical Knowledge & Expertise:
 Patient/family centred approach
 Able to manage acute paediatric
and neonatal emergencies
appropriate to level of experience*
 Experience and competence in
common practical procedures
Clinical Skills
Application form
 Satisfactory assessments from
supervisors
Interview
 Reference supports quality of skills
Reference
 Shows evidence of reflection on
personal skill development
Personal Attributes:
 Shows aptitude for practical skills,
e.g. hand-eye co-ordination,
dexterity
 Demonstrates the value of multidisciplinary working
 Awareness of cross specialty
issues such as child protection
 Experience of administrative
duties, e.g. duty rotas, committees
 Able to prioritise own workload
Management
Skills
 Basic understanding of clinical risk
management in relation to NHS
and personal activities
Application form
 Evidence of leadership
skills
Reference
 Demonstrates understanding of
non clinical issues and the bearing
on clinical performance


Audit Skills

3
Contribution to clinical audit on a
regular basis
Evidence that understands the
role of audit in changing clinical
practice
Shows understanding of the
principles and value of audit
Interview



Evidence of completed
audit projects
Evidence of own role in
change through audit
process
Demonstrates
enthusiasm for audit
projects
‘when evaluated’ is indicative, but may be carried out at any time throughout the selection process
* Anaesthetic trainees applying for Paediatric Intensive Care are not required to have these competences to be eligible to apply.
Application form
Interview
Reference
Teaching Skills
 Demonstrates a commitment to
education and training at
undergraduate and postgraduate
level
 Demonstrates enthusiasm for
teaching and education
Academic
Achievements
 Understanding of how research
influences clinical practice
Research/
Publications
Transferable
Skills
 Understanding of ethical and
consent issues
 Ability to use Internet to find
relevant information
 Experience of organising /
communication skills/ leadership
positions
 Demonstrates an awareness of
importance of working in a team
and other team members needs
 Motivated
 Disciplined
 Resilient
 Shows understanding of
the different approaches to
learning
 Undertaking/
completed teaching
qualification
 Prizes
 Academic distinctions
 Demonstrates relevance of
academic achievements to
post applied for
 Research project
completed
 Involved in significant way
with research project
 Presentations/publications
 Evidence of training in
critical appraisal skills
 Evidence of understanding
of research methods
 Evidence of quality of
research/ reflection on
quality of research
 Evidence of magazines
edited, conferences
organised, etc
 Healthy balance between
work and outside activities
 Evidence from reference
for holistic approach to life
Application form
Interview
Reference
Application form
Interview
Reference
Application form
Interview
Reference
Application form
Interview
Reference
 Those qualities defined in GMC
Duties of a Doctor
 Polite and considerate
Interpersonal and
communication
skills
 Recognition of limits of
professional competence
 Respect for other points of view
and for patient involvement
 Honest and trustworthy
 Ability to work with colleagues in
ways that best serve patients
interests





Flexible approach
Empathy
Openness
Genuineness
Awareness of non-verbal
and verbal
communications skills
Interview
Reference