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CONTENTS
1. BODIES RESPONSIBLE FOR SPECIALIST REGISTRAR
TRAINING IN OCCUPATIONAL MEDICINE
1.1. General Medical Council
1.2. Postgraduate Medical Education & Training Board (PMETB)
1.3. Faculty of Occupational Medicine
1.4. Specialty Advisory Committee of the Faculty
1.5. Regional Postgraduate Dean
1.6. Deanery Specialty Training Committee
2. ENTRY REQUIREMENTS AND RECRUITMENT PROCEDURES FOR SPECIALIST
REGISTRAR-GRADE TRAINEES IN OCCUPATIONAL MEDICINE (N.B. THERE WILL BE
NO RECRUITMENT TO SPR TRAINING AFTER 1 AUGUST 2007)
2.1. Entry requirements and General Professional Training
2.2. Recruitment to SpR posts in the NHS
2.3. Recruitment to 'industry' posts
2.4. Recruitment of doctors already working within an organisation
2.5. Locum Appointments - Training (LAT posts)
2.6. Fixed Term Training Appointments (FTTAs)
2.7. Registration with the postgraduate dean
2.8. Allocation of Training Numbers
2.9. Registration with the Faculty
3. CCT TRAINING PROGRAMMES IN OCCUPATIONAL MEDICINE
3.1. Appointment of an educational supervisor
3.2. Requirements of a training programme
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3.3. Supervision
3.4. Research
3.5. Part-time posts in a programme
3.6. Flexible (part-time) training
3.7. Overseas training
4. ABSENCES FROM HIGHER SPECIALIST TRAINING
5.
TRAINING AGREEMENTS
6. ASSESSMENT, APPRAISAL AND ANNUAL REVIEWS IN THE SpR GRADE
6.1. Assessment
6.2. Appraisal
6.3. Annual review and record of in-training assessments (RITA)
7.
RITA FORMS
8. THE QUALIFICATIONS OF AFOM AND MFOM
8.1. AFOM examination
8.2. MFOM
9. COMPLETION OF TRAINING
9.1 Recommendation for award of CCT
ANNEX 1 -
Model SpR person specification form
ANNEX 2 -
Training curriculum in occupational medicine
ANNEX 3 -
Core competencies in occupational medicine
ANNEX 4 -
Model training agreement
ANNEX 5 -
Annual assessment report form
ANNEX 6 -
Grievance procedures for trainees
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ANNEX 7 RITA Forms
ANNEX 8 -
Generic post approval
1. Bodies responsible for Specialist Registrar (SpR) training in
occupational medicine:
1.1. General Medical Council
The General Medical Council is the independent regulator for doctors in the UK. Its statutory
purpose is 'to protect, promote, and maintain the health and safety of the public by ensuring
proper standards in the practice of medicine'. The GMC's powers and duties are set out in the
Medical Act 1983. Its job is to ensure that patients can have confidence in doctors. It does this
in the exercise of its four main functions:
i)
setting and securing specific standards for UK undergraduate medical education and
for the first year of the Foundation Programme leading to full registration and entry
to the medical register
ii)
keeping up to date registers of qualified doctors. All doctors wishing to practise
medicine in the UK must be on the List of Registered Medical Practitioners and since
1st January 1997 it has been a legal requirement that, in order to take up a consultant
post (other than a locum consultant appointment) in a medical or surgical specialty in
the NHS, a doctor must be included in the specialist register.
iii)
determining the principles and values that underpin good medical practice
iv)
dealing firmly and fairly with doctors whose fitness to practise is in doubt.
On 1 April 2010 the GMC merged with PMETB (see 1.2 below).
1.2. Postgraduate Medical Education and Training Board (PMETB)
The Postgraduate Medical Education and Training Board (PMETB), was established by the
General and Specialist Medical Practice (Medical Education, Training and Qualifications)
Order 2003 to develop a single, unifying framework for postgraduate medical education and
training and was the competent authority (statutory regulator) for postgraduate medical
education from 30 September 2005 until 31 March 2010. It took over the responsibilities of the
Specialist Training Authority of the medical Royal Colleges (STA) and the Joint Committee on
Postgraduate Training for General Practice.
PMETB’s statutory functions were: (i) to establish standards of postgraduate medical
education and training; (ii) to secure these standards; and (iii) to develop and promote
postgraduate medical education and training. Its statutory objectives were to safeguard
service users and to ensure the needs of trainees and employers were met.
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These responsibilities resulted in a body that defined high level principles (e.g. standards for
curriculum development and the specification of training competencies; generic standards for
training; principles of quality assured training and assessment); approved the curricula and
assessment arrangements of Royal Colleges and Faculties; approved individual training posts
and programmes; inspected Postgraduate Deaneries; conducted periodic national surveys of
trainees and trainers. These activities are now carried out by the GMC.
For more information about the merger visit this GMC webpage.
1.3. Faculty of Occupational Medicine
The Faculty of Occupational Medicine performs the same role as other medical Royal
Colleges in specialist medical training. The Faculty is responsible (on behalf of GMC)
for setting the curriculum and competencies for SpR training in occupational
medicine, and for recommending to GMC that a CCT should be awarded. The award
of a CCT will lead to inclusion on the GMC’s Specialist Register. It is also responsible
for setting the standards for and awarding the diplomas of Associateship and
Membership of the Faculty. Further details of these qualifications are included in this
Handbook, and are available separately from the Faculty office. The Faculty is
represented at regional level by a Regional Specialty Adviser (RSA) who may also have
a Deputy.
1.4. Specialty Advisory Committee of the Faculty
The Specialty Advisory Committee (SAC) advises the Faculty on specialist training in
occupational medicine and is accountable to the Faculty Board. It is responsible for
giving advice to trainees in the SpR grade and assessing whether a trainee has
completed specialist training satisfactorily so that the Faculty may recommend the
trainee to GMC for award of a CCT. The terms of reference and membership of the
Faculty SAC are set out in Section 1.
1.5. Regional Postgraduate Dean
The Regional Postgraduate Dean oversees all aspects of postgraduate medical
training in his/her deanery, including SpR grade trainees in occupational medicine
both within and outside the NHS. The dean is responsible for issuing the National
Training Number (NTN or NTN(I)) and for the annual review of assessments of these
trainees (RITA) with the assistance of a deanery training committee.
1.6. Deanery Specialty Training Committee
The Deanery Specialty Training Committee consists of practicing specialists in the
region. The committee and its Chair are appointed by the regional postgraduate dean
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to advise and assist in all matters relating to the delivery of postgraduate medical
education within Faculty guidelines. The Faculty RSA and Deputy will usually be
members of the committee, and the RSA often chairs the committee.
Some deaneries may appoint a Programme Director, who is primarily responsible for
ensuring the quality and management of training posts (on behalf of the dean), and
acts as a point of contact for trainees in the region. In practice, the roles of RSA, STC
Chair and Programme Director are often combined, but it must be remembered that
the RSA reports to - and represents the interests of - the Faculty, and the STC Chair
and Programme Director represent the postgraduate dean.
2. Entry requirements and recruitment procedures for Specialist Registrargrade trainees in occupational medicine (N.B. There will be no
recruitment to SpR Training after 1 August 2007)
2.1. Entry requirements and General Professional Training
a. The minimum entry requirements set out by the Faculty for a trainee to enter the
SpR training grade are as follows:
a minimum of two years of General Professional Training which must be
undertaken in supervised training posts at SHO level
or satisfactory completion of General Practice Vocational Training
or possession of a Certificate of Equivalent Experience.
It is important that the experience gained should be wide and varied, and should be in
posts with direct involvement in patient care. Thus, in addition to posts in General
(Internal) Medicine, prospective trainees are encouraged to work in other specialties.
Multi-disciplinary rotations in educationally approved SHO posts (not necessarily
restricted to hospital practice) can offer such experience. In general, any JCHMT
approved post is acceptable, however it is unlikely that the minimum amount of GPT
acquired in a single specialty would provide enough breadth of experience for entry
into specialist training in occupational medicine.
b. Where candidates have undertaken GPT partly or wholly overseas, the burden is
upon them to provide detailed information on the educational approval and
training content of their GPT posts to ensure that the appointments committee
has adequate information when assessing their application. The candidate must
provide evidence of both breadth of experience and training to a standard
equivalent to UK GPT.
c. The regional postgraduate dean will decide whether an SpR candidate appearing
before an appointments committee has fulfilled the requirements for General
Professional Training, taking advice from the Faculty representative on the
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appointments committee, the Regional Specialist Training Committee, or the
Faculty Specialty Advisory Committee if necessary.
2.2. Recruitment to SpR posts in the NHS
Recruitment and formal appointment to NHS SpR posts are the responsibility of the
Regional Postgraduate Dean. The recruitment procedures are laid down in ‘A Guide
to Specialist Registrar Training (February 1998)’ commonly known as the ‘Orange
Guide’, and should be closely followed. Before advertising the post, it is essential to
ensure that:
a. the post has full or provisional educational approval from the Faculty
b. the post has Postgraduate Dean’s approval in regard to:
 manpower approval;
 appropriate funding;
 support of the Deanery Specialty Training Committee.
2.3. Recruitment to ‘industry’ training posts or NHS posts funded through income
generation
The same standards should apply to recruitment to both NHS posts and to industry or
non-NHS posts to ensure that entry to the two training pathways is comparable. It is
recognised, however, that employers in the private sector will have their own
recruitment procedures, and that terms and conditions of employment will vary. The
following guidance should be followed by non-NHS organisations (or NHS Trusts
appointing a trainee to an NTN(I) post funded through income generation):
a. the post must have full or provisional educational approval from the Faculty
before it is advertised. It is therefore essential that any proposed training post
is discussed with the Regional Specialty Adviser, and that the application
forms for approval of the post are sent to the Faculty SAC for consideration at
least one month before the post is advertised. Any time spent in a post that
does not have educational approval will not under any circumstances count
towards higher specialist training;
b. the Regional Postgraduate Dean’s approval must be sought, as it is the Dean’s
responsibility to ensure that the training post is appropriate before issuing the
NTN(I). This will normally be done by the Chair of the Deanery STC;
c. vacant posts must be advertised, to ensure open ‘competitive entry’ to the
training programme;
d. recruitment procedures must conform with good employment practice, and
must not be directly or indirectly discriminatory on the grounds of ethnic
origin, country of graduation, gender, age, disability, religion or sexual
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orientation;
e. at least two references should be sought for each candidate, with specific
reference to the areas outlined in the Person Specification Form, and ideally
using a structured reference process. Appropriate checks for criminal
convictions should be made;
f. the appointments board or interview panel will be the responsibility of the
employing organisation;
g. to ensure that potential SpR grade trainees appointed to approved non-NHS
training posts are of a standard equivalent to their NHS counterparts,
arrangements should be made for both the Faculty and the Regional
Postgraduate Dean to be represented on the employer’s appointment board
or at one of the appointment interviews if a sequential process is involved. If
such arrangements cannot be made, the successful applicant must attend an
Appointments Committee with representation of the Faculty and
Postgraduate Dean, as soon as possible, to confirm their eligibility to enter
higher specialist training. Entry into higher specialist training is conditional
upon the agreement of the Postgraduate Dean and the Faculty representative,
and failure to attend an appropriate Appointments Committee will lead to a
delay in admitting the candidate into higher specialist training. In view of the
size of the specialty, it may be necessary for the applicant to attend an
Appointments Committee in a neighbouring region, or for an ad hoc
committee to be set up by the deanery. In those circumstances, the employer
may wish to make the appointment ‘subject to the approval of the
Postgraduate Dean and the assignment of a NTN(I)’;
h. the decision to appoint any particular applicant lies with the employer, but the
decision to assign a national training number (NTN(I)) lies with the
Postgraduate Dean.
A model Person Specification Form is attached (Annex 1). The Person Specification
Form should be used to assist the short-listing process. It may be adapted to the
requirements of the employer provided that:
a. it does not conflict with the constraints of paragraph 2.3d;
b. the minimum educational criteria are not lower than those specified by the
Faculty on behalf of GMC.
2.4. Recruitment into training of a doctor already working within an organisation
(creation of a training post)
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Occasionally, a doctor who is already working within a non-NHS organisation will wish
to enter a Higher Specialist Training programme within that organisation, either full or
part-time. It is important that such a request is discussed with the prospective
Educational Supervisor and the Regional Speciality Adviser – who will normally
consult the Regional Postgraduate Dean - before any decision is made.
In regard to the training post, it is essential that:
a. an educational supervisor is identified, and a training programme outlined;
b. application forms are sent to the Faculty for educational approval of the
post (any time spent in the post before educational approval is granted will
not under any circumstances count towards HST recognised for the
purposes of CCT), and
c. the Regional Postgraduate Dean is informed of the intention to create a
non-NHS training post, and that an NTN(I) will be requested.
In regard to the potential trainee:
a. It is not necessary to advertise a post that is already occupied, but the
doctor seeking the NTN(I) must be formally assessed by an Advisory
Appointments Committee. If interviews for an NHS post or posts in
occupational medicine are occurring, then such a ‘validation’ can be carried
out by the Committee set up for the purpose. Otherwise the potential
trainee should attend an ad hoc Advisory Committee with representation
of the Faculty and Postgraduate Dean as soon as possible to confirm their
eligibility to enter specialist training;
b. If the Regional Postgraduate Dean is satisfied that the candidate is suitable
for HST, and that the post has educational approval, an NTN(I) will be
issued.
2.5. Locum Appointments – Training (LAT posts)
a. Appointments to locum positions where the appointee may wish to have the time
spent in the post allowed towards Higher Specialist Training should follow the
guidelines above for either NHS posts or non-NHS posts. In particular, it is
essential that the trainee should occupy the post for a minimum of three months,
and that a training programme based on the Faculty’s curriculum is agreed
prospectively between the educational supervisor, the programme director
(where appropriate) and the Faculty’s Training Committee;
b. Only those NHS or non-NHS posts that already have educational approval will be
suitable for LAT appointments. These posts must be advertised to ensure open
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competitive entry;
c. Trainees appointed to LATs will be eligible for a NTN or NTN(I) in open
competition with other candidates meeting the person Specification. They are
not entitled to preferential consideration.
2.6. Fixed-term Training Appointments (FTTAs)
Appointment to a Type II FTTA is unlikely in occupational medicine, and advice should
be sought from both the Regional Postgraduate Dean and the Faculty should a FTTA
be suggested.
2.7. Registration with the postgraduate dean
The regional postgraduate dean maintains a register of SpRs. Details of the
registration, an estimated CCT date and core personal information on a trainee will be
entered by the postgraduate dean in a special form (Form A) which will become part
of the trainee’s personal Record of In-Training Assessment (RITA) as described in the
“Orange Guide”. A copy of RITA Form A will be sent to the Faculty.
2.8. Allocation of training numbers
SpR trainees will hold the same training numbers throughout their occupational
medicine training in the same deanery. They retain their numbers even when they
take time out for research, take leave of absence or gain experience abroad as long as
such arrangements have been agreed with the postgraduate deans and the trainees
intend to return to complete their CCT training. However, a new training number will
be issued if there is movement between an NHS and a non-NHS training programme.
A new training number will also be issued in the event of permanent transfer between
deaneries;
NHS trainees
An SpR appointed to an NHS post funded by the Department of Health or
other re-mapped NHS funding will be issued a National Training Number
(NTN) by the regional postgraduate dean from the stock available from the
Department of Health.
Non-NHS trainees
A non-NHS trainee in SpR training, or an NHS trainee in a post funded from
non-NHS sources will be issued an Industrial Training Number [NTN(I)] by the
regional postgraduate dean to confirm his/her training status and to assist the
postgraduate deans in monitoring the trainee’s training progress. Such
numbers are unlimited as they do not form part of the NHS manpower
planning process. Armed Forces SpR trainees will be issued NTNs by the Tri-
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Service Dean from a separate stock. Guidance on movement between training
posts that involve a change of deanery can be found in the “Orange Guide”.
2.9. Registration with the Faculty
a. An occupational medicine SpR trainee is required to register with the Faculty.
A registration form (Form M1) is available from the Faculty office and will be
sent to the trainee when the Faculty receives his/her RITA Form A (see
paragraph 2.6.1). The completed form should be returned to the Faculty with
the appropriate fee. A Training Record will be issued by the Faculty for a
registered trainee to log all training activities for the purposes of assessment,
annual review (RITA) and maintenance of records relevant to revalidation;
b. A registered trainee who is not yet an Associate of the Faculty will become an
SpR member of the Faculty. He/she will receive the Newsletter, journal
(Occupational and Environmental Medicine) and other regular mailings of the
Faculty.
3. CCT training programmes in occupational medicine
The minimum duration of a CCT training programme in occupational medicine is six years
full-time – a minimum of two years of general professional training in SHO posts, followed
by a minimum of four years higher specialist training (see paragraph 4 for flexible
training).
3.1.The educational supervisor:
a. There must be at least one named educational supervisor for the training
programme. The educational supervisor must be on the GMC’s specialist
register as an accredited specialist in occupational medicine and be approved
by the Faculty SAC;
b. When approving an educational supervisor, the Faculty will take account of
attributes including:




Experience or knowledge of the Faculty’s training process and content;
CPD compliance;
Involvement in regular medical audit;
Recent attendance at (or willingness to attend) an educational
supervisory skills course;
c. If you become a trainer within the first year as an MFOM, you will need to find
a training mentor who is an MFOM/FFOM, is on the Specialist Register and
is/has been an experienced trainer. The Faculty of Occupational Medicine will
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need to be made aware of your mentor.
d. An application for approval of a CCT training programme/post should be made
by the educational supervisor(s) first to their RSA and then to the Specialty
Advisory Committee of the Faculty (see Section 6 of the Handbook for details).
3.2. Requirements of a training programme:
a. a balanced and adequate range of instruction and experience in the principles
of occupational medicine within a structured programme covering the
training curriculum (see Annex 2), with rotations and/or attachments
included;
b. a wide range of defined practical experience;
c. increasing clinical and managerial responsibility with experience;
d. protected training time for study during working hours;
e. suitable and sufficient facilities for study and to conduct a supervised
dissertation project by research which is obligatory for the completion of
training and award of MFOM;
f. be undertaken in one or more posts approved by the Faculty and, if
appropriate, other training placements approved by the Faculty and the
postgraduate dean.
The first year is an introduction to occupational medicine and the functions of
management and employee representatives in the workplace. The trainee should not
be expected to spend more than 50% of their time in clinics.
The second year is concerned with enlarging experience and theoretical knowledge.
A comprehensive academic course could be appropriately included to prepare the
trainee for the AFOM examination. The subject for research/dissertation should be
chosen and started. An initial research proposal should be submitted and accepted
by the Faculty before the end of the second year of specialist training (i.e. by the
24th month of full-time training, or the part-time equivalent). It is therefore
essential that trainees identify a suitable project and submit an initial proposal as
early as possible in their training programme.
Note: Academic training in occupational medicine on a full-time, distance learning,
day or block release basis is required for all candidates for the AFOM examination of
the Faculty.
Educational credit may be given for approved courses undertaken prior to entry into
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higher specialist training:
Successful completion of a Faculty approved AFOM course prior to entry to
higher specialist training may attract a maximum of three months educational
credit.
Successful completion of a Master’s degree course prior to entry to higher
specialist training, in an area relevant to occupational medicine and
undertaken in a Faculty approved educational establishment, may attract a
maximum of twelve months educational credit.
Any course undertaken during the four year training programme will not
attract extra educational time credit, but up to twelve months of training may
be spent in a Faculty approved research post, or full-time educational course
aimed at AFOM and a higher degree (e.g. a twelve month full-time MSc
course).
The third year consolidates the experience gained already and complements any
deficiencies by secondments or visits to other industries and occupations.
In the final year, if not already achieved, individual responsibility should be taken for
some aspect of the management of an occupational health service. The research
project (dissertation) should be completed.
The trainee must pass the AFOM examination and submit a satisfactory dissertation
to the Faculty within the training period. Permission for an extension of the training
period in order to achieve AFOM or a satisfactory dissertation will be considered by
the Faculty and the postgraduate dean on a case-by-case basis.
3.3.Supervision
The named educational supervisor must:
a. ensure that he/she has a thorough knowledge of the trainee’s job and
responsibilities, and of the hazards of the relevant occupations;
b. during the first year, provide close supervision and be available to the trainee
for consultation (preferably face to face) at least daily, and give or arrange
formal instruction on at least one half day per week. Provided the trainee
makes good progress, the degree of supervision should decrease
progressively over the next three years. By the final year the trainee will be
expected to practise with considerable independence, meeting the supervisor
for formal discussion and/or instruction for at least half a day each month in
addition to the normal contacts of the working day;
c. encourage and facilitate other relevant activities to broaden the trainee’s
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experience, e.g. attendance at local postgraduate centre meetings, clinical
assistantships, research;
d. assist the trainee to obtain knowledge of other occupational hazards, illnesses
and processes through visits to other industries, NHS hospital occupational
health units, and (where possible) the HSE;
e. assist with the dissertation, e.g. assisting the trainee to identify an acceptable
topic for study and in the preparation of the protocol for submission. It may
be necessary for the educational supervisor to facilitate an arrangement with
a suitable person or academic unit to guide the work and assist as required
from the preparation of the protocol for submission through to the final
presentation;
f. provide the postgraduate dean with a detailed educational assessment of the
trainee for the annual review of assessments (RITA).
3.4.Research
A research period may contribute up to 12 months towards the duration of the
training programme provided that the content is relevant to the practice of
occupational medicine and is undertaken in an educational establishment approved
by the Faculty. Some trainees may wish to spend more than 12 months in research,
either before obtaining an approved post or by stepping aside from training for a year
or more while in post. This is perfectly acceptable but no more than 12 months
educational credit will accrue. It will remain essential to acquire the full balance of
occupational medicine training.
3.5.Part-time posts in a programme
It is acceptable for a CCT training programme in occupational medicine to be made up
of a number of part-time posts provided that approval of the programme is sought in
advance, the training curriculum is fully covered by a sufficient range of training
opportunities and the arrangements for supervision are satisfactory.
3.6.Flexible (part-time) training
a. Flexible training may be approved under Article 7(3) of the European
Specialist Medical Qualifications Order 1995 when, for well-founded
individual reasons, full-time training is not practicable;
b. The key aims of flexible training are:


to retain doctors who are unable to train full-time;
to keep arrangements in line with full-time training;
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 to maintain a balance between flexible arrangements and service
needs;
c. Approval for flexible training must be sought through the RSA to the
postgraduate dean. The same criteria for approval and assessment of flexible
training will apply as to full-time training;
d. The total length of training of flexible trainees must not be less than that
required for full-time training;
e. All trainees in the SpR grade are eligible to apply for flexible training. Fulltime trainees may apply to become flexible trainees and flexible trainees may
apply to revert to full-time training at any time.
3.7.Overseas training
a. Up to one year of experience of overseas training may be recognised towards
the completion of higher specialist training in occupational medicine;
b. SpR trainees already in a training programme in the UK must seek
prospective approval of overseas training from the Faculty and the
postgraduate dean;
c. Armed Forces personnel training overseas are required to return to the UK for
annual assessment.
4. Absences from Higher Specialist Training
The CCT date identified at entry into the programme assumes progression through
Higher Specialist Training with no break of service or absence, other than contractual
holiday entitlement and authorised study leave. Other absences will be presumed to
extend the CCT date, unless the Regional Postgraduate Dean is satisfied (after
consultation with the educational supervisor and the Chair of the Deanery Specialty
Training Committee) that no essential element of training has been missed. Such
absences, which may include research, military service, maternity leave, paternity
leave, sickness or compassionate leave, are discussed in Note 1 (below).
‘Out-of-programme’ experience may be authorised by the Postgraduate Dean, after
consultation with the Deanery STC. It must be covered by a Form RITA F, and will
extend the CCT date. Out-of-programme experience includes:
a. Research posts (Note 2);
b. ‘Non medical training’ (e.g. flying courses, military staff command courses,
other management training) (Note 3);
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c. Military service which is unsupervised and ‘non-training’ (Note 4);
d. Training and experience in other medical specialties relevant to
occupational medicine but not formally accreditable as part of the Facultydefined training programme.
Requests for breaks from HST for reasons other than those listed above must be made
by the Trainee to his / her Educational Supervisor and to his / her employer in the first
instance. It is essential to note that non-NHS employers are under no obligation to
permit absences for reasons other than those contractually agreed or those outlined
in Note 1 (below). If the employer agrees to grant the trainee an extended ‘career
break’, the trainee must then discuss the proposal with the Chair of the Deanery STC
and the Regional Specialty Adviser.
The Chair of the Deanery STC will discuss the merits of the request with the
Educational Supervisor, the Regional Postgraduate Dean, and the RSA. A request will
not normally be granted if:
a. It coincides with the issue of (or likelihood of) a recommendation of
extended training (RITA E), or
b. It exceeds 12 months.
If a ‘career break’ is not approved, the trainee should be notified of the decision in
writing by the Chair of the Deanery STC, with a copy to the Faculty for information.
If a period of up to 12 months’ break is authorised:
a. The trainee will keep their NTN or NTN(I), but in the case of an NHS
trainee holding an NTN, the RPGD may use the funding related to their
post to employ a LAT or FTTA;
b. The Chair of the Deanery STC should notify the Faculty of the agreement,
and complete a form RITA F;
c. The trainee must contact his / her Educational Supervisor and the Chair of
the Deanery Training Committee at least three months before the
expected date of return to training, to confirm the return date;
d. Once the trainee has returned to the training post, the Chair of the
Deanery STC should notify the Faculty of the date of resumption of
training, and confirm the recalculated CCT date;
Note 1:
Authorised absences may occur for a number of reasons, including inter alia:

Sickness leave;
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 Bereavement or other compassionate reasons;
 Maternity or paternity leave;
Absences of up to three months for reasons other than contractual holiday
entitlement and authorised study leave must be discussed with the Chair of the
Deanery STC, who will advise the Regional Postgraduate Dean on whether any
recalculation of CCT date is required, taking into account the trainee’s current
programme year, their progress through the training programme and whether any
essential element of training is being missed. If the absence results in an essential
element of the training programme being missed, but the Deanery STC determines
that no extension of training is required, a form RITA D should be issued, specifying
the targeted training required. If the Deanery STC decides that an extension to
training is required, a form RITA F should be issued to cover the period of absence,
and the Faculty notified of the recalculated CCT date.
Any absence beyond three months will extend the training period. The Deanery STC
must decide whether the CCT date is extended by the entire length of the absence, or
whether three months of absence may be permitted before recalculating the CCT
date. This will depend on the trainee’s current programme year, their progress
through the training programme and the elements of training that have been missed.
Note 2:
Longer absences may be authorised if the trainee is to undertake particular research,
usually associated with University appointments and MRC fellowships. The trainee
will retain their NTN or NTN(I), and the Deanery STC should notify the Faculty of the
proposed absence and likely date of return to the training programme by issuing a
form RITA F at least once a year (see ‘A Guide to Specialist Registrar Training 1998’
Section 10).
Note 3:
Management training:
Full time management training courses approved prospectively by the Faculty or
Deanery STC Chair may count for a maximum of three months educational credit
within a training programme. Any time in excess of three months will be ‘out-ofprogramme’. The Deanery STC should issue a form RITA F with the recalculated CCT
date.
The value of the Army Junior Staff Command Course in relation to general
management training is limited to four weeks educational credit. Any time spent on
the course in excess of four weeks will be ‘out-of-programme’, and the Deanery STC
should issue a form RITA F with the recalculated CCT date.
Military Senior Staff Command courses may count for a maximum of three months
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educational credit within a training programme.
NB: Armed Services trainees may not count more than three months total
educational credit for Staff Command courses, even if both the Junior and Senior
courses are undertaken.
Note 4:
Where a trainee is absent on active military service, his / her case will be assessed on
its merits by the relevant Deanery STC or RITA panel, to determine whether any of
the time spent on active service was both supervised and appropriate to training in
occupational medicine, and could therefore be allowed to count towards the CCT
date. The Deanery STC will issue form RITA F to cover any period of absence on
active service that is not recognised for HST, and notify the Faculty of the
recalculated CCT date.
5. Training agreements
a. The subject of training agreements is featured in Section 15 of the “Orange
Guide”. It is the Faculty’s view that training agreements should be adopted for
all training posts to protect both NHS and non-NHS trainees, and to remind
employers and supervisors of their responsibilities;
b. Subject to regional arrangements, a training agreement should include all the
main parties with an interest in the effective delivery of SpR training. These
would be the postgraduate dean, the employer(s)/educational supervisor(s)
and the trainee. It should be signed as soon as the SpR begins his/her training
programme and reviewed regularly;
c. It would be reasonable for an SpR trainee to expect the following from the
other parties to the agreement:
1. a statement of principle describing the aims of the training programme
and the standards of achievement required of him/her;
2. the names and contact details of those who will be responsible for
providing guidance, counselling and assessment;
3. a clear explanation of the methods of assessment to be used and their
frequency;
4. a commitment to providing an educational plan;
5. a commitment to regular tuition by the educational supervisor(s);
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6. provision of an appropriate medical library and any other necessary
educational/training aids and support;
7. a commitment to providing appropriate levels of protected time for
education and study time.
8. An SpR trainee’s obligations under a training agreement should include
the following:
9. a commitment to take an active part in the training programme;
10. participating fully in the relevant assessment, appraisal and review
procedures, and taking an active role in counselling arrangements,
where appropriate, to make sure that any difficulties are resolved as
soon as possible;
11. agreement to a training plan with the educational supervisor(s);
12. giving adequate notice of “out-of-workplace” study time;
13. making best use of research or study time;
14. agreement to take part in training others, both students and others
whom the trainee could possibly assist.
Annex 4 contains a model training agreement.
6. Assessment, appraisal and annual reviews in the SpR grade
6.1.Assessment
a. Assessment is the process of measuring progress against defined criteria
based on the Faculty’s curriculum. Trainees have to meet an agreed standard
to be able to move from year to year on the training programme and to
achieve a CCT. Assessment procedures aim to provide both trainers and
trainees with a picture of the individual’s progress;
b. The educational supervisor is primarily responsible for assessment, which
should take into account:

objective measures (examination results, structured exercises set
throughout the year);
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 achievement of specific goals set through the year in relation to the
Faculty’s curriculum and core competencies;
c. The training curriculum for occupational medicine and a list of the core
competencies are included as Annexes 2 and 3.
6.2. Appraisal
a. Appraisal is the process whereby the supervisor provides, through
constructive and regular dialogue, feedback on performance and assistance in
career progression. Appraisal is a confidential process and not part of
assessment. However, appraisals may be informed by assessments that are
carried out throughout the year;
b. A trainee is required to keep a detailed Training Record to log his/her training
activities. A Training Record will be provided to a trainee on registration with
the Faculty;
c. Further guidance on assessment and appraisal can be found in “The Good
Assessment Guide – a practical guide to assessment and appraisal for higher
specialist training” ed. Brian Jolly, Janet Grant, Joint Centre for Education in
Medicine, 1997.
6.3. Annual review and record of in-training assessment (RITA)
a. Every specialist registrar grade trainee undergoes an annual review, usually
towards the end of each year in the training programme. A flexible trainee will
also be assessed annually. The review is usually carried out by a small panel of
specialists under the aegis of the deanery STC. The review is not intended to
be an assessment in itself, but is intended to ensure that adequate
assessments of knowledge, skills, attitudes and behaviour have been carried
out in the trainee’s workplace.
b. The date of the review will be communicated by the assessment panel
chairman, normally the Chair of the deanery STC, to the trainee and the
educational supervisor well in advance.
c. The trainee will need to submit his/her Training Record (including the CPD
record) to the panel chairman. The educational supervisor will also need to
complete and submit an annual assessment report, which must be agreed with
and countersigned by the trainee. A sample form is attached as Annex 5, but
supervisors and employers may wish to use their own system and forms, to
demonstrate that assessments have been based on regular appraisal. The
trainee may enter a note of dissent (See Annex 6 – Grievance Procedures).
Such documents are expected to reach the assessment panel chairman at least
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two weeks before the assessment interview. The assessment panel chairman
will also need to ensure that the visitors’ report on the relevant training post(s)
and reports from previous annual assessments are available.
d. The trainee will usually take part in the review, and have access to all the
documentation being taken into account. The educational supervisor(s) may
attend if required by the panel, or at their own request (for example to give the
panel particular information on the training post or programme), but will not
be present when the trainee is being interviewed so that any problems with
the standard of supervision can be freely discussed. If necessary, the panel can
consult the educational supervisor(s) separately.
e. The review will normally take 30 to 60 minutes. During the interview, the
trainee’s Training Record and annual assessment report(s) will be reviewed
and his/her progress through his/her training programme assessed. Any
deficiencies or omissions will be identified and where appropriate remedial
action recommended.
f. At the end of the interview, the panel will agree and inform the trainee
whether he/she has reached the level of competence required at that stage of
his/her training and whether he/she should progress to the next year, and if not
what additional training will be required. It is important that if further training
is required, the remedial actions are agreed with the trainee and the
educational supervisor, through additional communication by telephone or in
writing if necessary.
g. The RITA panel chairman will prepare a written report for agreement by the
other panel members. This report may be a RITA Form C, D, E or G or may
supplement RITA Form C, D or E.
h. The appropriate RITA form must be endorsed by the chairman of the deanery
training committee, the trainee (to indicate that he/she understands, but not
necessarily accepts or agrees with, the recommendations) and the
postgraduate dean (unless the trainee decides to seek a review or make an
appeal). Copies of the RITA form and additional report if appropriate will be
sent to the postgraduate dean’s office, the Faculty, the trainee and the
educational supervisor.
i.
On the rare occasion where informal and formal action have not succeeded in
helping a trainee to reach a satisfactory standard of progress and it is clear that
there is no reasonable prospect of achieving this, the trainee may be advised
to withdraw from the programme. This process will involve the postgraduate
dean and/or the Chair of the Deanery STC. Support and counselling will be
made available to ensure that appropriate career choices are made.
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j. The trainee has the right to seek a further review or appeal to the
postgraduate dean if he/she is not satisfied with the outcome of the annual
review. Details of the review and appeal procedures are set out in Section 14
of the “Orange Guide”.
7. The RITA forms
Samples of the forms can be found in the “Orange Guide” and are reproduced in Annex 7.
Form A – Core Information on the Trainee
The formal registration of an SpR trainee into a CCT training programme begins with
the completion of Form A where core information on the trainee is recorded. The
trainee must confirm on entering the training programme or grade or on acquiring
his/her NTN or NTN(I) that the information on Form A is accurate.
Form B – Changes to Core Information
The trainee will be responsible for notifying the postgraduate dean and the Faculty of
any changes to the core information recorded on Form A. Such changes and other
appropriate amendments will be noted in Form B for confirmation by the trainee on
the next review occasion.
Form C – Record of Satisfactory Progress within the Specialist Registrar Grade
If satisfactory progress is confirmed at an annual review, a Form C will be completed
as a record. A Form C must be obtained for each year of the programme and is
especially important in the final year of training.
Form D – Recommendation for Targeted Training – Stage I of “Required Additional
Training”
This form will be used where the review has revealed general areas in which the
trainee requires additional training but not in a particular specialist unit, placement or
attachment, e.g. training in the general professional competencies of communication
skills, record keeping etc. The educational supervisor will need to take steps to ensure
that the trainee is provided with extra guidance and supervision in these aspects of
training. A Form C must subsequently be completed following a Form D
recommendation to indicate satisfactory progress.
Form E – Recommendation for Intensified Supervision/Repeated Experience – Stage II of
Required Additional Training
This form will be used when the trainee has failed to acquire or reach a satisfactory
level of specific skills, or has failed to demonstrate specific competencies at an
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appropriate point in the training programme. The trainee will be required to return to
a placement or attachment – or will not progress to the next year of the programme –
until the necessary competencies are acquired and demonstrated. A Form C must
subsequently be completed following a Form E recommendation to indicate
satisfactory progress. In the final year, a Form G may be required at the end of
additional training.
Form F – Record of Out-of Programme Experience
Where an SpR trainee, once awarded an NTN or NTN(I), wishes to pursue out-ofprogramme activities, e.g. research or overseas experience, the consent of the
postgraduate dean and the Faculty should be sought prospectively, especially if
he/she wishes to count such activities towards a CCT. Trainees in such activities
should return a Form F at intervals of no greater than one year in order to retain their
NTN or NTN(I), confirm their intention of returning to the programme and update the
estimated CCT date.
Form G – Final Record of Satisfactory Training
This signals the satisfactory completion of the training programme, giving the date on
which training ends. It will not be issued until all elements of the training programme
are completed, and in particular, it will not be issued until a satisfactory dissertation
has been submitted and accepted by the Faculty. Copies are sent to the Faculty to
enable a recommendation for CCT to be made to GMC. The form also records the
trainee’s career intentions after completion of training, and in particular whether the
NTN will be relinquished.
8. The qualifications of AFOM and MFOM
8.1.
AFOM Examination
Please note: the last sitting of the AFOM was in January 2010. A
candidate who has not passed the AFOM examination before
September 2010 will be eligible to sit, and will be required to pass
the Part 2 MFOM examination instead (see Membership
Regulation M50 and associated guidance).
The Regulations and syllabus for the AFOM examination can be found in Section 3.
(N.B. All trainees starting in post before 31 July 2007 must refer to Section B or, if they
plan to switch to the new curriculum, refer to the ‘Transitional Provisions’ on page 13).
An SpR trainee will normally be expected to sit the Associateship (AFOM)
examination by the end of year two or the beginning of year three of his/her training
programme and to have passed this examination by the end of year three. Whilst
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failure to pass the examination will not be an automatic bar to progressing to year four
of the training programme, the RITA review panel will consider very carefully whether
a trainee without the AFOM has sufficient background knowledge to progress to the
final year. Where not satisfied that this is the case, the panel may recommend that a
trainee remains at year three until he/she has passed the examination. If after a
further six months the examination has still not been passed, unless the deanery
training committee is satisfied that the failure to pass the examination is outside of
the trainee’s control (e.g. illness), it may have to recommend withdrawal of the
trainee’s NTN or NTN(I).
8.2.MFOM
The Regulations for the award of Membership are found in Section 3. (N.B. All
trainees starting in post before 31 July 2007 must refer to Section B or, if they plan to
switch to the new curriculum, refer to the ‘Transitional Provisions’ on page 13).
Advancement from Associateship (AFOM) to Membership (MFOM) of the Faculty is
awarded on satisfactory completion of four years in approved training posts and the
submission of a satisfactory dissertation. A trainee should plan his/her dissertation
well in advance and should have obtained approval of the initial dissertation proposal
by the end of year two of training.
He/she is expected to have submitted an MFOM dissertation by the end of the fouryear training programme. Where the dissertation is not of a sufficient standard, the
trainee will be expected to carry out the recommendations of the assessors and resubmit the dissertation as soon as possible. He/she will be required to remain in an
approved training post until MFOM is obtained. If not, a further period of approved
training may be required before the Faculty would make a recommendation for award
of a CCT. A trainee who is unable to complete the MFOM dissertation requirement
before the end of the four-year training period should seek approval from the Faculty
and the postgraduate dean for an extension of the training period. Normally an
extension of up to twelve months may be granted, indicated by the issuing of a RITA E
form. The progress of the dissertation will be assessed by the RITA panel after six
months, but if a trainee has not obtained the MFOM by the end of twelve month
extension to training, unless the Faculty and the deanery training committee are
satisfied that the failure to obtain the MFOM is beyond the trainee’s control (e.g.
illness), the postgraduate dean may withdraw his/her NTN or NTN(I).
9. Completion of training
An SpR trainee will need to fulfil the following requirements before he/she is deemed to
have completed a CCT training programme:
a. at least four years of higher specialist training in a training programme
undertaken in Faculty-approved post(s), with satisfactory annual assessments
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by the deanery training committee and satisfactory completion of the Training
Record;
b. award of Associateship of the Faculty (AFOM) by examination;
c. award of Membership of the Faculty (MFOM) on submission of a satisfactory
dissertation.
9.1.Recommendation for award of CCT
This takes place through the following process:
i. When a doctor is within six months of completion of their specialty
programme the Postgraduate Dean will notify the Faculty of the final
annual assessment outcome and that the trainee has satisfactorily
achieved the required competences.
ii. If the Faculty believes that all the requirements of the CCT curriculum
will be met by the time the trainee is due to complete the training
programme, the Faculty will notify the GMC of the trainee’s
completion of training date.
iii. The GMC will invite the trainee to make an application for entry onto
the Specialist Register, around four months before the completion of
training date.
iv. On completion of training the trainee should complete an Application
for Membership / Completion of Training form and return it to the
Faculty. Upon approval of the application for membership, the Faculty
will send a recommendation to the GMC.
v. Once the GMC has received the recommendation and the application
from the trainee they will issue a CCT certificate and the trainee’s
status on the GMC Register will be updated.
vi. If the application and recommendation is received before the
completion of training date, then a certificate will be granted on the
completion of training date. If the application or recommendation is
received after the completion of training date, then the certificate will
be granted on the date it is processed.
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ANNEX 1
CV = Curriculum Vitae / Application Form
I = Interview
Ref = references
Specialist Registrar in Occupational Medicine
Person Specification
Essential
QUALIFICATIONS
CLINICAL EXPERIENCE
CLINICAL SKILLS
KNOWLEDGE
ORGANISATION,
PLANNING &
MANAGEMENT
RESEARCH
AUDIT
…continued:
GMC Registration
MB BS or equivalent
A minimum of 2 years
broad post-registration
clinical training or
satisfactory completion
of General Practice
Vocational Training or a
Certificate of Equivalent
Experience
Appropriate clinical
knowledge
Competent to work
without direct
supervision where
appropriate
Clear thinking, with an
analytical approach to
problems
Knowledge of evidencebased practice
Aware of limits of own
knowledge
Some understanding of
occupational medicine
Ability to organise one’s
work, and prioritise
clinical need
Ability to work in multidisciplinary teams
Understanding of the
basic principles of
epidemiology
Evidence of participation
in clinical audit
When
evaluated
CV
CV
I, Ref
I, Ref
Desirable
MRCP or
MRCGP
Experience in a range
of medical specialties
(e.g. respiratory
medicine,
dermatology,
rheumatology)
When
evaluated
CV
CV
MRCP / MRCGP
Understanding of
clinical risk
management
CV
Awareness of
management and
financial issues, and
resource constraints
Experience of
committee work
Understanding of
clinical governance
Evidence of previous
research
CV, I
I
I, Ref
I
I, Ref
I
I, Ref
CV, I, Ref
CV, I
I
CV, I
I
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Essential
When
evaluated
TEACHING
CAREER
PROGRESSION
PERSONAL SKILLS
MOTIVATION
OTHER
No unexplained gaps in CV
CV, I
Communication & language
skills:
(ability to communicate
clearly in written and
spoken English; ability
to build rapport, listen,
persuade, negotiate)
Decisiveness:
(ability to take
responsibility, make
decisions, lead with
appropriate authority)
Interpersonal skills:
(open, non-defensive,
cooperative,
empathetic, sense of
humour)
Non-judgemental:
(approach to patients)
Resilient:
(ability to work under
pressure and to cope
with set-backs)
Flexibility:
(ability to cope with
change)
Thoroughness:
(Identifies and deals
with all relevant issues,
punctual, meets
deadlines)
Initiative and enthusiasm:
(self-starter, motivated,
enthusiastic, shows
curiosity)
Evidence of interest in
occupational medicine
I, Ref
Meets appropriate medical
standards
P/E health
screening,
Ref
Desirable
Evidence of
teaching
experience
Knowledge of
teaching methods
Appropriate
progression to date
When
evaluated
I
CV, I
I, Ref
I, Ref
I, Ref
Ref
Ref
Ref
Ref
CV, I, Ref
CV, I
Evidence of
previous
experience of
occupational
medicine
CV
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ANNEX 2
TRAINING CURRICULUM FOR OCCUPATIONAL MEDICINE
The curriculum for specialist training in occupational medicine comprises the following elements:
OCCUPATIONAL HAZARDS TO HEALTH








Physical, chemical, biological, ergonomic, psychosocial and other hazards to health in the
workplace, and the illnesses which they cause
Methods of evaluating and controlling the risk from hazards
Principles of toxicology, occupational hygiene and ergonomics
Occupational health standards
Clinical features and investigation of occupational diseases
Principles of health surveillance
Biological monitoring
Emergency treatment of acute poisoning and injury at work
ASSESSMENT OF DISABILITY AND FITNESS FOR WORK






Principles of assessing fitness for work
Statutory and advisory requirements of fitness for specific jobs
Methods of rehabilitation and redeployment at work and in the community and
availability of resources
Factors affecting absence attributed to sickness
Disablement benefits
Principles of ill-health retirement
COMMUNICATIONS





Organisation of occupational health services in the UK and role of the Health and Safety
Executive
Organisation of other health services in the UK and in particular the NHS
Role and organisation of other occupational health professions
Ethical guidelines for communications with doctors, managers and others
Principles, techniques and resources in communication
RESEARCH METHODS
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
Sources of scientific information

Principles of epidemiology and medical statistics

Ethical considerations in research
MANAGEMENT






Principles and practices of management
How to manage a budget
Needs assessments and marketing techniques for occupational health services
Structure and design of training courses
Industrial relations
Principles of audit
OCCUPATIONAL HEALTH LAW AND ETHICS






The legislative framework of occupational health in the UK and EC
Acts, regulations, codes of practice and guidance governing occupational health and
safety including the reporting of occupational injury and disease
Industrial compensation systems
The interaction between law and ethics in occupational health practice
The roles of the medical professional and expert witness
Litigation procedures
ENVIRONMENTAL MEDICINE





Physical, chemical and biological hazards to health, arising in the environment from
industrial activities
Methods for assessing and controlling environmental hazards
The principles of integrated pollution control
Control of industrial major accidental environmental hazard
The role of other professional groups with an interest in environmental health
HEALTH PROMOTION



Major health risks relevant to working populations
Principles of health promotion and education
Health promotion agencies and sources of information
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ANNEX 3
CORE COMPETENCIES IN OCCUPATIONAL MEDICINE
IDENTIFICATION OF OCCUPATIONAL HAZARDS TO HEALTH







Assessment of working environment
Evaluation of risks
Information and advice on control measures
Identification and evaluation of specialist assessment of working environment
Clinical case management
Health surveillance programmes
Assessment and advice on first aid facilities
ASSESSMENT OF DISABILITY AND FITNESS FOR WORK





Advise on impairment, disability and handicap in relation to work
Advise on fitness for work placement
Advise on rehabilitation and redeployment
Advise on ill-health retirement
Advise on absence attributable to sickness
COMMUNICATION WITH PATIENTS, MANAGERS AND OTHER HEALTH CARE
PROFESSIONALS






Read, write and converse proficiently in the English language
Organise and write a report
Make clear oral presentation to an audience with effective use of audiovisual equipment
Communicate with people with different levels of intelligence and understanding
Apply legislative and other ethical requirements for confidentiality
Participate effectively as a member, secretary or chair of a committee
RESEARCH METHODS



Convert a problem into a researchable question
Carry out a literature search
Plan data collection for simply survey (sample selection and recording and storing data)
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
Carry out simple statistical manipulations to summarise data

Use a computer for the storage and analysis of data

Interpret scientific data in journals and from own research

Recognise and initiate the investigation of clusters of disease in a workforce

Use of external statistician or epidemiological expert

Report on an investigation orally and in writing
MANAGING AN OCCUPATIONAL HEALTH SERVICE










Manage an occupational health department
Identify the occupational health need of an organisation
Define the goals and objectives of an occupational health service
Define the role of occupational health staff and formulate job descriptions
Organise record keeping using computers if appropriate
Negotiate and manage a budget
Market occupational health services
Evaluate the quality of an occupational health service and carry out clinical audit
Select, appoint, supervise and appraise staff performance
Design a training programme
OCCUPATIONAL HEALTH LAW AND ETHICS

Advise managers, safety representatives and employees of their responsibilities under
health and safety law
ENVIRONMENTAL MEDICINE

Assessment and control of environmental exposures from industrial activities
HEALTH PROMOTION


Assess needs for health promotion
Organise, provide and evaluate health promotion programmes
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ANNEX 4
POSTGRADUATE MEDICAL AND DENTAL EDUCATION
CCT
[name of] Deanery
Training Agreement for Higher Specialist Trainees (Specialist Registrars) pursuing a Certificate of
Completion of Training (CCT) in Occupational Medicine
Part One:
Background Information
[Title] [Forenames] [Surname]
Name of specialist registrar
Training to obtain a Certificate of Completion of Training in Occupational Medicine
1.
The parties to this agreement are the above named specialist registrar
and
[name of postgraduate dean]
the Postgraduate Dean
2.
This agreement covers your training in an approved training programme in the [name of]
Region. Your continued progress on this training programme is subject to a satisfactory
annual assessment.
3.
A brief outline of assessment procedures at individual placements is set out in Appendix 1.
The assessment documents will be held as part of your Record of In-training Assessment
(RITA) in the postgraduate office and will be made available to the Faculty of Occupational
Medicine. The annual review of training assessments will be carried out under the aegis of
the Deanery Occupational Medicine Specialty Training Committee.
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4.
Your training programme will be co-ordinated by your educational supervisor in
consultation with the Deanery Occupational Medicine Specialty Training Committee. The
minimum notice of rotational moves will be one month, however, every effort will be
made to notify you of your move well in advance of one month. All placements will be
educationally approved by the Faculty of Occupational Medicine, linked to the annual
review, and in line with the overall training programme description. Where practicable any
unusual personal circumstances will be taken into account when deciding your learning
placement.
5.
Description of the training programme: If you have not already received a description of
the training programme, this is available from your educational supervisor.
Part Two:
The Training Programme
6.
If you feel that your training placement is not delivering the range and depth of experience
appropriate to your stage on the training programme, or that your educational supervision
is inadequate, it is of the utmost importance that you take action in accordance with
Appendix 3.
7.
Induction: At the start of the programme, and at the start of each individual placement if
your programme is rotational, you will be introduced to your role by your educational
supervisor. This will include the provision and discussion of the operational procedures of
the unit along with any clinical guidelines or protocols in use.
8.
Terms of employment: You should receive a detailed job description at the start of your
programme, and at the start of each placement if your programme is rotational, setting
out the terms of your employment. This should include an outline of your key duties,
anticipated weekly routine, and arrangements for teaching and research. The employer's
normal terms and conditions of employment will apply to you, but these should be
consistent with those applicable to Specialist Registrars working in the NHS. In particular,
there will be protected time for teaching and research.
9.
Specialist Registrars with University commitments: Should receive an honorary contract
from their University, together with details of any requirements relating to teaching and
research.
10.
University staff: with honorary specialist registrar commitments, should receive an
honorary contract from the NHS Trust or other organisation with which they are carrying
out their clinical and commitments. See Appendix 4 for further particulars regarding
University Lecturers.
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11.
Meeting with educational supervisor: During each placement there will be regular
meetings with your educational supervisor. It is intended that these may lead to the
adjustment of duties or emphasis in order to progress with your educational plan, and
agreed learning aims and objectives.
12.
Training courses and study leave: You will be encouraged to undertake an academic
training course in Occupational Medicine during the first two years of your training
programme. This training course must be one that is approved by the Faculty. For trainees
in the NHS, a copy of the study leave documentation and an application form are available
from the Regional Postgraduate Dean's office.
Part Three:
13.
Educational plan. Shortly after taking up your placement, time will be set aside for an
initial meeting with your educational supervisor. The purpose of this meeting is to
establish, against the framework of the curriculum of the Faculty of Occupational
Medicine, your previous experience, the overall aims of the training programme, and the
educational priorities of your first year. Your progress will be reviewed with you regularly
and the educational plan will be updated at the start of each year of the training
programme. The plan will be adjusted where necessary, either informally (as outlined in
para 12, above), or following recommendations arising from the formal review of intraining assessments. (See Appendix 1).
Part Four:
14.
General educational facilities
A range of educational facilities is available to you in each placement. Details of these
facilities will be available from your educational supervisor.
Part Five:
15.
Educational plan
Declaration
Successful specialist registrar training requires time, effort and commitment on the part of
educational supervisors, trainees, those managing and funding higher specialist training
and employers. In the [ ] Deanery we will do our best to see that you receive all the help,
support and resources that will enable you to complete your specialist registrar training
programme successfully. The Chair of the Deanery Specialty Training Committee /
Programme Director for Occupational Medicine is
Name:
Address:
He/she will act on behalf of the Postgraduate Dean in relation to your training. In the
unlikely event of problems which cannot be resolved by your educational supervisor or the
Chair of the Training Committee / Programme Director you may make representations
direct to the Postgraduate office.
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16.
For your part, you are expected to:
a)
have read the detailed curriculum produced by the Faculty of Occupational
Medicine for specialist registrar training in occupational medicine;
b)
familiarise yourself with your training programme;
c)
participate fully in your clinical and educational programme and be prepared to
spend some of your own time on educational activities. Please note that timetabled postgraduate training sessions and educational programmes are as much
part of the time-table as clinical activities;
d)
develop a personal educational plan with your supervisor at the start of your
training programme, and at least annually thereafter. This plan should take into
account your current training needs and the time and resources available;
e)
contribute to audit, research and other relevant work being undertaken in your
training programme;
f)
co-operate with your educational supervisors in order to make all necessary
progress during your placement;
g)
give adequate notice of study and annual leave so that suitable arrangements
can be made to organise the service provision;
h)
remember at all times that your colleagues have their own educational
requirements and make sure that your own educational needs and plans integrate
with those of your colleagues.
i)
keep a detailed Training Record (as produced by the Faculty of Occupational
Medicine) and to complete promptly and fully all training and assessment
documentation required of you by your educational supervisors or the
postgraduate office
j)
participate as required in assessment interviews, in particular your annual review;
k)
assist where possible and appropriate in the training of students and others whose
training you could assist;
l)
advise the Regional Postgraduate Dean's office and the Faculty of Occupational
Medicine of any change in your name and/or your address;
m)
accept the terms and conditions applying to training number holders, as specified
in ‘A Guide to Specialist Registrar Training’ (see Appendix 2).
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Signed ...........................................
Postgraduate Dean
or Chairman of the Specialty Training Committee for
Occupational Medicine
Date ..........................
Signed...........................................
Educational supervisor on behalf of the Employer(s)
Date..........................
I agree to do my best to fulfil these commitments. Please issue me with a Training Number
(NTN/VTN/NTN(I)) and a Certificate of Entry to the Specialist Registrar Training Programme.
I shall commence my Training Programme on .......................(date)
at ...............................................................
Signed .....................................
Date ......................
[Title] [Forename] [Surname]
Training Agreement - Appendix 1
Outline of procedures required to meet responsibilities with respect to Specialist Registrar training and to inform the
annual assessment process.
Assessing the needs and setting objectives
At the beginning of each placement the educational supervisor and trainee should discuss the trainee’s educational
needs over the coming training period. From this a plan to meet these needs should be discussed and agreed,
covering:
a)
education and training objectives to be achieved, covering skills, knowledge and attitudes to patients and
colleagues and in line with Faculty of Occupational Medicine's curriculum and ‘Good Occupational Medical
Practice 2010’. Any objectives, the achievement of which is a prerequisite for progression to the next stage in
the training programme should be clearly identified as such;
b)
how the training programme itself will help achieve these objectives;
c)
any formal training that may be required and how this will be provided;
d)
responsibilities the trainee has to secure his/her achievement of the objectives.
The agreed written plan should be signed by both educational supervisor and trainee and should be forwarded to the
Chair of the Specialty Training Committee or Programme Director for approval on behalf of the Committee.
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Regular review of progress
Every twelve months and/or at the end of each individual placement in a rotational programme:
a)
the educational supervisor should provide an assessment report which must clearly show the achievements in
relation to the agreed objectives;
b)
it must be signed by both educational supervisor and trainee and forwarded to the Chair of the Specialty
Training Committee.
Annual record of in-training assessments (RITA)
The above documentation will be used as the basis for the trainee’s end of year/annual review. Further details of the
review process can be found in the Faculty’s Training Handbook.
Appraisal
In addition to the above formal assessment meetings, the Postgraduate Dean requires that all trainees take part in
regular appraisal meetings. These are meetings between the trainee and his/her educational supervisor, to discuss the
trainee’s progress.
These must be:
a)
b)
c)
non-threatening;
not formally documented although a note should be made that the meeting has taken place;
confidential.
Such frequent informal meetings are a normal part of good educational supervision.
Training Agreement - Appendix 2
The following requirements are taken from Paragraph 12, Section 7 of ‘ A Guide to Specialist Registrar Training’. In this
context the term NTN and VTN are interchangeable.
All those eligible for a Training Number will be required, before it is issued, to indicate formally that they
accept the following specific requirements:
i.
they must be engaged in activities approved by and agreed with the postgraduate dean which are
compatible with their training programme (this may include research and leave of absence from the
programme for, for example, maternity and sick leave).
ii.
they must complete all necessary documentation recording progress in the grade, e.g. RITA Forms;
iii.
they must ensure that their postgraduate dean is aware of their location and intentions when they are
undertaking out-of-programme activities, research outside their normal employment, taking leave of
absence or gaining experience abroad;
iv.
if, under paragraph 12(i) they are engaged in work outside their normal employment and cease to pursue,
for any reason, the research or other activity which the postgraduate dean (taking account of advice from
research supervisors and the Faculty of Occupational Medicine) has agreed is compatible with the retention
of the Training Number, they must inform the postgraduate dean at once. The postgraduate dean may
then decide whether it is appropriate for them to retain the Training Number. The arrangements for
appealing against the loss of a Training Number are described in Section 13;
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v.
if they hold a Training Number, and wish to begin or return to a CCT training programme, they must accept
a reasonable offer of a suitable SpR placement. While postgraduate deans will do their best to meet the
requirements for placements from returning researchers, a placement in a specific location cannot be
guaranteed. Working through a system of “lead deans” with responsibilities for specific specialties, the
postgraduate deans have established a mechanism to ensure that doctors returning to training from
research and other recognised activities outside the NHS can be matched to available training placements.
Training Agreement - Appendix 3
Training in occupational medicine occupies a minimum of four years (full-time), but each placement or training
element must deliver the training expected, in order for the trainee to be ready to progress to the next year of the
programme. Therefore, it is most important not to allow a problem situation to continue. If a problem comes to light,
then please take the following action promptly.
1.
Provide your educational supervisor with written notification of the problem, and arrange a meeting to
discuss and resolve the issues.
2.
If you feel unable to discuss the problem with your educational supervisor, or if having taken this line of action
the problem still persists, then please contact the Chair of the Specialty Training Committee with written
details of the problem.
3.
If the problem is not resolved satisfactorily please contact the Postgraduate Dean in writing in confidence.
Training Agreement - Appendix 4
University Lecturers
Trainees who are employed by universities, typically as lecturers, will have responsibilities to and with those
universities for research and teaching. The marrying of those responsibilities to their training and with their clinical
work will require careful consideration.
Normally particular priorities should be resolved by discussion between the trainee/lecturer, the academic head of
department and the educational supervisor. It is recognised that because of the extra responsibilities of academic
trainees it may take longer than expected to complete training.
If conflicts cannot be resolved, they will need to be taken to the Postgraduate Dean and the Training Dean of the
Faculty. In those rare cases where performance appears unsatisfactory then, where this is a training issue, it will lie
within the remit of the Postgraduate Dean. Where it relates to University duties, it lies with the relevant University,
and where it is a clinical matter it lies with the relevant Trust or other organisation to whom the trainee may be
contracted as part of the training programme.
In general placement co-ordination and assessment will take place under the aegis of the relevant Specialty Training
Committee, but this will only be with full University input. The trainee’s educational plan will be set up, as normal with
the educational supervisor, but with appropriate allowance for academic University objectives.
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ANNEX 5
Annual Training Assessment Report
This form should be completed prior to each RITA review, and submitted to the RITA panel
together with the Training Record.
Name of trainee:
Training post:
Name of educational supervisor:
Period covered by report:
Changes to organisation / company:
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Changes to training programme:
Summary of progress against training objectives (specific details are contained in the Training
Record):
Assessment of:
Reliability (including sickness absence):
Self-motivation:
Leadership:
Administration:
Team-working:
Learning skills:
Relationships with:
colleagues
patients / employees
managers
other staff
General comments from educational supervisor:
Major areas of concern / adjustments required to training programme:
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Conclusion Satisfactory progress (objectives met), or
Progress sufficient to proceed (problems identified to be addressed), or
Unsatisfactory progress (significant problems identified)
Trainee’s comments:
Signature of educational supervisor……………………………………Date…………….
Signature of trainee…………………………………………………….Date…………….
ANNEX 6
GRIEVANCE PROCEDURES FOR TRAINEES
Informal grievance procedures:
a. Whenever possible all concerns about the Training Agreement/Programme should be
raised and resolved through local discussions between the trainee, educational supervisor,
employer and possibly the Chair of the Deanery STC or Programme Director (where there
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is one). Initially, the trainee should raise any concerns with their educational supervisor
informally and, if necessary in writing as soon as possible. If a trainee feels unable to raise
the matter directly with their educational supervisor or if this does not result in a
satisfactory resolution of the problem it should be brought to the attention of the Chair of
the Deanery STC or Programme Director who will seek to resolve the matter by discussion
between the two parties.
b. Depending on the circumstances, the Chair of the Deanery STC will inform the trainee’s
employer and the Faculty of Occupational Medicine of any pertinent issue that may
impede the trainee’s completion of training.
c. Trainees may also contact and discuss their concerns with the trainee representative on
the Deanery STC, who will be able to give impartial confidential advice and where
appropriate make representations on behalf of the trainee.
Formal grievance procedures:
a. If a trainee feels it is necessary to proceed to a formal grievance procedure this must be
undertaken in a manner consistent with the employer’s grievance procedures. If necessary
the employer should involve the Chair of the Deanery STC. As a course of last resort, the
Faculty Specialist Advisory Committee is available to advise and help in serious training
matters, which have not been resolved at a local level.
ANNEX 7
RITA FORMS
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Record of In-training Assessment (RITA): Specialist Registrar Grade
Form A:
Core information on Specialist Registrar (to be confirmed on entering grade/receiving an
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NTN (or VTN))
1
Region:
2
Deanery:
3
Full name:
4
5
Sex:
6
Date of birth:
(dd mm yy)
GMC Registration No.:
7
Medical school awarding
primary qualification:
(name and country)
Immigration status (if not
a UK/EEA national)
(indicate if permit
free/work permit)
Primary contact address:
8
9
11
13
15
17
19
10
Year of primary
qualification:
(dd mm yy)
NTN/VTN:
12
Home/other address:
Programme eligible for
award of CCT: (Y/N if no state its purpose)
Specialty 1 for award of
CCT:
Specialty 2 for award of
CCT:
(if awarded as “Dual
Certification”)
14
Royal College/Faculty
assessing training for the
award of CCT:
20
Date of entry to grade/
programme:
(dd mm yy)
Estimated date of award
of CCT: (mm yy)
Initial appointment to
programme - Full/Part
Time:
(Express Flexible
Training as a % of Full
Time Training)
College Diploma or
part thereof, or
equivalent and Postgrad
Academic qualification
16
18
Additional training
activities if undertaken:
21
23
Sub-specialty training
programme 1:
Experience in Research/
Academic medicine:
22
24
Sub-specialty training
programme 2:
Other activities while
holding NTN/VTN:
(please state)
I confirm that the core information recorded in Form A is correct and that I understand the arrangments for reviewing
progress within the Specialist Registrar Grade or while I hold an NTN/VTN allocated by the Postgraduate Dean.
Specialist Registrar (signature) __________________________________________
Date ________________
Chairman of Specialist Training Committee (signature) _____________________
Date ________________
Date of First Review: __________________
Record of In-training Assessment (RITA): Specialist Registrar Grade
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Form B:
Changes to core information (Form A)
(to be confirmed at each annual or equivalent review)
Region:__________________________
Deanery:__________________________________
Name:___________________________
NTN/VTN/FTN:___________________________
Specialty:________________________
Training programme reference:_________
Royal College/Faculty recommending award of CCT:_________________________
Item
No
Descriptor
11
Primary Contact
address
12
Other/home
address
Amendment
Date of
change
Authorisation
(Chairman STC)
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RECORD OF IN-TRAINING ASSESSMENT (RITA) : SPECIALIST REGISTRAR GRADE
FORM C : Record of satisfactory progress
Region:
Deanery:
Name
____________________________
NTN/VTN/FTN:
Specialty:
____________________________
_____________________
Training
____________________________
Programme
Reference
Estimated date of award of CCT:
_________________________________________________
Royal College/Faculty recommending award of CCT
Royal College of
_____________________
Date of review :
Assessment: YES / NO
Penultimate
Year
Period covered : from ........................................... to ....................................................
Year/phase of training programme reviewed (circle) : 1, 2, 3, 4, 5, 6, or Other (state) .................................................
Circle if assessing the result of Stage I or Stage 2 of Required Additional Training :
Experience gained during period of review (full details of programme should be attached) :
Placement/
Dates:
Post/Experience
from
to
Stage I
Stage 2
In/Out of
Programme
PT/FT
Pt Tm as % FT
1
2
3
4
Documentation taken into account during the review and known by trainee :
1
Log book
2
JCHST assessment forms
3
Curriculum vitae
4
Summary of courses/meetings attended and summary of audit/research undertaken.
5
Training portfolio
6
RITA A Form
(Name) ....................................................................................................................
has successfully completed the assessment requirements for progress to the next/final year/phase of his/her training programme
(delete as required)
Chairman of Specialist Training Committee (signature)__________________________________
Date 25 September 02
I confirm that :
a)
b)
I intend to continue with my training programme and wish to retain my NTN/VTN/FTN
the core information Form A and amendments to it Form B are correct
Specialist Registrar (signature) ............................................................
(circle)
Y/N
Date of next review(unless not relevant) .................
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RECORD OF IN-TRAINING ASSESSMENT (RITA) : SPECIALIST REGISTRAR GRADE
Form D:
Recommendation for Targeted Training - Stage 1 of Required Additional Training
Region:
(to be completed only if this recommendation is made in place of a Form C satisfactory progress report)
Deanery:
Name
____________________________
Specialty:
____________________________
_____________________
NTN/VTN/FTN:
____________________________
Training
Programme
Reference
Estimated date of award of CCT:
_________________________________________________
Royal College/Faculty recommending award of CCT
Royal College of
STAGE 1: Recommendation for “targeted training”. Period covered: from …...........................
_____________________
to
.................................……
Date.............................. Year/phase of training programme reviewed (circle) : 1, 2, 3, 4, 5, 6, or other.
Experience gained during period of review (full details of programme should be attached) :
Placement/
Dates
Post/Experience
from
to
In/Out of
Programme
PT/FT
Pt Tm as % FT
1
2
3
4
5
Documentation taken into account during the review and known by trainee :
1
2
3
4
(Name) ……………..……............................................................. needs ‘targeted training’ in the following areas:
1
2
3
4
The Specialist Training Committee has determined that the doctor may proceed to the next year / phase of training, but should be closely
supervised for the next 3 / 6 / 12 months (delete as required). H/she must be reviewed at the end of this period where a “satisfactory progress
review” Form C will indicate if an adequate standard has been reached.
Chairman of Specialist Training Committee (signature) .……….............................................................………
Date.....................…….
I understand the recommendations of the Specialist Training Committee
I confirm that the core information on Form A is correct
Specialist Registrar (signature) ....................................................................................…………
Date of next review..………………….
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Postgraduate Dean (signature) .....................................................................................………..
Date.........................….
RECORD OF IN-TRAINING ASSESSMENT (RITA) : SPECIALIST REGISTRAR GRADE
Form E:
Recommendation for Intensified Supervision/Repeat Experience - Stage 2 of Required
Additional Training
(to be completed only if this recommendation is made in place of a Form C satisfactory progress report)
Region:
Name
Deanery:
____________________________
____________________________
NTN/VTN/FTN:
Specialty: ____________________________
Training Programme Reference _____________________
Revised Estimated date of award of CCT:
_________________________________________________
Royal College/Faculty recommending award of CCT
Royal College of
_____________________
STAGE 2: Recommendation for “Intensified Supervision/Repeated Experience”
Date.........................…………...
Period covered: from ..................... to ..................... Year/phase of training programme reviewed (circle) : 1, 2, 3, 4, 5, 6, or other
Experience gained during period of review (full details of programme should be attached) :
Placement/
Dates
Post/Experience
from
to
In/Out of
Programme
PT/FT
Pt Tm as % FT
1
2
3
4
5
Documentation taken into account during the review and known by trainee :
1
2
3
4
(Name) ……………..……............................................................. has failed to satisfy the assessment requirements of the current year / phase of
training in the following areas:
1
2
3
4
The Specialist Training Committee has determined that the doctor should not proceed to the next year / phase of training, but should spend an
additional period of 3 / 6 / 12 months (delete as appropriate) or other period (insert)………. In training in the specific areas listed above. H/she
must be reviewed at the end of that period where a “satisfactory progress review” Form C will indicate if an adequate standard has been reached.
Chairman of Specialist Training Committee (signature) .……….............................................................………
I understand the recommendations of the Specialist Training Committee
Date.....................…….
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I confirm that the core information on Form A is correct
Specialist Registrar (signature) ....................................................................................…………
Date of next review..………………….
Postgraduate Dean (signature) .....................................................................................………..
Date.........................…
RECORD OF IN-TRAINING ASSESSMENT (RITA) : SPECIALIST REGISTRAR GRADE
Form F:
Report of “out-of programme” experience
(to be completed at no longer intervals than one year in place of a Form C)
Region:
Deanery:
Name
____________________________
NTN/VTN/FTN:
Specialty:
_______________________________
______________________
____________________________
Training
Programme
Estimated date of award of CCT:
_________________________________________________
Royal College/Faculty recommending award of CCT
Royal College of
Reference
_____________________
I confirm that:
i
the post or experience has the prospective approval of the postgraduate dean
Y/N
ii
the Royal College/Faculty has recognised the post or experience as counting towards
a CCT
Y / N / Not relevant
iii
the aim of my out-of-programme experience is ...............................................................................................…...............
iv
I intend to re-enter training (subject to adequate progress) on …...........................................….(insert approximate date)
v
the provisional date for the award of my CCT is ....................…......................................................................................
vi
I wish to retain my NTN / VTN / FTN
Date
……………….............................
Y/N
Period covered:
from ………….....................
to ………….....................
Most recent complete year/phase of training programme reviewed (circle) : 1, 2, 3, 4, 5, 6, or Other (state)
Experience gained during period of out-of programme :
Placement/
Post/Experience
from
1
Research
2
Clinical
3
Other
Dates
to
In/Out of
Programme
PT/FT
Pt Tm as % FT
Each section (1, 2 or 3) must be accompanied by a signed report from the supervisor.
State any concurrent NHS substantive or honorary appointment if held: ...................................................................…..................
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I also confirm that the core information on Form A is correct
Specialist Registrar (signature) ………………....................................................…………………………. Date
………………
I agree that ..............................……………….................................................................................. (name) can retain his / her NTN / VTN
This decision is based / is not based on interview with the SpR
Postgraduate Dean (signature) ………………....................................................…………………………. Date
………………
If not returned to training, date for next return requiring authorisation for retention of NTN / VTN
.......................................................
RECORD OF IN-TRAINING ASSESSMENT (RITA) : SPECIALIST REGISTRAR GRADE
FORM G :
Final Record of satisfactory progress
(to be completed on satisfactory completion of a CCT programme and forwarded to the relevant Royal College or Faculty)
Region:
Name
Deanery:
____________________________
NTN/VTN/FTN:
____________________________
Specialty:
____________________________
_____________________
Training
Programme
Estimated date of award of CCT:
_________________________________________________
Royal College/Faculty recommending award of CCT
Royal College of
Reference
_____________________
Date of review :
Period covered : from ........................................... to ....................................................
Circle if assessing the result of Stage I or Stage 2 of Required Additional Training :
Stage I
Experience gained during period of review (full details of programme should be attached) :
Placement/
Dates:
In/Out of
Post/Experience
from
to
Programme
PT/FT
1
2
3
4
5
Documentation taken into account during the review and known by trainee :
1
2
3
4.
(Name) ....................................................................................................................
has successfully completed all the assessment requirements for his/her prescribed CCT training programme
Stage 2
Pt Tm as % FT
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He/she will formally complete the required training programme on dd/mm/yy
Chairman of Specialist Training Committee (signature)__________________________________
Date
I confirm that :
a) I intend to remain in the grade during the six month “period of grace” and wish to retain my NTN/VTN (circle)
b )my training is now concluded and I no longer require a NTN/VTN
c) the core information Form A and amendments to it Form B are correct
Specialist Registrar (signature) ............................................................
Y/N
Y/N
Date of next review(unless not relevant) .................
Faculty of Occupational Medicine Training Handbook
Section 2
Guide to Specialist Training
Revision 2
Page 51 of 52
08/12
____________________________________________________________________________
ANNEX 8
GENERIC POST APPROVAL
Situation:
1.
Organisations with national coverage may have several training posts around the UK.
2.
These posts may be very similar, in that arrangements for supervision, facilities and
experience offered tend to be applied to the same standard across the organisation.
3.
Currently each training post is administered individually, requiring the full local post
approval with a post visit.
4.
This appears to be inefficient. More than one team of Faculty visitors and RSA is included
simultaneously in approving what might be very similar posts.
Targets:
1.
That the Faculty should develop a process for generic approval of posts within a training
organisation.
2.
That this process not compromise the quality of training and that the PGD is in agreement
with the arrangements.
Proposal:
1.
Generic post approval be considered under certain circumstances;
2.
Criteria for the training organisation should be:
(a) Evidence of pre-existing training capability. The organisation should have a proven track
record of provision of training with more than one SpR having successfully completed the
specialist training within the specified time frame.
(b) A commitment to high quality supervision, with demonstrable compliance with SAC
person specification for the supervisor role.
(c) Agreement that all training posts within the organisation be of equivalent quality.
Essentially the Faculty is transferring the quality control to the organisation itself, which must
be prepared to demonstrate that it has mechanisms in place to ensure this.
3.
Applications for generic approval should be submitted via the appropriate RSA (probably
the region in which the organisation has its head office) to the Faculty. The organisation might
be required to provide evidence to support the criteria above, in addition to the standard post
approval documentation, to the RSA/Training Dean/other SAC member for discussion.
Faculty of Occupational Medicine Training Handbook
Section 2
Guide to Specialist Training
Revision 2
Page 52 of 52
08/12
____________________________________________________________________________
4.
If agreement is given by the Training Dean for generic approval to proceed the PGD should
be notified.
5.
The organisation will then arrange a Faculty visit for post approval in the usual manner, to
one of the posts under consideration. If the post is approved the RSA’s in other regions
containing posts will be notified.
6.
This arrangement will not extend to recruitment of SpR’s into any of these posts, which
must be undertaken as currently with the knowledge of and input from the RSA and local PGD.