Andrew SkinnerJames Cook University Hospital

STC chair

Being an ES

Being an ES

• Good supervision is essential

• Support

• Advice

• Revalidation

• Not Friendship

So we need good ESs

• Trained

• Approved by your DME - the GMC is keen on this

• E&D - and selector training, ARCP training, appraisal training and so on would help us a lot

• Something else, ideally the deanery approved course

• Good practice in Educational Supervision - you may even see me there.

The basics• Arrange to meet them

• Meet them!

• Cover the essentials

• Get them to document it

• You check it

• They upload it to their E-portfolio

• Meet them within 2 weeks

• Somewhere safe

• Plan all aspects of their training over the attachment

• What can they sign off in this attachment?

• What assessments do they need?

• MSF every year plus for every ICM attachment - BOTH!

• Audit or something equivalent

What else?• Basically are they OK?

• Look at their appraisal, ARCP and anything from their last place

• Ask them

• Are their plans and ideas realistic?

• Where are they heading in the next few years?

• Do you need to make changes and adaptations to support them?

• Be kind

• Be supportive

• There is no need to make friends

• Actually it might be better not to BUT

• You must be trustworthy and honest for them

• You need to be available always and meet from time to time - documented meetings

• You need to actively make certain they are OK

• You need to be a conduit for any events and opinions in the department

• You don't need support for routine meetings but both parties might consider it…

• The school is there to help – honestly•Especially if there is anything at all amiss•We need to know

•Progress, health, stress – anything – esp. time off

• All of the curriculum needs WPBAs mapped to key learning outcomes in the curriculum

• ICM Annex F needs a large number of competencies but now can use evidence from anaesthetics

• Make sure they've read the Gold Guide and the relevant bits of the curriculum - it is their training after all

• The rules on time and non AL / SL have changed

• There are four bits:

• Basic

• Intermediate

• Higher

• Advanced

They are all separate

Finally

• At the end of an attachment there is an end of attachment form (paper and a pilot)

• Unless it is pre ARCP, when it is the ESSR and electronic

• The trust will send to the PSU any significant events

• You should already know about these and it is worth commenting on the forms, especially if they are closed, because the PSU isn't full of anaesthetists

CT1

• Are they registered with the college?

• In an MDO?

• In a trades union (IMHO)

• Plans for the IAC or if they've done that do they have a certificate? Have the school and the RCoA got copies?

CT1

• Are their plans for the primary sound?

• The college suggests not taking the MCQ before the IAC

• Have they any idea how much time a postgraduate exam takes?

CT1 & 2 - Will they get an ST job?

• BLTC and the whole CT curriculum - without this they simply lose the job. Obs is essential. They cannot finish it off in ST3

• Google Anaesthetics Portfolio 2013 Self Assessment Criteria

• Audit? Managed a big project, closed the loop? Read the guidance. More than one a year scores

• Presentations other than audit? Ideally regional meetings or better, more than one a year

• Teaching - consistent and at a high level. Feedback or evidenced?

• ALS plus two more (this is a change)

• Primary before 12/12 (this is a change)

Actually of course they will!

But there are popular UoAs

ST3 & 4• All the above but

• Are they going to get the final?

• Will they get it early so they can move on to their CV?

• S/L if they've not done neuro and cardiac to see it done, probably paeds too

• Tons of work - really. Do they have a plan? Courses? The right books?

ST3 & 4• Have they got a BLTC? Do the college

and the school both have a copy?

• Are they registered as an intermediate trainee with the college?

• Do they have a good plan to do all the curriculum?

• What can they sign off in your unit?

ST5, 6 & 7• They must have the hang of it now but

• Make sure the college and the school have a copy of their ILTC

• They must have had a projected CCT date from the college, in writing and the deanery and the school must each have a copy

• Make sure they have realistic plans for the curriculum

• and for their CV

Anaesthesia for neurosurgery, neuroradiology and neurocritical care Cardiothoracic anaesthesia and cardiothoracic critical care General duties

Airway management* Day surgery ENT, Maxillo-facial and dental General, urological and gynaecological surgery Management of respiratory and cardiac arrest* Non-theatre Obstetrics Orthopaedic Regional Sedation Transfer medicine Trauma and stabilisation Vascular surgery

Intensive care medicine Paediatrics8 of the 13 General duties units need to be completed* Means essential so these two and six more

Essential units ST5, 6 & 7

Optional units ST5, 6 & 7

• Pain medicine

• Ophthalmic

• Plastics/Burns

• Anaesthesia in developing countries

• Conscious sedation in dentistry

• Military anaesthesia

• Remote and rural anaesthesia

• Do they know what they want to do?• Where?• Look at consultant job adverts on NHS

jobs• What will they put in the boxes?• Tell them to write an ideal application

and spend the rest of their time making their CV fit it

• Make sure they don’t click on “send”!• Will they get a job and will it be one they

want

• Management course

• Current ALS, perhaps others

• Attended a research methods course

• Sign off the professionalism bits of the curriculum

Advanced year

• This is new (well newish)

• 12/12 of advanced training

• ST6 & 7

• Few new clinical skills

• It is for the CV not the curriculum

• Emphatically it is not to catch up

• It really needs to be done by end of ST6 so the work done is coming to fruition by job applications

• It means good projects not simply gassing

• You can do most things with the school's support

• It isn't simply the old fellowships, most of these are simply part of a general duties module

•Domain 1 – Clinical practice

•Domain 2 – Team working

•Domain 3 – Leadership

•Domain 4 – Innovation

•Domain 5 – Management

•Domain 6 – Education

Advanced year

Advanced options•Anaesthesia for neurosurgery, neuroradiology and neurocritical care

•Cardiothoracic anaesthesia and cardiothoracic critical care

•Intensive care medicine

•Obstetrics

•Paediatrics

•Paeds ICM (they need urgent help!)

•Pain medicine

•Plastics/Burns

Everything else is in general duties

General duties•Airway management

•ENT, maxillo-facial and dental surgery

•General, urological and gynaecological surgery

•Hepatobiliary surgery

•Vascular

•Day surgery

•Sedation and conscious sedation in dentistry

•Orthopaedics

•Regional

•Trauma and stabilisation

•Transfer medicine

“Several” “at least two”

ARCPs

• Trudie will talk about them in detail

• Outcomes 1-6, 7 and 8

• The bad outcomes are 6 and 1 unless you are really really ready

• All on evidence and only evidence - you cannot come and plead

• They are the formal assessments of progress to a tenured job with a good salary

• So they will be formal and searching

• We dress properly and I think they should

• They cannot be a stranger to the curriculum but neither should they be a stranger to ironed shirts and tidy dress.

• They are all face to face now

• We can clarify and advise

• We do not need to reconvene if we've seen them

• If you have any doubts at all contact us - the surprise bad outcome is really bad

• Evidence of remediation is not taken as read

• We need to know about any leave that isn't annual leave or study and professional leave - it all tots up now

ARCPs - your job

• Is to verify that the evidence is correct

• Summarised on the ESSR form

• Confirm as far as you know the revalidation questions

• Which you will know if you and your dept are working properly

It sounds worse than it is!

• But the standard of ES supervision and support, especially the honesty and integrity, is key to attracting both trainees and new colleagues