FFSRH/MFSRH, CSRH CPD Programme and LoC recertification

The Faculty of Sexual and Reproductive Healthcare (FSRH)

The Faculty of Sexual and Reproductive Healthcare has a membership of over 15,200 (14,880 in UK and 320 overseas). It is a Faculty of the Royal College of Obstetricians and Gynaecologists and sets standards in contraception thus improving health care for all. The FSRH has a specialty training programme in Community Sexual and Reproductive Health (CSRH) leading to registration on the Specialist register of CSRH.

The Faculty:

Gives academic status to the discipline of sexual and reproductive health care. Maintains and develops standards of care and training. Promotes the effective interaction of reproductive health care with related disciplines. Gathers, collates and provides information in support of basic and continuing education in the discipline. Advances medical knowledge and encourages audit and research in the discipline.

The Faculty has had a mandatory continuing medical education programme (known as recertification) since its inception in 1993. There are two programmes, one addressing the needs of Fellows and Members and one addressing holders of the Diploma of the Faculty of Sexual and Reproductive Health. (DFSRH).

In order to bring the FSRH recertification requirements into parity with other Faculties and the Royal Colleges, doctors recertifying from 2012 are required to gain 250 credits in each five year recertification cycle.

Doctors should now aim to collect credits at a rate of 50 per year.

Statement of Principle

The Faculty supports the Ten Principles for College/Faculty CPD schemes as published by the Academy of Royal Medical Colleges¹.

1. INTRODUCTION

The rationale behind participation in CPD and the relevance of CPD to revalidation.

Definition of “Continuing Professional Development”

A continuing process, outside formal undergraduate and postgraduate training, that enables individual doctors to maintain and improve standards of medical practice through the development of knowledge, skills, attitudes and behaviour. CPD should also support specific changes in practice.

Revalidation is the process that will ensure that licensed doctors remain up to date and fit to practise. The two key elements of Revalidation are:

• To confirm that licensed doctors practise in accordance with the GMC’s generic standards (relicensure);
• To confirm that doctors on the specialist register and GP register meet the standards appropriate for their specialty (recertification).

The contribution of CPD to Revalidation is set out in the Chief Medical Officer’s Report, ‘Medical Revalidation – Principles and Next Steps’. Medical Revalidation.

The report states that:

• “Continuing professional development (CPD) is the process by which individual doctors keep themselves up to date and maintain the highest standard of professional practice
• The GMC will require documented proof of CPD as an essential component of the information needed for successful appraisal and revalidation
• CPD belongs to the individual, but there is a need for the organised collection of evidence of appropriate activity, together with some audit of the adequacy of any individual’s programme. To facilitate these requirements, the Colleges and Faculties of the Academy of Medical Royal Colleges have developed CPD Schemes.
• It will be desirable to increase the linkage between CPD and appraisal. Appraisal focuses on meeting agreed educational objectives.
• Monitored systems that define College or Faculty approved educational activities may assist the meeting of those objectives.
• Effective CPD schemes are flexible and largely based on self-evaluation. This lets doctors develop what they do in the context of their individual professional practice while providing evidence for external scrutiny.
• The principles underpinning CPD schemes need to be as simple as possible while providing a good foundation on which to build an appropriate portfolio unique to the individual doctor.”

The Ten Principles support this approach, and in particular, Principles 1, 2 and 10 set out the relationship between CPD, Appraisal and Revalidation. The CPD programme is intended to inform the appraisal process which will culminate in a recommendation to the General Medical Council (GMC) that the doctor has fulfilled the requirements for revalidation. For this reason it is important for the doctor to keep a record of their CPD activities and to fulfill the requirements of the programme in order that the FSRH can confirm that the doctor has done this.

 

2. THE PRINCIPLES OF THE CPD PROGRAMME

Normally, credits given for CPD should be based on one credit equating to one hour of educational activity (or an equivalent measure of educational activity). The minimum required should be an average of 50 credits per year. Credits for un-timed activities such as writing, reading and e-learning should be justified by the participant or should be agreed between the provider(s) and College/Faculty directors of CPD (Principle 4).

It will be the responsibility of individual doctors to ensure that they undertake a range of CPD activities that reflect the local and national needs of their practice and their own learning needs.

• 2.1 Those who are required to participate in the CPD Programme

  All doctors who have a licence to practise will be required to provide documentation that they are participating in CPD in order to keep up to date and fit to practise. Documentation of participation in, and learning from, CPD to the standards set by the College or Faculty will be a requirement for specialist recertification.

• 2.2 Individual personal responsibility for CPD

  Individuals have the responsibility to record CPD that has educational value. Where an activity has not been formally approved for CPD, it is the responsibility of the individual to record the activity and document the learning achieved. Learning may reinforce existing good practice as well as provide new knowledge.

  Self-accreditation of relevant activities and documented reflective learning should be allowed and encouraged (Adapted from Principle 5a). It will be the responsibility of individuals to ensure that they undertake a range of CPD that reflects the local and national needs of their practice and their own learning needs.

• 2.3 How CPD Credits are registered

  Self-accreditation of educational activities will require evidence. This may be produced as a documented reflection. Evidence of attendance at live events or of participation in all other CPD activities should be provided. (Principle 6).

  Doctors wishing to use the FSRH CPD programme should collect evidence and submit to the FSRH office at the end of the five year period three months before their personal revalidation date.

3. THE PROGRAMME

• 3.1 Activity

  As CPD is based on self-assessment, doctors are advised to be involved and engaged in various developmental activities under the areas outlined in the GMC in Good Medical Practice Revalidation.

  Good professional practice

  1. Maintaining good medical practice
  2. Relationships with patients
  3. Working with colleagues
  4. Teaching and training
  5. Management
  6. Audit
  7. Research

  These areas will play a major part in a doctor's appraisal process, which will link into his/her revalidation with the GMC.

• 3.2 Core and Non-core CPD Activity
  
  
  • 3.2.1 'Core' CPD activity

    At least 100 of the credits (100/250) must be in subjects related to Sexual and Reproductive Health. The Faculty has produced a list of topics (which is not exhaustive), which can make up these ‘core' credits (see page 11).

  • 3.3.2 ‘Non-core’ CPD activity

    Up to 150 of the credits (150/250) may be in any area relevant to the doctor's medical work (ie. other than Sexual and Reproductive Health) but MUST include some training in non-clinical professional skills such as teaching, audit methodology, appraising or interviewing skills (see Professional section).

• 3.3.1 The Faculty recognises four categories of CPD
  • Local (L)
  • External (E)
  • Personal (P)
  • Professional (Pr)

  The Faculty requires that the minimum of 100 ‘core' credits contain activities in EACH of the first three categories (L), (E), (P), while there must be some Professional (Pr) activity included in ‘non-core' credits. All categories can include core and non-core.

• 3.3.2 Credit requirement per year and per each 5-year cycle
  • Annual requirement: a minimum of 50 CPD credits
  • 5-year CPD cycle requirement: a minimum of 250 CPD credits

  In special circumstances credits in excess of 50, accrued during one year may be used to count against the minimum requirements in the following year. This would be at the discretion of the General Training Committee (see 3.3.4).

• 3.3.3 Rate of 'Core' CPD Credits

  Certain activities such as re-certifying a Letter of Competence contribute a fixed number of 'core' CPD credits and others have a maximum allocation of credits.

• 3.3.4 Special Circumstances

  Fellows/Members who wish to accrue 'core' CPD credits for an activity that is not mentioned are advised to write to the General Training Committee in order to ascertain the type and amount of credits that may be counted as 'core', before their recertification date.

• 3.3.5 Recording CPD activity

  The Faculty logbook (http://www.fsrh.org/pdfs/FellowsMembersRecertLogbook.xls) allows members to record all activities as they are undertaken. There are sections to record the amount of credits in each category and whether it is 'core' or 'non- core'.

• 3.3.6 Course Programmes

  When applying for certification of participation in the CPD programme a member will NOT always be required to submit supporting evidence of CPD activity, such as course programmes, attendance certificates etc. with their application. However, the General Training Committee will spot check 10% of applications and reserves the right to ask for documentation or evidence of all Professional Development activity. This may change in future to each member having to submit their portfolio once during the 5 year re-accreditation cycle for a check. Doctors are required to keep CPD documentation for their annual appraisals which will be needed for 5 yearly GMC Relicensing

  Local/Internal (L)
  This CPD activity can take place either within the doctor's place of work/department, associated department eg: social services or the local Postgraduate Education department.
  • Local meetings. Attendance at educational meetings eg. postgraduate meetings, study day, updating courses, journal club, case conferences, audit meetings, multidisciplinary meetings, clinical reviews, discussion meetings on new guidelines etc. 1 credit per hour of CPD activity undertaken.
  • Organisation/chairing of educational meetings. 1 credit of CPD per meeting chaired. Maximum of 2 credits of CPD per meeting organised, depending on workload involved. If the same meeting is organised/chaired regularly it can only be counted once per year.
  • Local formal presentations. eg. invited speaker at local postgraduate meetings, formal teaching of medical undergraduates or other health professionals. 3 credits per presentation lasting up to half an hour, up to maximum 5 credits for one hour. Each presentation, if not changed/revised, can only be counted once per 5-year cycle, no matter how many times it is presented. If the content of a presentation has undergone revision it may be counted again.
  • Local informal presentations. eg ad hoc one-to-one teaching of trainees or tutorials, case discussions with colleagues/trainees/students, facilitation of group work etc. Informal presentations may be distinguished from formal presentations in that they may take place ad hoc and do not require lengthy preparation. Maximum of 1 credit per hour, up to a maximum of 6 per year.
  • Participation in Medical Undergraduate Examinations. Preparation and/or presentation of undergraduate teaching does not routinely qualify for CPD credits. Where a new presentation is being prepared, a credit claim may be thought justified, reflective notes can be used to illustrate points learnt. Credits are not automatically allocated for undergraduate examining alone. If a credit claim is thought justified, you should contact the Faculty for further advice

   

  External (E)
  • National and international meetings and conferences. Attendance at speciality meetings relevant to the doctor's medical work e.g. FSRH Annual Symposium, Current Choices, Deanery Adviser Meetings, European Society of Contraception (ESC) meetings, Royal College of Obstetricians & Gynaecologists (RCOG) meetings, British Association of Sexual Health & HIV (BASHH) meetings etc. Number of credits as approved by the Faculty of Sexual & Reproductive Healthcare or other relevant College or Faculty.
  • FSRH meetings. Attendance for at least one day of a FSRH Annual Scientific meeting, Current Choices or Joint BASHH and FSRH Spring conference is compulsory once in the five year recertification cycle.
  • Organisation/chairing of educational meetings. 1 credit of CPD per meeting chaired. Maximum of 2 credits of CPD per meeting organised, depending on workload involved. 5 credits for organising old-style DFSRH course and 2 credits for new-style Course of 5 If the same meeting is organised/chaired regularly it can only be counted once per year.
  • Formal presentations. Invited speaker or presentation at recognised National/ International conference or meeting on a relevant topic. 3 credits per presentation lasting up to half an hour, up to maximum 5 credits for one hour. Each presentation, if not changed/revised, can only be counted once per 5-year PGD cycle, no matter how many times it is presented. If the content of a presentation has undergone revision it may be counted again.
  • Informal presentations. eg facilitation of workshops, chairing a session at national / international meeting. Maximum of 1 credit per hour. Each of these activities can only be counted once per year, no matter how many times it is presented.
  • Participation in Medical Postgraduate Examinations. This includes setting of examination questions, OSCEs, critical reading questions (CRQs), marking of papers/case reports/dissertations.
    • Attendance at Examiner's conferences. CPD credits as allocated and certified by the exam organiser.
    • Postgraduate exam meeting eg. to set exam questions, OSCEs etc. 3 credits per meeting.
    • Examining for mock postgraduate exams. 1 credit per hour up to maximum of 5/year.
    • Examining at MFSRH, MRCOG, DRCOG, MRCGP, Dip GUM examinations. CPD credits as allocated and certified by the exam organiser.
    • Design/development of eg MEQ, CRQ, OSCE scenario. 2 credits per question.
    • Design/development of e-learning module. See under ‘Personal’, point 3.
    • Marking of case histories or evidence based commentaries (EBC). 2 credits.
    • Marking of dissertations. 3 credits.
    • Supervision of dissertations. 3 credits.
  • Contribution to Faculty / Royal College committee work. Serving continuously on a committee. 3 credits per year. If also chair of committee, an additional 5 credits per year may be claimed. Involvement in the development of clinical standards, clinical guidelines, or DFSRH course assessment, Career Grade Trainee Assessments. Subspecialty trainee assessments or undertaking specific projects as part of FSRH/Royal College committee work or any other specific projects undertaken. CPD points allocated by the committee or group convening such work projects eg CEU or GTC.
  • Contribution to wider NHS work. eg member of NICE, SIGN or other national relevant working group/committee. 1 credit per meeting up to a maximum of 6 credits per year. If also chairing of wider NHS working group/committee, 2 credits per meeting up to a maximum of 12 credits per year.

   

  Personal (P)
  • Letters of Competence.
    LoC MEd (8 credits) for obtaining initial award or re-certification.
    LoC IUT and LoC SDI (5 credits each) for obtaining initial award or re-certification.
  • FSRH Special skills modules (SSM). eg Menopause 10 credits
  • Audit. 5 credits per audit project. 3 credits ‘re-audit’ of previous audit project to complete the cycle. 1 credit for initiation/supervision of audit project.
  • Refereed publications. This includes publications in a peer reviewed journal or book, writing a module for FSRH e-learning package, or other projects at the discretion of the Faculty. 5 credits per publication.
  • Other publications. This includes non-refereed publications such as lay press articles, radio presentations, articles for nursing magazine etc. on core topics. 2 credits per publication and 1 credit per radio presentation. Maximum of 12 credits per year provided he topic of each publication is different.
  • Poster presentations. Design and presentation of poster at local or national meetings. 3 credits/poster. Each poster presentation can only be counted once per 5-year cycle, no matter how many times it is presented.
  • Book Authorship, Editorial/Peer Review work.
    • Sole author of book on core topic maximum of 20 credits – check with General Training Committee (GTC).
    • Sole editor of a book on core topic, 10 credits per book.
    • If the member is one of a number of joint editors, then 5 credits per book can be claimed.
    • Editing a single paper, 2 credits per paper.
    • Peer reviewing an article, 2 credits per article.
    • Other types of editing, peer reviewing, book writing – check credit status with the Faculty/GTC.
  • Personal Learning Project. This is an opportunity for a doctor to learn a new skill and use that time and experience towards their CPD. Examples include training in abortions, colposcopy, menopause, sexually transmitted infections, psychosexual medicine, forensic gynaecology, child protection, genital mutilation, domestic violence, endometrial ablation, ultrasound, female sterilisation or vasectomy. For personal learning projects achieved through completion of a FSRH (or RCOG) Subspeciality Module. Number of credits as allocated by FSRH. For other supervised or self-directed learning projects, maximum of 20 credits per project. Check credit status with the GTC.
  • Distance learning project. Royal College, Faculty or other approved distance learning programmes (eg BMJ learning, Doctors.net). This category may be extremely useful to doctors who are unable to access other CPD due to personal or geographical reasons. Any CPD approved project will specify the number of credits allocated. (This will also include using the E-learning modules from the DFSRH course as updating material (e-SRH)
  • Other Personal Development activity. eg shadowing the work of others, visiting other centres to learn about other forms of service delivery and working patterns. Maximum of 5 credits. If in doubt with credit status check with Faculty.
  • Additional postgraduate degree. Undertaking a relevant postgraduate degree eg. Masters level. In Education, Epidemiology or Medical Law, Diploma in GUM. If a project is to be used for CPD, the number of credits should be agreed by the Faculty before it is commenced. Maximum of up to 40 credits/project.
  • Writing grant applications. 5 credits/application.
  • Research project. Writing and performing a research project. The number of credits should be agreed by the Faculty before it is commenced. Maximum of up to 40 credits/project.
  • Journal reading in personal time. 1 credit per issue of a peer reviewed journal up to a maximum of 12 credits per year for all professional journal reading activity. Eg: for the FSRH journal all four quarters 4 credits.
  • Reflective learning. eg from case discussions, incident reports etc 1 credit per case.
  • Other. eg providing mentoring (eg being mentor for LoC MEd candidate), appraising colleagues. Maximum of 5 credits.

   

  Professional (Pr)
  This category covers the learning needs of a member to widen the knowledge and skill in areas related to general professional, service and organisation development. A minimum of 25 credits should be obtained in this category. When undertaking training in the following areas the member can collect 1 credit per hour up to a maximum of 150 credits per 5-year cycle. Most of these training programmes are run by the local Trust training departments/Postgraduate Deanery, but they may also be provided by other organisations. Examples of Professional CPD activities:
  • Assessment skills, summative and formative
  • Appraisal, clinical supervision, coaching, mentoring skills
  • Clinical governance issues
  • Risk management, incident reporting and analysing
  • Adult education, teaching and learning techniques
  • Training the trainers
  • Interviewing, consultation and communication skills
  • Critical Reading skills
  • Health and Safety measures
  • Management training
  • Basic Life Support training (may only be counted once per 5 year CPD cycle)
  • Audit skills
  • IT skills
  The above list of examples is not exhaustive.

This is not intended to be an exhaustive list but is indicative of the types of areas considered to be core CPD areas by the Faculty of SRH. Members may seek guidance from Deanery Regional Advisors or the General Training Committee if unsure as to whether any topic falls within or out of the Core area.

 

• Audit - relevant to sexual and reproductive health (SRH)
• Cancer screening - cervix, ovary, breast, bowel, prostate, testes, colposcopy
• Contraception - all methods, reversible and irreversible, new methods
• Endocrinology - Reproductive
• Epidemiology - related to SRH, World population issues
• Ethical issues - associated with SRH
• Failed pregnancy - abortion, miscarriage, ectopic
• Forensic gynaecology, Sexual Assault.
• Genitourinary medicine - sexually transmitted infections, HIV, AIDs
• Infertility/Subfertility - male and female
• Legal issues - associated with contraception, SRH, medical negligence, consent, confidentiality
• Medical gynaecology - menorrhagia, dysmenorrhoea, dyspareunia, endometriosis, PCOS, amenorrhoea, pelvic pain, PMS ,continence, menopause.
• Medical/Surgical problems - impact on sexual health and contraception
• Menopause - climacteric, HRT, PMB, osteoporosis, alternatives to HRT
• Needs of Special groups – eg: People with learning and physical disabilities, the homeless, travellers, drug abusers, ethnic and religious issues, the young.
• Post natal depression
• Preconceptual care - prenatal diagnosis
• Psychosexual issues - relationship issues, gender identity
• World wide Contraception, SRH

Members should start collecting credits five years before the date of recertification and aim to collect an average of 50 credits per year. A record of all CPD activity should be kept as a log book or electronic portfolio. Specific exclusions from consideration for CPD credits Meetings sponsored solely by or promoting products or companies, unless justified by the participant eg presenter at the meeting.

4. Planning and review of individual CPD activity

CPD and Annual Appraisal

Revalidation in the field of CSRH will be under the Specialty Specific framework of the RCOG using the CPD programme outlined here and the appraisal toolkit developed by FSRH. Participation in the Faculty based CPD schemes should normally be confirmed at the annual appraisal as part of the revalidation process. The Individual will need to present their CPD activity/ portfolio to their appraiser and will need to show they have met the annual requirement of 50 credits (Principle 2) (Principle 7).

Annual appraisal will lead to a personal development plan which will include future CPD activity The CPD undertaken should reflect and be relevant to the doctor’s current and future profile of professional practice and performance (Adapted from Principle 1). A copy of the Faculty’s Appraisal Toolkit 2009 is available at: Toolkit

Examples of Evidence for CPD activity for submission to the General Training Committee in the event of a "Spot Check".

The Faculty may require you to submit these documents as part of a routine spot check. (These are meant to guide doctors in preparing their recertification portfolios and are by no means exhaustive).

Educational Activity	EVIDENCE TO BE RETAINED
Attendance at courses or Faculty approved courses directly related to SRH or related to Members other areas of medical work	Course programme, attendance certificates or other proof of attendance
Courses related to Consultation skills	Course programme, attendance certificates or other proof of attendance
Training in educational techniques	Course programmes, attendance certificates or other proof of attendance Evidence of teaching in Adult education Programmes Evidence of training/participating in assessment techniques
Video consultation reviews	Statement of satisfactory assessment from approved reviewer
Small group teaching and one to one tutorials	Letter/certificate of participation by group leader or tutor + discussion topics/ material
Peer review of clinical practice	Journal acknowledgement of receipt of final report
Research & audit projects	Written documentation of research/audit project
Commissioning & implementation of SRH services	Letters of appointment relating to commissioning/service development role, reports of work undertaken with results if any
Completion of approved Faculty or College distance learning packages	Dated copies of reviews and completed answer sheets
Critical reading skills eg Journal club, Journal reading	Details of Journal issues with notes or notes and references.
Informal CPD eg. Staff discussion on guideline and implementation	Record of date /activity and short reflection on developmental content.
Case discussions	Notes kept on the case and action points as in reflective learning, incident report and action taken.

5. Approval and quality control of CPD activities

The Faculty does not formally approve or quality assure CPD events that have been organised by other organisations. The responsibility of deciding the educational value of such meetings rests with the individual. Where the Faculty promotes events it ensures, along with any partner organisations involved, that the events are aimed at the appropriate level, and with appropriate content, for its members – this falls within the remit of the Meetings Committee.

• 5.1. There are a number of items that need to be considered:
  
  • Is the event relevant to your overall learning programme?
  • What will you gain educationally? A check of the publicity literature should inform this choice as this will give you.
  • What subjects are being covered and in what detail and level.
  • The educational aims of the event.
  • A clear description of those for whom the event is primarily intended and what other groups may find it of interest.
  • The format of the event (eg. lectures, workshops) and who the speakers and facilitators.
  • Whether there are materials, such as speakers notes, being made available.
    
• 5.2. Use of feedback and reflection

  After the event the individual will need to reflect on how useful the material presented was and what education they have received eg. was it useful to them in their current practice, was the presentation appropriate, did the event allow them to interact, was the teaching reflecting evidence-based clinical practice or current research. Documented reflective learning is encouraged and a written record of this is acceptable as evidence (Principles 5a and 6).

• 5.3. Evaluation of events

  It is important that events allow for delegates to submit a written evaluation of their opinions of the various components of the meeting/event eg syllabus content, educational value, quality of speaker. All feedback, whether positive or negative should be given to the event organizer. Providers of events should make available evaluations for prospective delegates.

• 5.4. Who carries out the approval of CPD activities

  The General Training committee of the FSRH oversees the CPD programme and decides what activities qualify for CPD.

• 5.5. How the performance of the whole system is monitored

  The General Training Committee audits the programme to verify that claimed activities and the number of credits claimed are appropriate.

• 5.6 Audit of Compliance

  A percentage of submitted portfolios are randomly selected for audit (10%) during their cycle and the individual will be required to present his supporting documents. The committee will highlight any areas that need to be addressed or improved and the individual will be notified to take action.

  This process of verification will remain in place until, or unless an alternative quality assurance process is established across all medical specialties.

• 5.7. Consequences of failing to provide evidence or providing insufficient evidence

  Any individual failing to supply sufficient evidence would in the first place be invited to resubmit further evidence to support their claims. Failure to produce sufficient evidence to support claimed credits will result in an individual’s annual statement being annotated accordingly for the year involved and the individual subsequently being subject to audit annually for a defined period.

  Those failing to do so would have their case forwarded to the General Training Committee (GTC) for advice and a final decision. Further failure or suspected falsification of evidence for claimed CPD activities may call into question the individual’s fitness for revalidation, and may result in referral to the GMC/GDC (Adapted from Principle 10).

• 5.8. How auditors are trained

  Office staff responsible for monitoring the recertification process have an in-depth knowledge of the system and are supported by a nominated member of the General Training Committee who will advise individuals experiencing difficulties.

6. Administration

The programme is administered by clerical staff supporting the GTC. The system is overseen by the General Training Committee with one member dedicated to providing guidance to members and staff.

• 6.1 The Faculty CPD programme is available to all Fellows and Members and to non-Members and Fellows who practise in a relevant specialty (Principle 3).

  Non-members of the Faculty wishing to register for the programme need to contact the committee secretary for the current fee. 2011 £180 inc VAT for verification of a five year cycle.

  All Fellows/Members are automatically registered for the programme and will be advised of their recertification cycle and the submission dates for recognition of their data.

• 6.2 Responsibilities of Employers

  In its Guidance on Continuing Professional Development the GMC Guidance on CPD states:

  • Employers and organisations that doctors work in should recognise the benefits of allowing enough resources for doctors to carry out CPD activities.
  • Resources, such as time to think and access to on-site educational facilities, should be available to all doctors to allow them to develop professionally.

  The responsibility for fulfilling CPD requirements and achieving learning needs rests with the individual doctor. However, the employing organisation (including locum agencies, where applicable) should provide support for professional development in partnership with other relevant bodies.

7. SPECIAL CIRCUMSTANCES

All doctors who hold a licence to practise should remain up to date with the CPD requirements set out by their Medical Royal College or Faculty. Doctors working less than full time have an equal obligation to provide high quality patient care as do those working full time, and thus should maintain the same commitment to their CPD. Colleges and Faculties, as well as employers, should be as flexible as possible in enabling this commitment to be met for all doctors.

In addition, the local arrangements to facilitate CPD should reflect current NHS guidance on equality and diversity in the workplace 4.

In some circumstances participation in CPD may be difficult or impossible for periods of time. The following are some of the circumstances to be considered, and some of the ways in which these may be addressed:

• A rolling five-year programme
  A shortfall in CPD activity at the end of a fixed five-year cycle is difficult to make up. However, the use of a rolling cycle allows the average amount of activity to be maintained over five years if a shortfall occurs.
  
• Doctors undergoing remediation
  CPD will be an essential part of the remediation process.
  
• Doctors who are suspended
  This is likely to be rare, and the period of suspension before return to work, or a decision on re-training or remediation should be short. Where necessary it should be possible to make up any lost CPD credits over a five-year cycle.
  
• Sick-leave, Maternity Leave or other Career Breaks
  Any deficit in CPD activity should be made up over the remainder of the five-year cycle. This may be achieved either prospectively (where possible) retrospectively after return to clinical work, or a combination. Where the absence is for more than a year, advice from the College or Faculty should be sought.
  
• Doctors who have fully retired from clinical practice
  If a retired doctor wishes to retain a license to practise, then the CPD requirements of the College or Faculty should be met. As much flexibility as possible should be provided, and a doctor experiencing difficulty should contact the relevant College or Faculty.
  
• Non-consultant career grade doctors
  This group of doctors should meet the same CPD requirements as other career grade doctors in their specialty.
  
• Doctors working in isolated environments outside the UK
  In some circumstances the type of CPD activity available may not conform to the quality standards set by the College or Faculty. The doctor should self-accredit as much CPD as appears justifiable in terms of the learning achieved. Any shortfall should be made up on return to the UK. Periods of absence of more than one year may require specific CPD as agreed with the doctor’s appraiser, College or Faculty.
  
  

1. Academy of Medical Royal Colleges 10 Principles of CPD. AoMRC, London 2007.
   http://www.aomrc.org.uk/publications/reports-guidance/doc_download/9327-10-principles-of-cpd.html
   
2. Medical Revalidation – Principles and Next Steps. Department of Health, 23rd July 2008.
   http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_086430
   
3. Guidance on Continuing Professional Development. GMC, London, 2004.
   http://www.nhsemployers.org/excellence/equality-diversity.cfm
   
4. GMC good medical practice
   http://www.gmc-uk.org/static/documents/content/GMP_0910.pdf
   

Appendix 1

Academy of Medical Royal Colleges10 Principles of CPD
THE TEN PRINCIPLES FOR COLLEGE/FACULTY CPD SCHEMES

1. An individual’s CPD activities should be planned in advance through a personal development plan, and should reflect and be relevant to his or her current and future profile of professional practice and performance. These activities should include continuing professional development outside narrower specialty interests.
2. CPD should include activities both within and outside the employing institution, where there is one, and a balance of learning methods which include a component of active learning. Participants will need to collect evidence to record this process, normally using a structured portfolio cataloguing the different activities. This portfolio will be reviewed as part of appraisal and revalidation.
3. College/Faculty CPD schemes should be available to all members and fellows and, at reasonable cost, to non-members and fellows who practise in a relevant specialty.
4. Normally, credits given by Colleges/Faculties for CPD should be based on one credit equating to one hour of educational activity. The minimum required should be an average of 50 per year. Credits for un-timed activities such as writing, reading and e-learning should be justified by the participant or should be agreed between the provider(s) and College/Faculty directors of CPD.
5. a. Self-accreditation of relevant activities and documented reflective learning should be allowed and encouraged.
   b. Formal approval/accreditation of the quality of educational activities for CPD by Colleges/Faculties should be achieved with minimum bureaucracy and with complete reciprocity between Colleges/Faculties for all approved activities. The approval/accreditation process and criteria should be such as to ensure the quality and likely effectiveness of the activity.
6. Self-accreditation of educational activities will require evidence. This may be produced as a documented reflection. Formal CPD certificates of attendance at meetings will not be a requirement, but evidence of attendance should be provided, as determined by each individual College or Faculty.
7. Participation in College/Faculty based CPD schemes should normally be confirmed by a regular statement issued to participants which should be based on annually submitted returns, and should be signed off at appraisal.
8. In order to quality assure their CPD system, Colleges/Faculties should fully audit participants’ activities on a random basis. Such peer-based audit should verify that claimed activities have been undertaken and are appropriate. Participants will need to collect evidence to enable this process.
9. Until alternative quality assurance processes are established, the proportion of participants involved in random audit each year should be of a size to give confidence that it is representative and effective. This proportion will vary according to the number of participants in a given scheme.
10. Failure to produce sufficient evidence to support claimed credits will result in an individual’s annual statement being endorsed accordingly for the year involved and the individual subsequently being subject to audit annually for a defined period. Suspected falsification of evidence for claimed CPD activities will call into question the individual’s fitness for revalidation, and may result in referral to the GMC/GDC.