Community Sexual and Reproductive Health Specialty Training Programme (CSRH)

CSRH Specialty Training Programme is the most competitive specialist training programme in the UK. Launched in 2010, the Specialty curriculum in SRH aims to train a consultant workforce with the necessary leadership skills – and clinical skills - for community based Sexual and Reproductive Health services.  It aims to produce medical consultants who are trained both to deliver specialist clinical care themselves; but also, to be highly-skilled systems leaders who provide leadership to the bulk of routine SRH care that comes from nurses, GPs, healthcare assistants or other professionals. 

 

Decision aid for ARCPs - COVID-19

There are two routes available through the FSRH for medical practitioners who wish to gain specialist registration in Sexual and Reproductive Healthcare (SRH): 

  • CSRH - Community Sexual and Reproductive Healthcare
  • CESR - Certificate of Eligibility for Specialist Registration

Hear from one of our Specialty trainees about training on the CSRH programme.

Who to contact
For any questions regarding any of the two specialty training routes, please contact Mitesh Chauhan (Specialty Development Officer)
at specialty@fsrh.org or 020 7724 5187. 

Intellectual Property Rights
All intellectual property rights for any FSRH qualification including documents, materials and content belonging to and produced by the FSRH should not be used for purposes other than FSRH training. Should you wish to use any of the IPR for purposes other than FSRH training you must seek the FSRH’s approval in writing with your request via our copyright request form. We aim to respond to submissions of this nature within one working week.

2017 CSRH Curriculum

Entry requirements

Please download the CSRH person specification: ‘Community Sexual and Reproductive Health ST1’ for full details of eligibility at the following link.

Programme information 

Please download the full trainee handbook for a detailed overview of the programme. 

CSRH Curriculum & Pathway

The CSRH Specialty Training Programme is a six-year programme, divided into basic, intermediate and advanced training, across 15 modules. It is one of two training routes available through the FSRH for medical practitioners who wish to gain specialist registration in Sexual and Reproductive Healthcare (SRH).

2017 CSRH Curriculum pathway

 

 

 

 

 

 

 

 The CSRH Specialty Training Programme is a six-year programme, divided into basic, intermediate and advanced training, across 15 modules. It is one of two training routes available through the

Modules
Module 1 Basic Clinical Skills
Module 2 Contraception
Module 3 Unplanned Pregnancy & Abortion Care
Module 4 Gynaecology
Module 5 Specialist Gynaecology
Module 6 Pregnancy
Module 7 Menopause & PMS
Module 8 Genitourinary Medicine
Module 9 Public Health
Module 10 Teaching, Appraisal & Assessment
Module 11 Ethics and Legal Issues
Module 12 Leadership, Management & Governance
Module 13 IT, audit and Research
Module 14 Sexual Assault
Module 15 Sexual Problems

Link to full existing curriculum here. 

How will I learn?

You will learn using various methods including: 

  • Work-based learning
  • Induction and educational meetings (appraisal)
  • Training Courses/Events
  • e-Learning Resources

How will I be assessed?

You will be assessed using various methods including: 

  • MFSRH Examination
  • Workplace-based assessments (WPBAs)
  • Directly Observed Procedural Skills (DOPS)
  • Directly Observed Clinic (DOC)
  • Multi-source Feedback – Team Observation
  • Multi-source Feedback  - Patient Feedback
  • Reflective practice and recording reflection

Outcomes?

  • Upon successful completion of the CSRH Specialty Training Programme, the trainee will be eligible to apply to the GMC for Certificate of Completion of Training (CCT).
  • Specialist Registration, eligible to register as a Specialist GP

Fees

How to apply?

How to apply

Information and guidance

 Centralised recruitment for the Community Sexual and Reproductive Healthcare (CSRH) specialty is managed by Health Education England (HEE) on behalf of the FSRH programme at various locations. Further information on CSRH Specialty recruitment and application procedures can be found on the Health Education England Website here. You may also find the CSRH Applicant Guide and the CSRH FAQ section helpful in answering your application query.

 Online Application form

To apply for a place on the CSRH Specialty Training Programme, please complete the online application on the Oriel NHS recruitment portal here.

 If you have any queries about CSRH recruitment that cannot be answered via the methods above, please contact HEEE.recruitmenthelpdesk@nhs.net

 

 

MFSRH Exam

MFSRH Exam

 

2021 CSRH Curriculum

 

 

 

 

Introduction to the Community Sexual & Reproductive Healthcare (CSRH) curriculum

The FSRH will launch a new curriculum in August 2021 for the Community Sexual & Reproductive Healthcare (CSRH) specialty training programme. It is designed to equip the SRH profession with the skills, knowledge and attributes needed for the future. The CSRH curriculum has not fundamentally changed since its introduction in 2010, although minor changes have been made over the years.

While the detail of the clinical content remains unchanged, it will be presented in a different way with a much stronger focus on non-technical skills, patient safety and the patient experience.

The purpose of this training package is to guide SRH doctors through the transition to the new curriculum. It explains why a change was needed, what will be changing and the resources that will be available to enable doctors to successfully transfer to the new curriculum.

Additional resources will continue to be added to the Training Package during the implementation of the new curriculum so please do keep checking back!

Learning outcomes

When you have completed this training package, you will be able to:

  • understand why a change to the CSRH curriculum was needed
  • explain the structure of the new CSRH curricula and how it will be assessed
    • recognise what is different and the impact that this will have on the training programme/educational supervision
    • understand the transition process from the old to new curriculum and how to access the guidance materials/resources available to support this.

Key points

  • The FSRH will launch a new CSRH curriculum in 2019 to equip the SRH profession with all the skills, knowledge and attributes needed for the future.
  • All colleges and specialties are required by the General Medical Council to move to a high-level outcomes approach. This means specifying the general capabilities that all doctors should have by the end of their training programme. This is a very different approach to the current one which is based on the notion of competency in clinical skills and procedures.
  • The core training programme will remain at 6 years, with waypoints also remaining the same.
  • Much of the current clinical content is the same. However it will be described, packaged and assessed differently.
  • The new curriculum is designed to promote and encourage the exercise of professional judgement, both by the Trainee and the trainer. This is a fundamental concept of the new curriculum.
  • The current emphasis on tick-boxes and numbers of assessments will be replaced by an expectation that the Trainee doctor will take responsibility for their own learning, by deciding what evidence will be appropriate to demonstrate progress, and by assessing their own performance.
  • Likewise, Educational Supervisors will make global assessments of a Trainee’s performance and make a recommendation to the ARCP panel as to progression. The final decision as to progression will rest with the ARCP panel.
  • Detailed guidance for Trainees and Educational Supervisors on the expectations for each year and stage of training has been developed. This guidance is integrated in to the ePortfolio.
  • The curriculum will be delivered through a new version of the ePortfolio which has been designed specifically for our curriculum. All Trainees and Educational Supervisors will be able to access their old and new curricula on the new version.

The Curriculum

List of CSRH procedures

Forms

Assessment

What is the programme of assessment?

The programme of assessment refers to the integrated framework of examinations, assessments in the workplace and judgements made about a trainee during their approved programme of training.

The purpose of the programme of assessment is to clearly communicate the expected levels of performance and ensure these are met on an annual basis and at other critical progression points. It also demonstrates satisfactory completion of training as required by the curriculum.

What kinds of assessments are there?

The programme of assessment comprises the use of several different assessment types. These include workplace-based assessments (formative and summative) and MFSRH examinations (summative). Multi-source feedback in the form of Team Observation also continues. All our assessments are linked to the relevant Capabilities in Practice.

So what has changed?

In many ways, not much has changed about the way training is assessed. The workplace-based assessments are well established in CSRH training but have been revised to include an element of reflection and, in the case of Team Observation, self-assessment. The MFSRH will be changing to reflect the new curriculum, and there are also some structural changes – but the question types are the same. For the first time, the knowledge requirements for the curriculum will constitute the formal syllabus for the MFSRH.

The two main differences are the embedding of reflective practice and feedback into assessment; and the emphasis on professional judgement in reaching a global assessment. The process of assessment has moved from ticking boxes to professionals making judgements about progress in gaining the capabilities in practice required for independent practice. You will already be making these judgements in your current practice.

WPBA forms and instructions

Presentation on assessment

Curriculum Definitive Document

Knowledge Requirements

Matrix of progression

Trainee video

Case study - Develop case study of a patient as per RCOG

 

Knowledge requirements and MFSRH Syllabus

Workplace-based assessments

Objective Structured Assessment of Technical Skills (OSATS)

For the procedures that are fundamental to the practice of SRH, an objective assessment tool has been configured to aid the review process. OSATS are validated assessment tools for testing technical competency in a named technique. OSATS will be used throughout training until the trainee has demonstrated that they are competent to practice independently. The use of OSATS formatively can be undertaken as many times as the trainee and their supervisor feel is necessary. A trainee may be regarded as competent to perform a procedure independently after they have completed three summative OSATs by more than one appropriate assessor. For ST1-3 only, a Letter of Competence is equivalent to three summative OSATS for certain procedures.

Formative case-based discussion (CbD)

The CbD assesses the performance of a trainee in their management of a patient, or of clinical and non-clinical situations, to provide an indication of competence in areas such as clinical reasoning, decision making and application of medical knowledge in relation to patient care. It also serves as a method to document conversations about, and presentations of, learning experiences by trainees. The CbD should focus on a written record (such as written case notes, out-patient letter, and discharge summary or learning event, such as a teaching session, meeting or audit). A typical encounter might be when presenting newly referred patients in the outpatient department. The existing tool has been modified so that the trainee completes it and adds an element of reflection, as has been the practice in other specialties for some time. The CbD can be used for both clinical and non-clinical learning experiences.

 

Mini-Clinical Evaluation Exercise (mini-CEX)

This tool evaluates a clinical encounter with a patient to provide an indication of competence in skills essential for good clinical care such as history taking, examination and clinical reasoning. The trainee receives immediate feedback to aid learning. The mini-CEX can be used at any time and in any setting when there is a trainee and patient interaction and an assessor is available. The existing tool has been modified so that the trainee completes it and adds an element of reflection, as has been the practice in other specialties for some time.

Directly Observed Clinic (DOC)

The DOC is an assessment technique for senior trainees (ST4 and above) that uses a clinic to assess a number of competencies. The assessor uses multiple Mini-CEX proformas to cover a range of competencies that trainees must demonstrate as they work with multiple patients and colleagues during the course of the clinic. Although each consultation can be treated as a Mini-CEX, the assessor should also judge overall performance; in particular, whether a trainee has demonstrated a level of professionalism consistent with someone who will be mostly practicing independently and will soon be a consultant.

The DOC can, and where possible should, be combined with a short Patient Satisfaction Questionnaire (PSQ). This is given to patients by reception as they enter the clinic and collected as they leave. These patient responses should form part of the feedback trainees receive at the end of the assessed clinic. The PSQs can then be pooled with up to 30 other patient questionnaires from clinics, analysed and then reviewed by the trainee and their trainer. PSQs can also be developed by the local trust or the CSRH unit.

Multi-source feedback

The TO1 form is a multi-source feedback tool based on the principles of Good Medical Practice, as defined by the General Medical Council (GMC, 2019). TO1 forms are used to obtain feedback from a range of healthcare professionals and forms part of a trainee’s assessment. The TO1 is a snapshot feedback tool to be used by individuals at a fixed point in time. Individual team members completing a TO1 form should do so based on their experience of working with the trainee. The trainee will also be able to self-assess using a modified TO1 form (SO). The TO1 forms are summarised in a TO2 form which informs the ARCP. We have introduced the feature of self-assessment to the process, as required by most 360 feedback, thereby introducing trainees to what they will need to do as consultants.

A trainee needs to gather at least ten TO1 forms and complete one themselves as a self-assessment. It is suggested that more forms are sent out so that enough responses are received. The ePortfolio lets the trainee manage the process for completing TO1 forms, as follows:

  • Trainee decides with the Educational Supervisor who should receive the TO1 forms. It is important that this is a joint decision, and that the forms are sent to a broad range of colleagues in a variety of disciplines, and that this is done at an appropriate time, ie. before a placement has ended
  • Use the Ticket Request function in the ePortfolio to send out the forms
  • Trainee will be able to see how many forms have been completed; initially, however, only the Educational Supervisor can see what they say

TO2 form

The Educational Supervisor is responsible for reviewing the TO1 forms and generating a TO2 form for the ARCP. Having reviewed the content, Educational Supervisors should be encouraged to let their trainees see their TO2 form for themselves. If any forms include any unexpected ‘unsatisfactory’/‘improvement needed’ results, however, the Educational Supervisor may need to meet the trainee first in order to give constructive feedback and provide suitable support to address the issues identified, and to notify the training programme director of this plan. TO2 forms are used with other evidence to determine the ARCP outcome.

A particularly poor TO2 form can itself be enough to produce an ARCP outcome 3. A poor TO2 score would include either ‘unsatisfactory’/‘improvement needed’ or substantial negative comments in the free text sections. If a trainee receives such a score, the Educational Supervisor will discuss this with them before the ARCP.

The WBA forms will be embedded in the Training ePortfolio and are provided below for your reference:

Summative Assessment

  • Objective Structured Assessment of Technical Skills (OSATS)/Letter of Competence (LOC)

Formative Assessment

  • Case-based discussions (CbD)
  • Mini-Clinical Evaluation Exercise (mini-CEX)
  • OSATS – formative
  • Team observation (TO1), TO2 and self-observation (SO)
  • Directly Observed Clinic (DOC)
  • Patient Satisfaction Questionnaire (PSQ)

 

ARCP's

Matrix of progression

The matrix of progression has been adapted for the new curriculum. A downloadable version of the new matrix can be found here.

Educational Supervisors Report (ESR)

NEEDS SUBSTANTIAL EDITING

Trainees remaining on the 2017 Curriculum

Trainees remaining on the old curriculum will need to meet the requirements of the 2018-2019 Training matrix(link is external).

They should complete the Pre-2019 Advanced Competencies Form:

  • at present, this must be created by the trainee’s assigned Educational Supervisor (we will be introducing the ability for trainees to create this form in the coming weeks)
  • the supervisor does this by going into their own profile page, then selecting “Additional forms” > “Create Pre-2019 Advanced Competencies Form”
  • further information on this can also be found in Implementation note 8(link is external) on the RCOG website.

They should also complete the Pre-2019 Educational Supervisor’s Report (ESR):

  • as above, this must be created by the trainee’s assigned Educational Supervisor
  • the supervisor does this by going into their own profile page, then selecting “Additional forms” > “Create Pre-2019 Supervisor’s Report”
  • information regarding new ATSM CiP assessments should be added as free text to this form, within the ATSM section.

Trainees on the Post-August 2019 Curriculum

The majority of trainees will have transferred to the Post-August 2019 curriculum and will need to meet the requirements of the 2019-2020 Training matrix.(link is external)

Detailed information and guidance on completion of the new curriculum is available on the RCOG website:

They should also complete the New Annual Educational Supervisor’s Report (ESR). The RCOG has created a guide on creating and completing the ESR on the new ePortfolio, which is accessible  here.

Important points to note

  • All necessary CiP assessments, WPBAs, log entries, etc. must be completed before the ESR is created – existing draft ESR forms will not auto-populate with any of these items that are completed subsequent to ESR creation
  • The ESR has a trainee > supervisor > trainee workflow which must be followed, detailed in the guidance – failure to follow this workflow correctly will lock the form and prevent further data entry, and it is not possible for the RCOG to reverse this process at present.

 

Curriculum 2021 Resources

 

 

 

Background to the CSRH curriculum

Why have we done this?

If we think back to some of the drivers for the change and why are we changing the curriculum at all, we need to go back to David Greenaway's report, 'Shape of Training', which outlined what doctors in a modern healthcare system would look like and really trying to reintroduce broad-based training, particularly in the medical specialties. People do respiratory medicine or cardiology and there are very few general physicians left. We need to move away from highly specialised doctors and making sure that everyone within our specialty can deliver basic SRH care and work on on-call rotas.

 In tandem with this report, the GMC began to consider what should be the generic skills – non-technical skills such as communication and leadership - that all doctors should possess. These skills have become increasingly important, and although curricula referred to them, they were not sufficiently embedded. When you look at the reasons 2 for referral to the GMC, then it is often not for knowledge skills or technical skills – it is due to those non-technical skills The GMC therefore developed Generic Professional Capabilities, for all medical specialties to incorporate into their curricula, and thus we have a responsibility to make sure that we train our doctors in the skills that they're going to need for the future. So, like all the other postgraduate medical curricula, our curriculum has had to change its emphasis.

In terms of our own specialty curriculum, the need for doctors to follow the Community Sexual and Reproductive Health (CSRH) curriculum is evident in key public health policies in the United Kingdom over the past decade which have acknowledged the return on investment (ROI) and importance of accessible, high quality SRH services within the National Health Service (NHS). Fragmented commissioning pathways can create barriers to accessing SRH care, which in turn exacerbate health inequalities, particularly for those experiencing language, cultural, financial and geographical barriers.  In some instances, access to the full range of contraceptive methods may be restricted. GPs, practice nurses and other healthcare professionals must be adequately supported to gain and maintain the necessary competencies to deliver all available methods of contraception in order to reduce unplanned pregnancies and enable individuals to have children at a time of their choosing. 

 Promoting leadership in the CSRH curriculum will drive change and will also support the needed partnership-working with other healthcare providers, the voluntary sector and patients themselves. Supporting the population to manage their own health is an important part of addressing socio-economic inequalities but also SRH services will strike a balance between providing universal and targeted interventions.

 What kind of consultant are we looking for?

The CSRH consultant is a clinical expert, a systems leader of SRH services and provides training and support to a wide body of healthcare professionals.

The CSRH Consultant is a highly skilled doctor trained in Sexual and Reproductive Healthcare throughout the life course, including the following: managing the whole sphere of contraception (contraceptive provision for all people including those with medical or social complexities, and managing complex specialist contraception), gynaecology, abortion, unplanned pregnancy, menopause, PMS, psychosexual care and sexual wellbeing and the immediate management of STI and sexual assault. The CSRH CCT holder is also highly skilled in providing targeted SRH care for individuals with complex psychosocial needs.

 The CSRH consultant is able to manage and lead an SRH service in line with the principles of public health, while being able to provide teaching, training, mentoring and assessment support to all professionals providing contraception care and STI and SRH in various settings across the healthcare system. 

 CSRH specialists are not trained to provide ongoing HIV care and do not undertake maternity or obstetric care.

Presentation for a new curriculum for Comnimuty Sexual and Reproductive Health

How did we get there?

The FSRH embarked on a long journey in 2016, not just to review the CSRH but also to consider changes that were needed for the MFSRH. Activity intensified in 2019, with a number of focus groups and workshops, as outlined in Table 1 below. The FSRH Lay Rep and trainee representatives have played an active part in the creation of the new curriculum.

TABLE 1 CSRH AND MFSRH DEVELOPMENTAL WORKSHOPS

 

April 2019

Workshop 1

  • Develop the Curriculum descriptors for the CSRH Specialty Curriculum, mapped against each Professional Identity and Capability In Practice (CiP). 
  • Review competencies from 2017 CSRH Curriculum including clinical skills requirements (taking into account Aug 2018 Focus Group feedback, module guardian feedback 2018, stakeholder consultation feedback)
  • Categories of the competencies including patient presentations and conditions
  • Benchmark requirements against national standards and guidance

May 2019

Workshop 2

  • Further development of key skills and curriculum descriptors for the Capabilities in Practice

June 2019

Workshop 3

  • Develop programme of assessment

June 2019

Workshop 4

  • Further develop programme of assessment
  • Evidence to inform decision,
  • Level descriptors, entrustment decision scales
  • Review summative MFSRH assessment

July 2019

Workshop 5

  • Further develop programme of assessment
  • Review existing CSRH 2017 formative assessments (identify gaps, limitations)
  • Develop 2020 CSRH Matrix of progression
  • Develop blueprint of assessments mapped to CiPs

September 2019

Workshop 6

  • Review further modifications required to make current assessment tools suitable for the new curriculum
  • Develop CiP Guidance/Syllabus for 2020 CSRH Curriculum

September 2019

September 2019 Examiners Conference

  • Review proposals for changing the exams

January 2020

Examinations Convenor Workshop

  • Map existing MFSRH exams components against new 2020 Curriculum
  • Review existing blueprinting methods

January 2020

Workshop 7

  • Agree syllabus mapping and alignment between MFSRH Exams Question Bank and CSRH 2020 curriculum and syllabus.
  • Discuss gaps, levels, areas over/underassessed, and finalise MFSRH exams syllabus for each exam component

February 2020

Examinations Committee Meeting – Post workshop session

  • Review test blueprint and overarching blueprint
  • Review question weightings for the MFSRH exam components
  • Review exams mapping gap report

July 2020

CiP Guide Workshop

  • Workshop to review the CiP guides
  • Review the evidence required by a trainee for each CiP

July 2020

CESR Workshop to review Specialty Specific Guidance

  • Workshop to review the evidence required for the equivalence route to CSRH

As a necessary part of the process, the FSRH consulted widely about the changes it intended to make as outlined in Table 2 below. It also consulted the Lead Dean, Dr Ann Boyle, and NHS Employers.

 

TABLE 2 FSRH ONLINE CONSULTATIONS

 

July - August 2018

CSRH Sexual Assault Components Survey

September - November 2018

CSRH Curriculum Review Stakeholder Survey

September - November 2019

MFSRH Exams Review Stakeholder Survey

6 December 2019 – 20 January 2020

CSRH Curriculum Review Survey- internal curriculum (examiners, educational supervisors, trainees)

5 March 2020 – 24 March 2020

CSRH Curriculum Survey – Wider stakeholders

18 May 2020 – 31 May 2020

MFSRH changes survey – Wider stakeholders, internal curriculum (examiners, educational supervisors, trainees)

 

Who oversaw the development of our new curriculum?

The Specialty and Exams Review Project Steering Group (SESG)/Assessment & Curriculum Committee was responsible for overseeing the Specialty Curriculum Review Project, and the MFSRH Exams Review Project. As the project progressed, the Steering Group signed off progression and delivery of project milestones ensuring quality and educational robustness, as well as alignment with GMC standards and FSRH strategy. Members of the Steering Group met on a weekly basis to finalise the new curriculum and MFSRH for submission to the GMC. The SESG is the authority for this project and had final sign off all products to do with the review and implementation plan. The SESG reports to the Education Strategy Board and works closely with the main Assessment & Curriculum Committee, Examinations Committee and Specialty Advisory Committee.

The membership of SESG is shown below.

Co-Chair/Executive Sponsor

Dr Janet Barter (Vice President Specialty)

Co-Chair/Executive Sponsor (Internal FSRH)

Dr Jo Lawton (FSRH Director for Education and Training)

VP Specialty

Dr Janet Barter

Clinical Lead: CSRH Curriculum Review and Assessments

Dr Catherine Schunmann

Clinical Lead:  MFSRH Exams Review Project

Dr Gillian Robinson

Education Lead: Project Manager

Kim Scrivener

Specialty Advisory Committee Chair

Dr Charlotte Porter

Examinations Committee Chair

Dr Indhu Prabakar

Senior Users – CSRH Trainee Representatives

Dr Tom Hesse and Charlotte Gatenby

Patient and Public Consumer Representative

Toni Benfield

Trainer Representative
(Educational Supervisor/Trainer Representative)

Dr Manisha Singh

 

 

 

The Curriculum

Forms

Assessment

What is the programme of assessment?

The programme of assessment refers to the integrated framework of examinations, assessments in the workplace and judgements made about a trainee during their approved programme of training.

The purpose of the programme of assessment is to clearly communicate the expected levels of performance and ensure these are met on an annual basis and at other critical progression points. It also demonstrates satisfactory completion of training as required by the curriculum.

What kinds of assessments are there?

The programme of assessment comprises the use of several different assessment types. These include workplace-based assessments (formative and summative) and MFSRH examinations (summative). Multi-source feedback in the form of Team Observation also continues. All our assessments are linked to the relevant Capabilities in Practice.

So what has changed?

In many ways, not much has changed about the way training is assessed. The workplace-based assessments are well established in CSRH training but have been revised to include an element of reflection and, in the case of Team Observation, self-assessment. The MFSRH will be changing to reflect the new curriculum, and there are also some structural changes – but the question types are the same. For the first time, the knowledge requirements for the curriculum will constitute the formal syllabus for the MFSRH.

The two main differences are the embedding of reflective practice and feedback into assessment; and the emphasis on professional judgement in reaching a global assessment. The process of assessment has moved from ticking boxes to professionals making judgements about progress in gaining the capabilities in practice required for independent practice. You will already be making these judgements in your current practice.

WPBA forms and instructions

Presentation on assessment

Curriculum Definitive Document

Knowledge Requirements

Matrix of progression

Trainee video

Case study - Develop case study of a patient as per RCOG

 

Knowledge requirements and MFSRH Syllabus

Intro to Curriculum resources

A year in the life of an Educational Supervisor

We have produced some interactive animations for the new curriculum depicting A year in the life of an ES which can be accessed here:

Assessments: a trainees perspective

Contributors

ARCP's

Matrix of progression

The matrix of progression has been adapted for the new curriculum. A downloadable version of the new matrix can be found here.

Educational Supervisors Report (ESR)

NEEDS SUBSTANTIAL EDITING

Trainees remaining on the 2017 Curriculum

Trainees remaining on the old curriculum will need to meet the requirements of the 2018-2019 Training matrix(link is external).

They should complete the Pre-2019 Advanced Competencies Form:

  • at present, this must be created by the trainee’s assigned Educational Supervisor (we will be introducing the ability for trainees to create this form in the coming weeks)
  • the supervisor does this by going into their own profile page, then selecting “Additional forms” > “Create Pre-2019 Advanced Competencies Form”
  • further information on this can also be found in Implementation note 8(link is external) on the RCOG website.

They should also complete the Pre-2019 Educational Supervisor’s Report (ESR):

  • as above, this must be created by the trainee’s assigned Educational Supervisor
  • the supervisor does this by going into their own profile page, then selecting “Additional forms” > “Create Pre-2019 Supervisor’s Report”
  • information regarding new ATSM CiP assessments should be added as free text to this form, within the ATSM section.

Trainees on the Post-August 2019 Curriculum

The majority of trainees will have transferred to the Post-August 2019 curriculum and will need to meet the requirements of the 2019-2020 Training matrix.(link is external)

Detailed information and guidance on completion of the new curriculum is available on the RCOG website:

They should also complete the New Annual Educational Supervisor’s Report (ESR). The RCOG has created a guide on creating and completing the ESR on the new ePortfolio, which is accessible  here.

Important points to note

  • All necessary CiP assessments, WPBAs, log entries, etc. must be completed before the ESR is created – existing draft ESR forms will not auto-populate with any of these items that are completed subsequent to ESR creation
  • The ESR has a trainee > supervisor > trainee workflow which must be followed, detailed in the guidance – failure to follow this workflow correctly will lock the form and prevent further data entry, and it is not possible for the RCOG to reverse this process at present.

 

ARCP Case studies

Patient Case study

Self-assessment checklist for Training Package

Training ePortfolio

 

Full information coming soon

Transfer onto new curriculum

Regional Champions

FAQ's

ESR process

ePortfolio resources

ePortfolio technical issues

 

CESR route & information

Please download the GMC Specialty Specific Guidance for ‘Community Sexual and Reproductive Health’, which provides a detailed overview of application requirements and evidence required for CESR applications.

CSRH Specialty Curriculum
Please refer to the latest version of the CSRH Specialty Curriculum at the time of submission

Programme information - please down load the CESR Applicant Guide  for information on how to apply 

The CESR is one of three training routes available through the FSRH for medical practitioners who wish to gain specialist registration in Sexual and Reproductive Healthcare (SRH).

Current key dates

  • August 2020 - submission to the GMC Curriculum Advisory Group (CAG) with the new CSRH Curriculum & MFSRH Examination
  • November 2020 - initial response from the GMC CAG
  • January 2021 - decision from GMC on the new CSRH Curriculum and MFSRH examination
  • February 2021 - launch of revised ePortfolio
  • March 2021 - new CSRH Curriculum will be launched
  • October 2021 - deliver the new Part 1 MFSRH examination
  • June 2022 - deliver the new Part 2 MFSRH examination
  • August 2020 - submission to the GMC Curriculum Advisory Group (CAG) with the new CSRH Curriculum & MFSRH Examination

Please note, these dates may change and are subject to GMC approval in January 2021.

If you are a CESR applicant
The GMC CESR guidance for applicants states that applications are assessed against the curriculum that is in place at the time they apply. Any CESR application must be in alignment with the new Specialty Specific Guidance.

We will publish more guidance closer to the planned GMC decision date of January 2021, but please note that this date may change.

If you are a MFSRH Part 1/Part 2 exam candidates
We will share detailed guidance to support candidates as soon as possible after GMC approval.

 

Specialty Specific Guidance (SSG)

CESR Handbook

Doctors who wish to find out more about the application process for a CESR should refer to the GMC´s specialty specific guidance for CESR and CEGPR applicants available on its website. This pack provides applicants with the generic information they need to start putting together an application.

Is there any funding available?

There is up to £5,000 funding per applicant

 

If you are applying for Equivalence (CESR), there is an opportunity to apply for a grant towards your application. Grants will be awarded up to £5,000 per successful applicant. 

CESR Top-Up-Fund Application and criteria 
Please follow this link to apply for the CESR top-up fund

CESR Case study

How to apply for CESR

The Curriculum

List of CSRH procedures

Forms

Workplace-based assessments

Objective Structured Assessment of Technical Skills (OSATS)

For the procedures that are fundamental to the practice of SRH, an objective assessment tool has been configured to aid the review process. OSATS are validated assessment tools for testing technical competency in a named technique. OSATS will be used throughout training until the trainee has demonstrated that they are competent to practice independently. The use of OSATS formatively can be undertaken as many times as the trainee and their supervisor feel is necessary. A trainee may be regarded as competent to perform a procedure independently after they have completed three summative OSATs by more than one appropriate assessor. For ST1-3 only, a Letter of Competence is equivalent to three summative OSATS for certain procedures.

Formative case-based discussion (CbD)

The CbD assesses the performance of a trainee in their management of a patient, or of clinical and non-clinical situations, to provide an indication of competence in areas such as clinical reasoning, decision making and application of medical knowledge in relation to patient care. It also serves as a method to document conversations about, and presentations of, learning experiences by trainees. The CbD should focus on a written record (such as written case notes, out-patient letter, and discharge summary or learning event, such as a teaching session, meeting or audit). A typical encounter might be when presenting newly referred patients in the outpatient department. The existing tool has been modified so that the trainee completes it and adds an element of reflection, as has been the practice in other specialties for some time. The CbD can be used for both clinical and non-clinical learning experiences.

 

Mini-Clinical Evaluation Exercise (mini-CEX)

This tool evaluates a clinical encounter with a patient to provide an indication of competence in skills essential for good clinical care such as history taking, examination and clinical reasoning. The trainee receives immediate feedback to aid learning. The mini-CEX can be used at any time and in any setting when there is a trainee and patient interaction and an assessor is available. The existing tool has been modified so that the trainee completes it and adds an element of reflection, as has been the practice in other specialties for some time.

Directly Observed Clinic (DOC)

The DOC is an assessment technique for senior trainees (ST4 and above) that uses a clinic to assess a number of competencies. The assessor uses multiple Mini-CEX proformas to cover a range of competencies that trainees must demonstrate as they work with multiple patients and colleagues during the course of the clinic. Although each consultation can be treated as a Mini-CEX, the assessor should also judge overall performance; in particular, whether a trainee has demonstrated a level of professionalism consistent with someone who will be mostly practicing independently and will soon be a consultant.

The DOC can, and where possible should, be combined with a short Patient Satisfaction Questionnaire (PSQ). This is given to patients by reception as they enter the clinic and collected as they leave. These patient responses should form part of the feedback trainees receive at the end of the assessed clinic. The PSQs can then be pooled with up to 30 other patient questionnaires from clinics, analysed and then reviewed by the trainee and their trainer. PSQs can also be developed by the local trust or the CSRH unit.

Multi-source feedback

The TO1 form is a multi-source feedback tool based on the principles of Good Medical Practice, as defined by the General Medical Council (GMC, 2019). TO1 forms are used to obtain feedback from a range of healthcare professionals and forms part of a trainee’s assessment. The TO1 is a snapshot feedback tool to be used by individuals at a fixed point in time. Individual team members completing a TO1 form should do so based on their experience of working with the trainee. The trainee will also be able to self-assess using a modified TO1 form (SO). The TO1 forms are summarised in a TO2 form which informs the ARCP. We have introduced the feature of self-assessment to the process, as required by most 360 feedback, thereby introducing trainees to what they will need to do as consultants.

A trainee needs to gather at least ten TO1 forms and complete one themselves as a self-assessment. It is suggested that more forms are sent out so that enough responses are received. The ePortfolio lets the trainee manage the process for completing TO1 forms, as follows:

  • Trainee decides with the Educational Supervisor who should receive the TO1 forms. It is important that this is a joint decision, and that the forms are sent to a broad range of colleagues in a variety of disciplines, and that this is done at an appropriate time, ie. before a placement has ended
  • Use the Ticket Request function in the ePortfolio to send out the forms
  • Trainee will be able to see how many forms have been completed; initially, however, only the Educational Supervisor can see what they say

TO2 form

The Educational Supervisor is responsible for reviewing the TO1 forms and generating a TO2 form for the ARCP. Having reviewed the content, Educational Supervisors should be encouraged to let their trainees see their TO2 form for themselves. If any forms include any unexpected ‘unsatisfactory’/‘improvement needed’ results, however, the Educational Supervisor may need to meet the trainee first in order to give constructive feedback and provide suitable support to address the issues identified, and to notify the training programme director of this plan. TO2 forms are used with other evidence to determine the ARCP outcome.

A particularly poor TO2 form can itself be enough to produce an ARCP outcome 3. A poor TO2 score would include either ‘unsatisfactory’/‘improvement needed’ or substantial negative comments in the free text sections. If a trainee receives such a score, the Educational Supervisor will discuss this with them before the ARCP.

The WBA forms will be embedded in the Training ePortfolio and are provided below for your reference:

Summative Assessment

  • Objective Structured Assessment of Technical Skills (OSATS)/Letter of Competence (LOC)

Formative Assessment

  • Case-based discussions (CbD)
  • Mini-Clinical Evaluation Exercise (mini-CEX)
  • OSATS – formative
  • Team observation (TO1), TO2 and self-observation (SO)
  • Directly Observed Clinic (DOC)
  • Patient Satisfaction Questionnaire (PSQ)

 

Knowledge requirements and MFSRH Syllabus

CESR Support

Knowledge requirements and MFSRH Syllabus