Trials and tribulations of the annual review of competence progression – lessons learned from core medical training in London

Abstract

The annual review of competence progression (ARCP) was introduced as a way of keeping records and reviewing satisfactory progress through a medical curriculum for doctors in training. It provides public assurance that doctors are trained to a satisfactory standard and are fi t for purpose. A routine external review of the core medical training (CMT) ARCPs in London revealed documentation of satisfactory progression of trainees to the next level of training without the evidence to support their completion of the curriculum. An internal review and series of process interventions were subsequently conducted and implemented to improve the quality and standardisation of the ARCPs. This paper reviews these interventions, discusses the lessons learned from the internal review and highlights issues applicable to any ARCP process.

Postgraduate medical education quality metrics panels can be enhanced by including learner outcomes

“…25 Subjectively, the Quality Forum felt some regions were more rigorous than others in ensuring training requirements were met before awarding satisfactory outcomes, a claim substantiated in the literature. 25 28 Lack of consistency is a significant concern for quality metrics as it prevents benchmarking and comparison between regions. Benchmarking compares the performance of one institution or region against a comparator that represents best practice to identify any opportunities for improvement.…”

“…31 It may even be possible to produce a number of centralised ARCP panels that conduct the ARCPs across the country. 28 Administrative support is important and must be sufficient to meet the needs of the assessment so that the clinicians and assessment leads have the time to consider the academic issues of the assessment. 31 In short, ARCPs need the same processes, rigour, scrutiny and investment as other high-stakes assessments such as OSCEs.…”