Curriculum update

Background to curriculum change

Training curricula for all specialties and subspecialties are being revised in line with the General Medical Council’s (GMC) Excellence by Design standards for postgraduate curricula, introduced in 2017. These standards aim to improve the flexibility of training and to produce curricula that will better support patient, professional and service need, as set out in the Shape of Training Report.

Shape of Training was an independent review led by Professor David Greenaway that looked at potential reforms to the structure of postgraduate medical training in the UK. The final report was published in October 2013. The report indicated a need for doctors capable of providing general care in broad specialties across a range of different settings, requiring postgraduate training to adapt so as to prepare medical graduates able to deliver safe and effective general care.

In response to these recommendations, the College has undertaken the revision of 8 specialty curricula: histopathology, forensic histopathology, paediatric and perinatal pathology, diagnostic neuropathology and chemical pathology, which are managed exclusively by RCPath, and medical microbiology, medical virology, infectious diseases and tropical medicine, which are managed jointly with Joint Royal Colleges of Physicians Training Board (JRCPTB) via the Combined Infection Training (CIT) model.

The JRCPTB are leading on the revision of specialty curricula for haematology and immunology, with oversight from the Joint Training Committee.

Launch events

In 2021, the College held online Curriculum Launch Events for the new specialty curricula, dividing these into 3 presentations: chemical pathology, infection (joint launch with JRCPTB, comprising medical microbiology, medical virology, infectious diseases and tropical medicine) and cellular pathology (comprising histopathology, forensic histopathology, diagnostic neuropathology and paediatriac and perinatal pathology). These events were aimed at training programme directors and educational supervisors and were designed to give a better understanding of the incoming curricular changes and how these would affect trainers on a practical level. 

The recorded presentations and Q&A session are available below:

Chemical Pathology Curriculum Launch Questions and Answers

Questions

If I am on the transitional curriculum and take time out of training for a PhD after ST3, will I return to the transitional curriculum?

So the new curriculum has been approved by the GMC, does this mean that the project and critical appraisal Is now removed from FRCPath exams?

Is the 31st of July 2023 CCT date based on what was used on the previous curriculum? I.e. 5.5 years?

Will there be any resource training to familiarise trainees with the new LEPT system?

What is happening to Stage D requirements? When does your project need to be submitted by on the new curriculum?

If a trainee is not due their ARCP until December this year, will they stay on the current curriculum and using the current LEPT system until after the ARCP in the December?

I am a Chemical Pathology/Metabolic Medicine trainee, how many clinics do we need to attend across the domain to the new curriculum?

Will Chemical Pathology only trainees have clinic numbers defined as the same as Chemical Pathology/Metabolic Medicine?

If Chemical Pathology CCT is performed 31st July 2023, do I still need 12 months Stage D after passing the exam? Or can I pass the exam within a few months of CCT?

When will we know whether the project will continue/stop?

Can previous PHD’s be performed before commencing training?

Examinations

In the poster in ACB FOCUS few weeks ago, they mentioned changes in the FRCPath exam? But it was just mentioned that it’s not confirmed?

Will you be asking TPDs and other educators for their views on changes to the exams?

I have a CP/MM trainee ST6 whose FRCPath project is still outstanding. He will be expected to move to new curriculum. What about the status of FRCPath project if he moves to the new curriculum?

Training

I have a CP trainee who was supposed to have CCT in Dec 2021 but now delayed till at least September 2022 due to exam. So will she need to transfer to the transitional curriculum?

Competency in the generic CiPs are difficult to evidence. Do you have any suggestions as to how best to deliver and these aspects of training?

How will we then record our number of clinics which have already been done?

 

Cellular Pathology Questions and Answers

Training

Why the extra time for diagnostic neuropathology?

CiP 9. It is almost the opposite of the proforma reporting and the dataset reporting practice - how are the clinical educational supervisors expected to manager this dichotomy?

Is AOP every month, quarterly, half yearly, yearly or is it after every specialist attachment?

What is the guidance around the research module? Has the changed from the previous curriculum?

Is there anything in the new curriculum regarding molecular training?

For less than full-time trainees who are due an ARPC before spring 2022 will the move to the new curriculum be after their ARCP or wait to spring 2022

What will the numbers for stage D look like if stage D training is going to be 6 months? Half of these numbers?

Is the new curriculum published on the website?

How would go about addressing the lack of post-mortem practice in a centre?

Is there any scope for subspecialty training in the curriculum?

Is there any guidance on cervical cytology training which is now not reporting in our region making it difficult for trainees to access?

How does digital reporting sit with the curriculum? Digital reporting is not permitted for all cases and there is a defined validation process.

Is the timings for recruitment to paediatrics, forensic and neuropathology going to be changed to take into account the extra 6 months in ICPT?

Have you thought how trainees may achieve dual accreditation and re-enter the training programme? This raises the issue how to recognise existing competencies and adapting the CCT times.

Some specialist centres have complex cases hence fewer numbers, what is your advice regarding these.

Is there scope for a trainee to remain in training for more than 6 months post part 2?

Assessment

How would the Educational Supervisors and Training Programme Directors access the New LEPT system?

Examinations

Will the FRCPath Part 2 be reviewed as well?

Is there any change to when each exam can be first attempted?

 

Infection Diseases Questions and Answers

Training

Has there been any discussion about having a CCT for Infection Prevention and Control?

If trainees do stage 1 training, then do ID/MM, do they get triple accredited?

For Group 2 Dual trainees in ID/MM or ID/MV, what is the exact split to cover curricula in dual specialities- is it half and half of the 3 years

Is there national oversight and decision making about the proportion of NTN’s in the different CCT pathways? Who decides how many NTN’s are needed in ID/IM versus the pure MM for example?

Do trainees need to know which infection stem they want to train in when they start IMT? Or can they drop the 3rd year if they then want to train in ID/MMV?

For tropical medicine, will trainees have to go abroad for a year to achieve this CIP?

Some clarity about how IM is incorporated for ID IM trainees as CIT is the same for both ID MM/MV and ID IM and yet ID IM has to include IM CiPs?

Are 2 Educational Supervisor reports required for an ID/IM trainee during CIT when they are in the lab for a year and not doing any IM at all?

Can an IDMM consultant be the ES for GIM for IDGIM trainees?

A LTFT trainee could enter their final year of training in July 2022 and not have a CCT before August 2023, so what would they do?

Are there transition arrangements for trainees without MRCP still on modified curriculum and also trainees in final year but who end up still in training in Aug 23?

The descriptor required for CiP7 (dealing with imported infection) for a single CCT MM trainee in Yr 2 of HIT (i.e. at the end of pre-CCT training) is only 2 (entrusted to act with direct supervision)

Are there transition arrangements for trainees without MRCP still on modified curriculum and also trainees in final year but who end up still in training in Aug 23?

Will there be PYR’s for trainees in MM or MV as well as for the ID/ IM aspects?

What does entrustment level 4 mean in practice? All trainees are supervised to some extent, even during acting up periods.

Are MM or MV single CCT trainees able to join the programme from the ACCS route?

Should we be encouraging trainees who are switching to new curriculum in 2022, to "prepare" in the year 2021-22? Can they have access to the new e-portfolio early if they want?

We need clarity on the qualifications of the trainer to provide an ES report for each specialty

The table showed CIT trainees to be at entrustable level 2 requiring direct clinical supervision. How does this work with on-call?

Are the mono-specialties of microbiology and virology coming back. We were made to believe that mono-specialties would cease to exist

Examinations

I am interested to hear of changes to FRCPath Microbiology Part 2 exam