Creating consistency in training of Obstetrics and

Gynaecology across the UK

Developing a Standards Matrix for Educational
Progression

Background

The RCOG have noted that there is variation between deaneries on how to
assess training progression and outcomes. This can lead to inconsistencies in the
management of specialty O and G trainees across the UK. Issues that have
arisen are:

 Trainees who fail to pass MRCOG part 1 by the end of ST2 are given
different ARCP outcomes across the deaneries

 Deaneries use Work Based Assessments in different ways e.g. some

deaneries use the Opening and Closing the Abdomen OSATS as an essential
OSATS to pass from ST1 to 2. Others use this to assess more complicated
abdominal entry associated with gynaecological operating at ST4 level.

 Deaneries also assess and rate non clinical aspects of training differently
e.g. clinical governance, training of others, research and management.

The RCOG would like to take a national leadership role in coordinating the
standards of training in Obstetrics and Gynaecology.

Introduction

Training standards are set by GMC through standards documents and the
specialty guides and by RCOG through the curriculum. All training and
assessment of training should comply with the Gold or Orange Guides, as
appropriate, and all training in Obstetrics and Gynaecology must follow the GMC
approved RCOG developed curriculum. Both the RCOG curriculum and
associated assessment framework and the Gold Guide are regularly updated.

The ARCP process reviews the trainee’s progress. The outcome of the ARCP
should never be a surprise to the trainee or educational supervisor as any areas
of concern or exceptional success should have been discussed prior to ARCP.

Proposal

Although RCOG set out the content of the specialty curriculum and provide
guidance upon the required assessments and standards there is deanery
variation in the implementation. To provide structure for the deaneries we
propose a system to provide calibration.
 • The development of a national Standards Matrix for Educational
Progression which addresses the standard expected at each level of
training and guidance upon the ARCP outcome in situations where the
standards are not achieved.

• The standards matrix will be SMART Specific, Measurable, Attainable,

Realistic and Timely.

• The principles and specific detail of the standards matrix will be agreed by
consensus among the Heads of Schools/Chairs STC. The Standards Matrix
will be reviewed regularly in light of curriculum changes and feedback
from trainers and trainees through Heads of School/Chairs meeting.

• All deaneries should agree to implement and assess trainees

against the Standards Matrix. Additionally, through a process of
consensus, all deaneries will agree ARCP outcomes should
trainees fail to achieve the requirements of the standards matrix.

• It is recognised that specific trainee centred educational plans may need

to be developed for individual trainees at times. In the situation that a
Programme Director or Head of School has done this for an individual
trainee over a specific training time then this takes precedence over
consensus derived training standards.

• The development of these clear training objectives will allow objective

setting at the induction interview between Educational Supervisor and
Trainee.

Responsibilities of the RCOG

The RCOG will offer a leadership and facilitation role. The RCOG should co-
ordinate the design of the standards matrix guidelines for each of years ST1-7,
determining the minimum standards for clinical skills training, examinations,
workplace based assessments, and non clinical skills expected for each trainee
for each year of training.

This will be initially developed through SEAC in consultation with trainees

(through Trainee Committee). Thereafter discussion and consensus will be
arrived at through the Heads of Schools/Chairs meeting - this will be a regular
item on the agenda. Final ratification of the agreed standards matrix will be at
RCOG Education Board. RCOG will approach COPMeD for approval to strengthen
the reliability of the proposal.

The RCOG will publish the standards matrix for training on the website.

Responsibilities of the Deaneries

• The Deaneries will, through the Heads of School/Chairs STC and

Programme Directors (once the principle is approved by COPMeD), agree
the principles and specific standards regarding training for each ST level.
 • The Schools/STC can enter additional standards to the Standards Matrix.
Schools/STCs will be able to expect standards that are higher than the
minimum agreed but not lower.

• At deanery level the Standards Matrix must be made available to trainees

– the suggestion that this should be within the deanery website.

• The Schools should use the Standards Matrix at the ARCP of each trainee
to determine whether or not trainees have met the correct standard in
each area to pass through to the next year of training.

• The Heads of School/Chair STC should develop agreed national principles

relating ARCP outcomes with success/ failure against the Standards Matrix
for Educational Progression. These principles would be for general
guidance and would not prevent a PGD or HoS working outside these
guidelines in exceptional cases.

Responsibilities of the trainees

• Views of the trainees will be sought from the Trainees Committee

• The RCOG Trainees Committee representatives at SEAC and HoS/Chairs

meeting will be able to actively contribute to the development of the
Standards Matrix for Educational Progression.

• Individual trainees should be aware of the Standards Matrix and strive to

obtain all the standards expected, aiming higher than the requirements.

Process for Approval

• Proposal and provisional draft of standards matrix to be submitted to

SEAC (Sept 2010)

• Seek feedback from Trainees Committee upon proposal

• Revised proposal to be discussed at next HoS/Chairs meeting with

agreement to agree the first version of the standards matrix at the next
meeting (Spring 2011)

• SEAC HoS should be consulted to determine the initial Standards Matrix

involving.

• Seek feedback from Trainees Committee upon Standards Matrix

• Review of standards matrix at summer Education Board meeting.

• Seek approval of the principle from COPMeD

• Matrix on website for new entry trainees August 2011.

 • Consideration of asking COPMED to review the principles (as above
COPMeD must approve otherwise there is no guarantee of
implementation)

• At each HoS meeting, thereafter, the principles of training document and

the Standards Matrix should be discussed as a standing item.

Chair and Vice Chair SEAC September 2010.