Equivalence applications 2013: alternative routes to the GP and Specialist Registers

Transcription

1 Equivalece applicatios 2013: alterative routes to the GP ad Specialist Registers

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3 Itroductio This report gives a overview of decisios we made i 2013 o Certificates of Eligibility for Specialist Registratio (CESR) ad Certificates of Eligibility for GP Registratio (CEGPR). This is our first aual report o applicatios for CESR ad CEGPR. We hope that it will be useful for potetial applicats, ad help to iform others with a iterest i this. The report covers decisios that we made i What this report shows What are CESR ad CEGPR ad how are they awarded? What happeed i How we ve improved the process. Useful poits for applicats. Issues highlighted through the applicatio process. Our plas to update the CESR ad CEGPR processes. Geeral Medical Coucil 01

4 What are CESR ad CEGPR ad how are they awarded? Doctors who are appoited to hoorary, fixed-term or substative cosultat posts i UK health services must be o the Specialist Register. Doctors who practise as GPs i UK health services, other tha doctors i traiig, must be o the GP Register. 79% of CEGPR applicatios were successful i 2013 * 02 Geeral Medical Coucil

5 48% of CESR applicatios were successful i 2013 * Before a doctor ca be added to the Specialist or GP Register, we check that they have the traiig, qualificatios ad experiece eeded for their specialty. Most doctors demostrate that they have such traiig through successfully completig specialist traiig curricula desiged by the relevat medical royal college. We issue these doctors with a Certificate of Completio of Traiig (CCT), which etitles them to specialist or GP registratio. Doctors who have t completed approved traiig programmes, but who have gaied the equivalet qualificatios, kowledge, skills ad experiece ca apply for a CESR or CEGPR. We will work with the relevat medical royal college to review a rage of evidece ad make sure that the doctor has the equivalet qualificatios, kowledge, skills ad experiece for that specialty. * Data are from 1 Jauary to 31 December The umbers should ot be used to determie the likelihood of success; they are historical oly ad do ot idicate a pass mark. Each applicatio is assessed o its ow merit ad its ow evidece. Geeral Medical Coucil 03

6 The CESR/CEGPR process 90% of delegates o traiig courses ru by the GMC would be likely to recommed the evet to a colleague * Whole process from start to decisio ca take ie moths. Decisio must be retured to applicat withi three moths from poit at which applicatio is set to royal college or faculty. Applicat applies to the GMC for CESR or CEGPR. GMC seds applicat list of evidece to submit for applicats. Applicat submits evidece to the GMC. GMC quality checks evidece agaist the expected stadards for that specialty. GMC passes applicatio to medical royal college for evaluatio. Medical royal college returs its evaluatio to the GMC. GMC makes fial decisio o etry to the register. APPROVE Applicat s ame etered oto the GP or Specialist Register. Applicat ca: request a review withi 90 days of the decisio (see appedix 1 for details) reapply withi three years of the decisio (see appedix 1 for details) appeal the outcome withi 28 days of the decisio. * Data are from 1 Jauary to 31 December The umbers should ot be used to determie the likelihood of success; they are historical oly ad do ot idicate a pass mark. Each applicatio is assessed o its ow merit ad its ow evidece. These optios are applied flexibly ad ca be used more tha oce for each applicatio. Oce all the optios have bee exhausted, a applicat would eed to begi a ew applicatio. REJECT GMC advises applicat of decisio, icludig requiremets eeded to meet the stadards. 04 Geeral Medical Coucil Geeral Medical Coucil 05

7 What happeed i /5 applicats gaied their primary medical qualificatio from outside the EEA 06 Geeral Medical Coucil

8 Number of applicatios I applicatios were submitted * I 2013, we received 473 CESR applicatios ad 50 CEGPR applicatios. This is a slight icrease from 2012, whe we received 459 CESR ad 42 CEGPR applicatios. The umber of applicatios by type ad specialty i 2012 ad 2013 are show i appedix 2. We received applicatios i 57 specialties i 2012 ad 62 i The te most commo specialties accouted for 64% of applicatios i 2012, ad 60% of applicatios i I 2012, the most commo specialties were: geeral surgery (50 applicatios) trauma ad orthopaedics (44) geeral practice (42). I 2013, the most commo specialties were: geeral practice (50) geeral psychiatry (42) geeral surgery (39). * Data are from 1 Jauary to 31 December The umbers should ot be used to determie the likelihood of success; they are historical oly ad do ot idicate a pass mark. Each applicatio is assessed o its ow merit ad its ow evidece. Geeral Medical Coucil 07

9 Half of first applicatios are successful The graph below shows the umber of applicatios that were grated ad refused. This is broke dow by specialty ad medical royal college i appedix 3. I both years, about 50% of first applicatios were successful. Grated 2012 Rejected Not defemdable/ grated 1 5 applicatios Rejected 10 New CESR evaluatio 1 Heard Appeals Adjourmets Grated 2 2 Withdraw I 2013, 2 the highest proportio of were i surgical specialties 3 Total Geeral Medical Coucil

10 Where applicats gaied their primary medical qualificatio Table 1 shows where recet CESR ad CEGPR applicats gaied their primary medical qualificatio. Numbers for each coutry for the two periods are show i appedix 4. I 2012 ad applicats had a primary medical qualificatio from Idia Table 1: Where our applicats gaied their primary medical qualificatio * 1 Jauary 31 December 2012 CESR CEGPR Total % success UK % EEA % Rest of the world % Total Jauary 31 December 2013 CESR CEGPR Total % success UK % EEA % Rest of the world % Total EEA=Europea Ecoomic Area Four out of five applicats gaied their primary medical qualificatio from outside the EEA. We received a substatial umber of applicatios from doctors with a primary medical qualificatio from Idia (288 out of 1065 i total over both periods) ad from Pakista (165). * This data reflects umbers of applicatios rather tha those o which we have made a decisio. The umbers also iclude those applyig for CESR or CEGPR as well as applyig for registratio ad licece to practise. Geeral Medical Coucil 09

11 How we ve improved the process I Jauary 2013, we made 100% of decisios withi the legal deadlie 10 Geeral Medical Coucil

12 Streamliig the evaluatio process To make the evaluatio process as smooth ad quick as possible, our Specialist Applicatios team has worked closely with medical royal colleges to trai evaluators. This meas we do t have to sped time queryig iformatio or askig for additioal iformatio at this poit i the process. Durig 2013, we traied over 150 evaluators. Feedback has bee ecouragig. Evaluators gave their traiig sessio facilitators a average ratig of 90%. 91% of evaluators who atteded a traiig sessio said they would recommed the course to their colleagues. These traiig sessios have helped to improve the quality of evaluators writte assessmets. We have bee able to measure these improvemets by trackig the decrease i the umber of evaluatios that we retured to the medical royal colleges to ask for further iformatio or clarificatio. I 50% of evaluatios i 2012, we did ot eed to request ay further iformatio. This rose to 76% i Durig 2013, we traied over 150 evaluators Geeral Medical Coucil 11

13 Better support ad iformatio for applicats We have updated our guidace o CESR ad CEGPR applicatios to help applicats to supply the right iformatio at the right time. Our Specialist Applicatios team has also ru traiig sessios for over 100 prospective CESR ad CEGPR applicats, advisig them o how to structure their evidece. Over 100 potetial applicats atteded our traiig sessios i Geeral Medical Coucil

14 Meetig the legal deadlie for more applicatios The three-moth deadlie for decisios begis whe the applicatio is give to the medical royal college for evaluatio, ad eds whe we sed our decisio to the applicat. We have substatially reduced the turaroud time for CESR ad CEGPR applicatios. I 2012, we made fewer tha 40% of decisios withi the three-moth deadlie. I Jauary 2013, we made 100% of CESR ad CEGPR decisios withi deadlie for the first time sice the CESR/CEGPR applicatio process was established i Sice the, we have met the deadlie for over 95% of decisios every moth. I 2013, we received applicatios i 62 specialties Geeral Medical Coucil 13

15 Useful poits for applicats Applicats must demostrate all competecies i the curriculum 14 Geeral Medical Coucil

16 Commo errors to avoid From processig hudreds of applicatios, we have observed some commo errors that applicats make. Sedig documets we ca t accept Both a hospital stamp ad sigature from someoe i a medical supervisory role are eeded to autheticate ad validate cliical evidece submitted as part of a CESR or CEGPR applicatio. If cliical evidece is ot coutersiged by someoe i a medical supervisory role, this meas the evidece ca t be cosidered i the evaluatio. Whe this happes, we remid applicats about the guidace o our website ( certevidece). Our specialty specific guidace also addresses this topic ( Not readig the curriculum i full The applicatio will always be assessed agaist the curret versio of the curriculum. Curricula are competecy based ad applicats must demostrate all of the competecies withi them. Each curriculum has uique areas that eed to be fully addressed with relevat evidece. We suggest that applicats read the curriculum i full before they apply, ad agai oce they have compiled their evidece. This will help to make sure it covers all curriculum competecies. We do ot give evidece that is icorrectly validated or is ot autheticated to the evaluators because we caot be certai that it is a true ad accurate reflectio of the doctor s traiig ad experiece. This ca compromise the applicat s chaces of success. Geeral Medical Coucil 15

17 Nearly all specialty curricula require audit to be fully demostrated Failig to complete or demostrate completig the full audit loop Applicats eed to give us evidece of their experiece i cliical audit. The Natioal Istitute for Cliical Excellece (NICE) defies a cliical audit as a tool for improvig practice, patiet care or services provided It is used to measure curret practice ad care agaist a set of explicit stadards or criteria, idetify areas for improvemet, make chages to practice ad re-audit to esure that improvemet has bee achieved. The fidigs of the cliical audit provide evidece of the quality of practice ad care. Our guidace breaks cliical audits dow ito five stages: defiig criteria ad stadards for ivestigatig a area of practice collectig ad aalysig data from the ivestigatio assessmet of performace agaist criteria ad stadards presetig data i a peer review ad makig recommedatios closig the audit loop by evaluatig recommedatios agaist origial guidelies ad commetig o ay improvemets. 16 Geeral Medical Coucil

18 A applicatio wo t be successful uless it icludes evidece of the madatory core elemet of the curriculum All stages of audit must be demostrated i a applicatio. However, these stages do t eccessarily eed to be show by the same audit. For example, applicats ca demostrate that they have closed the loop o someoe else s audit work as part of geeral quality improvemet activity i order to meet the curriculum requiremets. Omittig sufficiet evidece of core elemets of curricula Applicatios are cosidered agaist the latest versio of the curriculum. These may be broke dow ito core ad higher specialty stadards that the applicats have to meet. A applicatio wo t be successful uless it icludes evidece of the madatory core elemets, eve if the applicat has evidece that they are meetig the higher specialty stadards. Similarly, havig a previous appoitmet to a higher traiig positio ca t i itself be used to show the applicat is meetig curret curriculum stadards. Relyig o secodary evidece Applicats ofte over-rely o secodary evidece, such as testimoials ad CVs. To be successful i the CESR ad CEGPR processes, applicats must give robust evidece to support domais oe, two ad three of Good medical practice before ay secodary evidece ca be cosidered. Primary sources iclude: curret or recet appraisals workplace-based assessmets exam results cotiuig professioal developmet credits from appropriate schemes verified cliical data ad referral letters from practice. Geeral Medical Coucil 17

19 We must make a decisio o the applicatio withi three moths of its referral to the relevat medical royal college Relyig o older evidece Ofte evidece from earlier practice will be ecessary as part of a applicatio. However, it is importat ot to rely too heavily o evidece that is more tha five years old. Not traslatig documets ito Eglish If a applicat is from a o-eglish speakig coutry ad is usig documets that are ot i Eglish, they must traslate all documets ito Eglish. Both the origial ad traslatio must be submitted together, ad we must be able to verify the traslatig orgaisatio. Guidace o this is o our website at Submittig evidece that does t demostrate a coectio to the applicat For example, we ca t accept presetatio slides if they do t idicate the applicat s role i the presetatio, or the aalysis of a audit without referece to the applicat s iput. It is vital that the applicat s role is clear ad that the evidece is relevat to the curriculum i which the applicatio is made. 18 Geeral Medical Coucil

20 Allow plety of time to prepare a applicatio O average, applicatios are about 1,000 pages log, so it ca take weeks to make sure that the evidece is ordered logically, addresses the appropriate requiremets of the domais ad gives evaluators the best chace of successfully evaluatig the applicatio. We must make a decisio o the applicatio withi three moths of its referral to the relevat medical royal college. This icludes time for the evaluators to costruct their evaluatio ad submit the report, ad for us to review to esure its cosistecy ad quality. This time also allows for us to make our fial decisio. This meas that a applicatio will usually take about ie moths from start to fiish. Oce a applicatio is submitted to us, it usually takes betwee three ad six moths to prepare it for evaluatio by our medical royal college parters. We ormally work closely with the applicat durig this time, liig up all the evidece with the checklist of requiremets so it meets the curriculum stadard. I our experiece, applicatios are much less likely to succeed whe there seems to be substatial evidece gaps. However, it is ultimately the applicat s decisio o whether a applicatio is set for evaluatio to the relevat medical royal college. Geeral Medical Coucil 19

21 Issues highlighted through the applicatio process I 2013, 82 applicatios were withdraw by applicats 20 Geeral Medical Coucil

22 Some commo errors that lead to applicatios beig withdraw I 2013, 75 (out of 578) CESR applicatios, ad seve (out of 56) CEGPR applicatios, were withdraw by applicats. This compares with 83 (out of 554) CESR applicatios ad 11 (out of 59) CEGPR applicatios i Applicatios were withdraw by applicats at our quality checkig stage before they were passed oto the medical royal college to evaluate. The most commo reasos for withdrawals were: We updated all our website guidace o CESR ad CEGPR applicatios durig 2013 to clarify our requiremets. We have improved the iformatio for applicats o how to autheticate their documets, validate their evidece ad make sure patiet cofidetiality is maitaied. You ca read the refreshed guidace at cesr_page_1.asp. the applicat had ot covered the etirety of the curriculum i which they were applyig ad could t supply additioal evidece i order to do so a substatial proportio of the applicat s evidece had ot bee validated (see page 15) a applicat had ot iteded to apply for the CESR or CEGPR. I each case, the applicat will have already paid the fee before the applicatio is withdraw. We refuded a proportio of the fee depedig o the stage at which the applicatio was withdraw. The closer the applicatio was to beig set to the college for evaluatio, the lower the refud. We updated all our website guidace o CESR ad CEGPR applicatios durig 2013 Geeral Medical Coucil 21

23 There has bee a rise i appeals Betwee 2012 ad 2013, we saw a large icrease i appeals agaist usuccessful CESR ad CEGPR applicatios (table 2). This icrease has meat that we, alog with medical royal colleges, have had to use more resources to support the process. Durig 2013, we received 23 writte ad oral appeals out of 271 usuccessful applicatios. I five cases, after lodgig a appeal, the doctor gave further evidece to meet the steps outlied i their origial rejectio. It was this additioal evidece after the origial decisio that demostrated their eligibility for etry oto the Specialist Register. This meat we did t cotest these appeals ad the doctors were grated their CESR ad specialist registratio. Of those that were actually heard as appeals, oly two out of 15 doctors were successful, as they had submitted additioal evidece for the appeal hearig that addressed the requiremets from their origial rejectio. Table 2: Outcome of appeals agaist rejected CESR ad CEGPR applicatios (2012 ad 2013) Appeals iitiated 3 23 Appeals as proportio of usuccessful applicatios 1.2% 8.5% Appeals ot defedable 1 * 5 * Appeals heard 2 15 Appeals withdraw 0 3 Successful heard appeals as a proportio of usuccessful applicatios 0% 0.7% * Grated etry oto the Specialist Register. Rejected. 2 adjourmets, 1 ew CESR evaluatio ordered, 2 grated etry oto the Specialist Register, 10 appeals rejected. Withdraw by doctor before the hearig. 22 Geeral Medical Coucil

24 The shortage of evaluators ca impact o our chaces of makig decisios o time We rely o medical royal colleges to evaluate CESR ad CEGPR applicatios. They have a pool of cliicias kow as evaluators from each specialty who do this. Whe a doctor appeals our decisio, they usually supply extesive additioal iformatio. We have to reassess their origial applicatio ad the additioal iformatio i partership with the relevat medical royal college. This is very time cosumig, so the icrease i both applicatios ad appeals has exacerbated the shortage of evaluators i some specialties. The umber of evaluators per applicatio ad the umber of applicatios per evaluator are show i appedices 5 ad 6. Decisios o CESR ad CEGPR applicatios must be made withi three moths, so this shortage affects our ability to meet the deadlie if a backlog develops. We have worked with medical royal colleges to pla ahead for these istaces, by givig earlier otice of pedig applicatios to their admiistrative teams. This gives the colleges more time to fid evaluators who are available to assess the applicatio, icreasig the likelihood that we will issue the decisio withi three moths. The icrease i applicatios ad appeals has exacerbated the shortage of evaluators Geeral Medical Coucil 23

25 Our plas to update the CESR ad CEGPR processes Curret applicatios iclude aroud 1,000 pages of evidece 24 Geeral Medical Coucil

26 Based o the recommedatios edorsed by our Coucil i October 2012, we have begu a programme of chage to review ad improve the CESR ad CEGPR processes. We will focus o two mai aims. To reduce the admiistrative burde o all parties ivolved i the equivalece applicatio process. To develop a process for applyig for CESR ad CEGPR that more closely mirrors the CCT etry route to the Specialist ad GP Registers. For a full list of the recommeded chages we are makig, visit Some chages are short-term ad medium-term adjustmets to our processes, which should have o major effect o applicats or o other parties ivolved i CESR ad CEGPR processes. The log-term chages, which will ot be i place util 2016 at the earliest, will substatially chage the way we hadle CESR ad CEGPR applicatios. Chages recommeded iclude: requirig CESR ad CEGPR applicats to have a licece to practise ad 12 moths experiece of workig i the UK over the past three years havig a way to test the applicat s kowledge i the relevat specialty evaluatig the applicat s performace i the relevat specialty i the UK. We will set up a process i which a applicat is assessed i UK practice, eablig them to produce evidece by way of a performace assessmet. Curret applicatios usually iclude aroud 1,000 pages of documetary evidece which show how the applicat meets the stadards. Our recommeded chages would mea that such extesive documetary evidece will o loger be eeded. As we begi to deliver these chages, we will ask iterested parties for advice ad expertise. Geeral Medical Coucil 25

27 Appedices 26 Geeral Medical Coucil

28 Appedix 1: Some key terms Stadards The stadards doctors have to meet reflect the curriculum of the specialty i which they are applyig. These stadards are based o our core guidace for doctors, Good medical practice. A review If a applicat is usuccessful, they ca apply for a review withi 90 days of receivig our decisio if: they have extra evidece that addresses the shortfalls i our decisio, which they had ot previously submitted, or A applicat will be evaluated agaist the curriculum i place at the time their reapplicatio is submitted. They therefore eed to cosider ay differeces betwee the curriculum that was i place for their origial applicatio, ad the curriculum i place whe they submit their reapplicatio ad submit evidece to cover these differeces. Whe someoe reapplies, we will review the additioal evidece they provide agaist the requiremets we outlied i their origial applicatio decisio. they believe that there has bee a defect i our procedure or other ufairess i the way that we processed their applicatio or made our decisio. Further iformatio o reviews ad reapplicatios ca be foud at certfurtheroptios. A reapplicatio Applicats ca reapply withi three years of receivig our decisio. A applicat usually reapplies: after completig the top-up traiig/experiece outlied i our decisio if they are able to provide evidece that addresses the shortfalls set out i our decisio, which they had ot previously submitted. Geeral Medical Coucil 27

29 Appedix 2: CESR ad CEGPR applicatios by type ad specialty Table 3: CESR ad CEGPR applicatios by type (1 Jauary 31 December 2012) Medical royal college specialty First applicatio Review Reapplicatio Reapplicatio review Total College of Emergecy Medicie Emergecy medicie Faculty of Occupatioal Medicie Occupatioal medicie Faculty of Public Health Public health medicie Faculty of Sexual ad Reproductive Healthcare Commuity sexual health ad reproductio Joit Committee o Surgical Traiig Breast surgery (o-cct specialty) Cardiothoracic surgery Number Grated Number Grated Number Grated Number Grated Number Grated Geeral surgery Neurosurgery Otolarygology Paediatric surgery Plastic surgery Trasplat surgery (o-cct specialty) Trauma ad orthopaedic surgery Urology Joit Royal Colleges of Physicias Traiig Board Geeral Medical Coucil

30 Medical royal college specialty First applicatio Review Reapplicatio Reapplicatio review Total Acute iteral medicie Number Grated Number Grated Number Grated Number Grated Number Grated Allergy Cardiology Dermatology Foresic ad legal medicie o-cct specialty) Gastroeterology Geeral (iteral) medicie Geitouriary medicie Geriatric medicie Haematology Multiple sclerosis (o-cct specialty) Neurology Nuclear medicie Ophthalmological geetics (o-cct specialty) Paediatric cardiology Palliative medicie Rehabilitatio medicie Real medicie Respiratory medicie Rheumatology Sport ad exercise medicie Trasfusio medicie (o-cct specialty) Royal College of Aaesthetists Aaesthetics Cardiothoracic aaesthesia (o- CCT specialty) Itesive care medicie Royal College of Geeral Practice Geeral practice Geeral Medical Coucil 29

31 Medical royal college specialty First applicatio Review Reapplicatio Reapplicatio review Total Royal College of Obstetricias ad Gyaecologists Obstetrics ad gyaecology Royal College of Ophthalmologists Number Grated Number Grated Number Grated Number Grated Number Grated Ophthalmology Royal College of Pathologists Histopathology Royal College of Paediatrics ad Child Health Commuity child health Commuity paediatrics (o- CCT specialty) Neoatal medicie Paediatric dermatology (o- CCT specialty) Paediatric eurology Paediatrics Royal College of Psychiatrists Child ad adolescet psychiatry Foresic psychiatry Geeral adult psychiatry (o- CCT specialty) Geeral psychiatry Old age psychiatry Psychiatry of learig disability Royal College of Radiologists Cliical ocology Cliical radiology Total Geeral Medical Coucil

32 Table 4: CESR ad CEGPR applicatios by type (1 Jauary 31 December 2013) Medical royal college specialty First applicatio Review Reapplicatio Reapplicatio review Total College of Emergecy Medicie Emergecy medicie Faculty of Occupatioal Medicie Occupatioal medicie Faculty of Public Health Public health medicie Faculty of Sexual ad Reproductive Healthcare Commuity sexual health ad reproductio Joit Committee o Surgical Traiig Cardiac Surgery (o-cct specialty) Cardiothoracic surgery Number Grated Number Grated Number Grated Number Grated Number Grated Geeral surgery Neurosurgery Otolarygology Paediatric surgery Plastic surgery Thoracic surgery (o-cct specialty) Trauma ad orthopaedic surgery Upper gastroitestial surgery (o-cct specialty) Urology Vascular surgery Joit Royal Colleges of Physicias Traiig Board Geeral Medical Coucil 31

33 Medical royal college specialty First applicatio Review Reapplicatio Reapplicatio review Total Number Grated Number Grated Number Grated Number Grated Number Grated Allergy Cardiology Cliical europhysiology Coagulatio ad trasfusio medicie (o- CCT specialty) Dermatology Dermatology ad veereology (o- CCT specialty) Diarrhoeal diseases (o-cct specialty) Edocriology ad diabetes mellitus Foresic ad legal medicie o-cct specialty) Gastroeterology Geeral (iteral) medicie Geitouriary medicie Geriatric medicie Haematology Ifectious diseases Medical ocology Medical ophthalmology Neurology Palliative medicie Rehabilitatio medicie Respiratory medicie Rheumatology Sport ad exercise medicie Royal College of Aaesthetists Aaesthetics Cardiothoracic aaesthesia (o- CCT specialty) Itesive care medicie Geeral Medical Coucil

34 Medical royal college specialty First applicatio Review Reapplicatio Reapplicatio review Total Royal College of Obstetricias ad Gyaecologists Obstetrics ad gyaecology Reproductive health (o-cct specialty) Reproductive medicie (o- CCT specialty) Royal College of Geeral Practitioers Number Grated Number Grated Number Grated Number Grated Number Grated Geeral practice Royal College of Ophthalmologists Ophthalmology Orbital, ocular plastic, ad lacrimal disease ad surgery (o- CCT specialty) Royal College of Pathologists Histopathology Royal College of Paediatrics ad Child Health Commuity child health Paediatric allergy, immuology ad ifectious diseases (o-cct specialty) Paediatric ifectious diseases (o-cct specialty) Paediatrics Royal College of Psychiatrists Child ad adolescet psychiatry Foresic psychiatry Geeral adult psychiatry (o- CCT specialty) Geeral psychiatry Geeral Medical Coucil 33

35 Medical royal college specialty First applicatio Review Reapplicatio Reapplicatio review Total Learig disability (itellectual disability) foresic psychiatry Number Grated Number Grated Number Grated Number Grated Number Grated Old age psychiatry Psychiatry of learig disability Royal College of Radiologists Cliical ocology Cliical radiology Total Geeral Medical Coucil

36 Appedix 3: Outcome of applicatios Table 5: Applicatios by college or faculty Orgaisatio Name Applicatios Grated Rejected Applicatios Grated Rejected College of Emergecy Medicie Faculty of Occupatioal Medicie Faculty of Public Health Faculty of Sexual ad Reproductive Healthcare Joit Committee o Surgical Traiig Joit Royal Colleges of Physicias Traiig Board Royal College of Aaesthetists Royal College of Geeral Practitioers Royal College of Obstetricias ad Gyaecologists Royal College of Ophthalmologists Royal College of Paediatrics ad Child Health Royal College of Pathologists Royal College of Psychiatrists Royal College of Radiologists Total Geeral Medical Coucil 35

37 Applicatios by medical royal college CEM FOM FPH FSRH JCST JRCPTB RCA RCGP RCOG RCOph RCPCH 3 RCPath RCPsych 40 RCR Appedix 4: CESR ad CEGPR applicats by coutry of primary medical qualificatio Table 6: Applicats by coutry of primary medical qualificatio (1 Jauary 31 December 2012) Coutry CEGPR CESR Total Coutry CEGPR CESR Total Idia Spai Pakista Libya UK Romaia Egypt Caada Australia Germay Nigeria Ira Iraq Czech Republic Uited States Netherlads Suda Ukraie South Africa Brazil Sri Laka Chia Syria Colombia Bagladesh Greece Republic of Irelad Polad Russia Turkey New Zealad Austria Myamar Greada Geeral Medical Coucil

38 Coutry CEGPR CESR Total Coutry CEGPR CESR Total Malta Jamaica Algeria Japa Argetia Jorda Bosia ad Herzegovia Serbia Frace Sloveia Ghaa Swede Hugary Triidad ad Tobago Israel Total Italy Table 7: Applicats by coutry of primary medical qualificatio (1 Jauary 31 December 2013) Coutry CEGPR CESR Total Coutry CEGPR CESR Total Idia Frace Pakista Greece UK Israel Egypt Lebao Nigeria Afghaista Australia Argetia Sri Laka Barbados Iraq Belarus Syria Bulgaria South Africa Czech Republic Suda Hugary Uited States Nepal Republic of Irelad Netherlads Spai Polad Italy Thailad New Zealad Tuisia Bagladesh Ugada Ira Ukraie Romaia Zambia Brazil Zimbabwe Libya Caada Turkey Cuba Chia Greada Germay Latvia Jamaica Total Jorda Myamar Geeral Medical Coucil 37

39 Appedix 5: Number of evaluators for each specialty Table 8: Number of evaluators for each specialty (July August 2013) * Medical royal college specialty Evaluator umbers Medical royal college specialty Evaluator umbers Joit Royal Colleges of Physicias Traiig Board Joit Committee o Surgical Traiig Acute (iteral) medicie 1 Cardiothoracic surgery 10 Allergy 7 Geeral surgery 18 Audiovestibular medicie 3 Neurosurgery 2 Cardiology 11 Oral ad maxillofacial surgery 2 Cliical europhysiology 4 Otolarygology 4 Cliical geetics 4 Paediatric surgery 2 Cliical pharmacology ad therapeutics 2 Plastic surgery 10 Dermatology 10 Trauma ad orthopaedic surgery 14 Edocriology ad diabetes mellitus 3 Urology 5 Gastroeterology 5 Vascular surgery 2 Geeral (iteral) medicie 7 Royal College of Aaesthetists Geitouriary medicie 5 Aaesthetics 10 Geriatric medicie 15 Itesive care medicie 10 Haematology 4 Royal College of Obstetricias ad Gyaecologists Ifectious diseases 5 Obstetrics ad gyaecology 8 Immuology 7 Royal College of Ophthalmologists Medical ocology 9 Ophthalmology 26 Medical ophthalmology 2 Royal College of Pathologists Neurology 6 Histopathology 34 Nuclear medicie 6 Chemical pathology 8 Paediatric cardiology 2 Diagostic europathology 2 Palliative medicie 7 Foresic histopathology 2 Pharmaceutical medicie 3 Medical microbiology 10 Rehabilitatio medicie 14 Medical virology 3 Real medicie 5 Paediatric ad periatal pathology 3 Respiratory medicie 5 Royal College of Paediatrics ad Child Health Rheumatology 9 Paediatrics 30 Sport ad exercise medicie 10 Royal College of Psychiatrists College of Emergecy Medicie Child ad adolescet psychiatry 6 Emergecy medicie 9 Foresic psychiatry 10 Faculty of Occupatioal Medicie Geeral psychiatry 58 Occupatioal medicie 6 Old age psychiatry 15 Faculty of Public Health Psychiatry of learig disability 12 * Evaluator umbers are from royal college ad faculty teams. 38 Geeral Medical Coucil

40 Medical royal college specialty Evaluator umbers Medical royal college specialty Evaluator umbers Public health medicie 6 Medical psychotherapy 1 Faculty of Sexual ad Reproductive Healthcare Commuity sexual health ad reproductio Royal College of Radiologists 20 Cliical ocology 7 Royal College of Geeral Practitioers Cliical radiology 7 Geeral practice 8 Appedix 6: Ratios betwee evaluators ad applicatios Table 9: Number of evaluators per applicatio i each specialty (1 Jauary December 2013) * Medical royal college specialty Evaluators per appicatio Joit Royal Colleges of Physicias Traiig Board Medical royal college specialty Joit Committee o Surgical Traiig Evaluators per appicatio Acute (iteral) medicie 0.5 Cardio-thoracic surgery 0.45 Allergy 3.5 Geeral surgery 0.20 Audiovestibular medicie NA Neurosurgery 0.29 Cardiology 0.37 Oral ad maxillofacial surgery NA Cliical europhysiology 4 Otolarygology 0.31 Cliical geetics 4 Paediatric surgery 0.33 Cliical pharmacology ad therapeutics NA Plastic surgery 1.11 Dermatology 0.4 Trauma ad orthopaedic surgery 0.18 Edocriology ad diabetes mellitus 0.75 Urology 0.17 Gastroeterology 0.36 Vascular surgery 0.67 Geeral (iteral) medicie 0.22 Royal College of Aaesthetists Geitouriary medicie 1 Aaesthetics 0.19 Geriatric medicie 2.14 Itesive care medicie 1 Haematology 0.4 Royal College of Obstetricias ad Gyaecologists Ifectious diseases 1.67 Obstetrics ad gyaecology 0.13 Immuology NA Royal College of Ophthalmologists Medical ocology 4.5 Ophthalmology 0.44 Medical ophthalmology 2 Royal College of Pathologists Neurology 0.67 Histopathology 5.67 Nuclear medicie 6 Chemical pathology NA Paediatric cardiology 1 Diagostic europathology NA Palliative medicie 1 Foresic histopathology NA * Evaluator umbers are from royal college ad faculty teams ad the applicatio data are from the GMC. NA Not applicable because o applicatios were received durig the period. The lower the umber, the more demad o the evaluators i that specialty. For example, there are 0.2 evaluators for each applicatio i geeral surgery compared with real medicie which has five evaluators per applicatio. Geeral Medical Coucil 39

41 Medical royal college specialty Evaluators per appicatio Medical royal college specialty Evaluators per appicatio Pharmaceutical medicie NA Medical microbiology NA Rehabilitatio medicie 2 Medical virology NA Real medicie 5 Paediatric ad periatal pathology NA Respiratory medicie 0.5 Royal College of Paediatrics ad Child Health Rheumatology 2.25 Paediatrics 0.73 Sport ad Exercise Medicie 0.83 Royal of College of Psychiatrists College of Emergecy Medicie Child ad adolescet psychiatry 0.3 Emergecy medicie 0.36 Foresic psychiatry 5 Faculty of Occupatioal Medicie Geeral psychiatry 0.77 Occupatioal medicie 1.2 Old age psychiatry 1 Faculty of Public Health Psychiatry of learig disability 1.09 Public health medicie 1.5 Medical psychotherapy NA Faculty of Sexual ad Reproductive Health Commuity sexual health ad reproductio Royal of College Radiologists 3.33 Cliical ocology 1 Royal College of Geeral Practitioers Cliical radiology 0.11 Geeral practice 0.09 Table 10: Numbers of applicatios per evaluator i each specialty (1 Jauary December 2013) * Medical royal college specialty Applicatios per evaluator Medical royal college specialty Applicatios per evaluator Joit Royal Colleges of Physicias Traiig Board Joit Committee o Surgical Traiig Acute (iteral) medicie 2 Cardiothoracic surgery 2.2 Allergy 0.29 Geeral surgery 4.94 Audiovestibular medicie NA Neurosurgery 3.45 Cardiology 2.73 Oral ad maxillofacial surgery NA Cliical europhysiology NA Otolarygology 3.25 Cliical geetics 0.25 Paediatric surgery 3 Cliical pharmacology ad therapeutics NA Plastic surgery 0.9 Dermatology 2.5 Trauma ad orthopaedic surgery 5.57 Edocriology ad diabetes mellitus 1.33 Urology 5.8 Gastroeterology 2.8 Vascular surgery 1.5 Geeral (iteral) medicie 4.57 Royal College of Aaesthetists Geitouriary medicie 1 Aaesthetics 5.4 Geriatric medicie 0.47 Itesive care medicie 1 Haematology 2.5 Royal College of Obstetricias ad Gyaecologists Ifectious diseases 0.6 Obstetrics ad gyaecology 7.88 Immuology NA Royal College of Ophthalmologists * Evaluator umbers are from royal college ad faculty teams ad the applicatio data are from the GMC. NA Not applicable because o applicatios were received durig the period. The lower the umber, the more demad o the evaluators i that specialty. For example, there are 0.2 evaluators for each applicatio i geeral surgery compared with real medicie which has five evaluators per applicatio. 40 Geeral Medical Coucil

42 Medical royal college specialty Applicatios per evaluator Medical royal college specialty Applicatios per evaluator Medical ocology 0.22 Ophthalmology 2.27 Medical ophthalmology 0.5 Royal College of Pathologists Neurology 1.5 Histopathology 0.18 Nuclear medicie 0.17 Chemical pathology NA Paediatric cardiology 1 Diagostic europathology NA Palliative medicie 1 Foresic histopathology NA Pharmaceutical medicie NA Medical microbiology NA Rehabilitatio medicie 0.5 Medical virology NA Real medicie 0.2 Paediatric ad periatal pathology NA Respiratory medicie 2 Royal College of Paediatrics ad Child Health Rheumatology 0.44 Paediatrics 1.37 Sport ad exercise medicie 1.2 Royal College of Psychiatrists College of Emergecy Medicie Child ad adolescet psychiatry 3.33 Emergecy medicie 2.78 Foresic psychiatry 0.2 Faculty of Occupatioal Medicie Geeral psychiatry 1.29 Occupatioal medicie 0.83 Old age psychiatry 1 Faculty of Public Health Psychiatry of learig disability 0.92 Public health medicie 0.67 Medical psychotherapy NA Faculty of Sexual ad Reproductive Healthcare Commuity sexual health ad reproductio Royal College of Radiologists 0.3 Cliical ocology 1 Royal College of Geeral Practitioers Cliical radiology 8.86 Geeral practice 11.5 Geeral Medical Coucil 41

43 Website: Telephoe: Geeral Medical Coucil, 3 Hardma Street, Machester M3 3AW Joi our facebook.com/gmcuk likd.i/gmcuk youtube.com/gmcuktv This iformatio ca be made available i alterative formats or laguages. To request a alterative format, please call us o or us at publicatios@gmc-uk.org. Published March Geeral Medical Coucil The text of this documet may be reproduced free of charge i ay format or medium providig it is reproduced accurately ad ot i a misleadig cotext. The material must be ackowledged as GMC copyright ad the documet title specified. The GMC is a charity registered i Eglad ad Wales ( ) ad Scotlad (SC037750) Code: GMC/AFER/0314