• Important changes in curriculum, assessment and certification are being introduced over the next few years
• Being a GP is the most important curriculum statement and you should become very familiar with it
• Even if you are already on a scheme at present, there are important changes to the way you obtain your Certificate of Completion of Training (CCT)
• If you are just starting on a three year scheme for General Practice, the assessment and MRCGP examination at the end will be different from what happens now
• More detail about these changes and the reasons for change can be found in The New GP Curriculum – an overview from the West Midlands Deanery web site Downloads section

The curriculum is stated in terms of what knowledge, skills, attitudes and expertise the learner will achieve. It covers:
 

Generic professional competencies

The qualities that are expected from all doctors, such as those that appear in Good Medical Practice.
 

Competencies that are specific to General Practice

There are many skills expected of GPs but some can be referred to as core skills and are found in the statement Being a GP. Examples of core skills are: managing the primary contact with patients, consulting in a patient-centred way, selective history-taking, tolerating uncertainty, managing co-morbidity, fair and efficient use of resources and having a holistic approach to practice.
 

The most important curriculum statement is Being a GP. Become familiar with this, and the rest will follow easily. To a great extent, the other curriculum statements merely interpret the core skills in a variety of contexts. They will help you prepare for assessments but are not essential reading for the early days.

Two other documents are worth read early in training: firstly The Enhanced Trainer’s Report which will orientate you to how you will be assessed in the workplace and what is the standard you have to reach in order to pass your assessments; and also read the curriculum statement The General Practice Consultation which outlines the communication skills needed to make good diagnostic and management decisions.
 

There are statements on the professional and managerial aspects of general practice; a series of statements on the care of special groups (acutely ill, children, elderly, women’s & men’s health, sexual health, cancer & palliative care, learning disabilities) and statements on clinical areas (cardiovascular, neurological, skin, metabolic, respiratory, musculoskeletal, trauma, ENT, eyes, digestive problems, mental health, minor surgery).
 

We believe that all the learning outcomes listed are achievable within the three years of GP training.
 

The most obvious change is that more training for general practice will take place in practice rather than hospitals. All three year rotations in this Deanery will contain some general practice in the first year as well as 12 months in a practice at the end. The middle section will be spent in speciality training in shorter (usually 4 month) posts, either in hospitals or in innovative posts. A diversity of programmes may include traditional half-day release programmes, more flexible, self-selected teaching modules or a mixture of both, whatever is appropriate for the individual’s learning preferences and final career choices. There will be a one-to-one relationship with a trainer as a mentor throughout the three years.
 

Summative assessment and the MRCGP exam are merging into a single assessment called nMRCGP. There are three elements to this new assessment:
 

1. Workplace-Based Assessment (WBA), which will take place throughout the three years
2. Applied Knowledge Test (AKT), a machine-marked test
3. Clinical Skills Assessment (CSA), which will probably take place at the start of the third year

Satisfactory completion of these three components will make candidates eligible for Membership of RCGP

More detail about assessment can be found in the fact sheet The New GP Curriculum – Assessment available at http://www.wmdeanery.org/Downloads/downloads.asp
 

The transition arrangements are still being decided so much of the detail here is provisional (Make sure you check the facts with the relevant authorities).
The Postgraduate Medical Education and Training Board (PMETB) have taken over responsibility for certification (from the JCPTGP). They have indicated that, until they have approved the new curriculum, the regulatory framework for a Certificate of Completion of Training (CCT) will remain the standard of Summative Assessment. Details are on the Royal College of General Practitioners (RCGP) website.

The college - through its Certification Unit - will process all applications to practise as a GP in the UK on behalf of the PMETB. Doctors in training should register with the RCGP Certification Unit as soon as possible after starting their programme, a one-off payment of £350 covers all processing of documents, as well as associate membership of the RCGP.

For people on three-year schemes the transition is already fairly clearly laid out. The MRCGP becomes the nMRCGP in August 2008. For any GP registrars doing self-construct schemes, planning a break or working part-time, the transition will be managed to ensure that no GPR is disadvantaged. The old exam will overlap for a short time, but if you register for the old exam (up to Feb 08) there will be a shorter time available to sit all the modules. The expectation is that most GP registrars will choose to undertake the new assessment because it is more straightforward.
 

If some of your training was undertaken abroad, you have had no UK training, or some of your UK posts were not approved for training, but you believe you meet the standards required of a UK GP then, instead of applying for a CCT, you apply to PMETB under article 11. Information on this is found on the PMETB website at: http://www.pmetb.org.uk/index
 

There are further information sheets available from the Deanery downloads section: http://www.wmdeanery.org/Downloads/downloads.asp#gp