Implementation of the New T&O Curriculum

By Rob Gregory

From August - October 2020, T&O training will need to comply with the new curriculum. This will be generally available following approval by the GMC which is expected in the near future. Changes are necessary in order to comply with the GMC New Curriculum Standards that focus on the generic skills required to be a safe, effective consultant. They incorporate an improved appreciation about the ways in which trainees learn, accommodate changes in the way in which care is delivered, incorporate the interim changes introduced annually up to 2018 and ensure that the end product of training is a consultant with a broad range of experience, able to independently manage an unselected emergency case-load but also able to develop a subspecialty interest. Whilst new iterations are inevitably accompanied by heightened levels of anxiety, it is important to recognise that most of the practical aspects of the curriculum remain unchanged, there are no significant changes to the syllabus and the subject of the assessments remains broadly unchanged, with only the method of assessment being significantly altered.

The three key elements with which trainers and trainees will need to become familiar are the Multiple Consultant Reports (MCR), the Generic Professional Capabilities (GPCs) and the Capabilities in Practice (CiPs). For those unfamiliar with these elements, and for those wishing to learn more, there is an excellent overview, Surgical Curriculum 2020, that can be accessed from the ISCP homepage. This also gives trainers the opportunity to undertake a ‘mock’ MCR and is strongly recommended.

Considerable support will be given to trainees and trainers in the lead up to the autumn but at trust level a decision will have to be made in advance about how the two MCRs required at the middle and end of a six-month attachment will be compiled, there being no didactic rules about this. A common method is likely to be a meeting at which members of the clinical team, not just consultant trainers, discuss the progress of all of their trainees, identifying areas of strength and areas where improvement is required. The conclusion of the meeting will be a recommendation specific to each trainee designed to meet their individual needs.

For each Programme the introduction of the new curriculum will be co-ordinated by the TPD, and again Programmes are likely to vary in how this changeover will take place. Many will wish to incorporate into a training faculty meeting, advice and guidance about the changes and how they should be implemented. TPDs in turn will be supported by the SAC and a meeting is scheduled for the evening of 2nd April, during the national selection process in Leeds, to discuss the curriculum implementation.

An inevitable query will relate to transition to the new curriculum for senior trainees. It has been normal practice recently for there to be a transition period, with senior trainees having the option of staying with previous JCST guidance, for example relating to old Critical Condition CBDs. Whilst this transition period will also apply to the New Curriculum, as it is predominantly the method of assessment rather than the subject of the assessment that is changing, it is hoped that Programmes will encourage all trainees to move to the New Curriculum in the autumn, thus removing the inevitable frustration felt by trainers when having to use two systems in parallel.

The introduction of the new curriculum may seem daunting but with advanced planning and with increasing familiarity with the process, it is likely that the transition will be smoother than feared, and trainees will rapidly begin to benefit. Certainly, the 500 trainees and trainers who have been introduced to the new curriculum over the last year consider it to be a significant improvement.