Quality assurance of curricula

We have a statutory function to set and review the standards for medical education and training. This includes our standards for postgraduate specialty curricula and assessments, Excellence by design.

Once curricula are implemented, we also have a responsibility to monitor their delivery, including the environments in which doctors are trained. Our Quality Assurance Framework describes our different quality assurance functionsand how they interact.

Obtaining strategic support for a curriculum

Changes to curricula and programmes of assessment must be prospectively approved by the GMC.

This document describes our process for endorsement of a new or amended curriculum purpose statement. A purpose statement is a short section at the start of a curriculum that explains its objective. It should describe the patient and service needs of the specialty and the scope of practice required. It should also set out the high level outcomes that a doctor who has completed the training programme should meet.

Approval of a curriculum purpose statement is required where an organisation is proposing any of the following changes:

a new curriculum

a change to an existing curriculum’s purpose statement

addition or removal of one or more high level outcomes of the curriculum.

This form should be used to apply for approval of a purpose statement; this approval should be sought before starting further development work on the curriculum.

Stage one: Strategic support

The GMC has set up the Curriculum Oversight Group (COG), which is made up of members of the UK Medical Education Reference Group. This has representation from organisations responsible for UK medical workforce planning and education, such as Health Education England, NHS Scotland, Wales Deanery, the Northern Ireland Medical and Dental Training Agency and the Departments of Health. It meets approximately every six weeks. Please contact us to schedule your submission into a COG meeting.

The group will tell us if the curriculum purpose statement and high level outcomes have the full support of the four countries of the UKand align with strategic workforce needs, including consideration and incorporation of relevant principles from the Shape of Training review. The UK Shape of Training Steering Group issued a reportin August 2017that provides guidance on implementation of the recommendations from the review. We recommend that curriculum development should not proceed until we have confirmed that the COG endorse the purpose statement.

Changes that do not fall into the three categories above may not need COG endorsement and can proceed directly to stage two, curriculum approval. Please contact us if you are not sure if your curriculum needs COG endorsement.

Please note that this form is for stage one, strategic support only.

Stage two: Curriculum approval

When you have developed your curriculum and consulted on the changes with your stakeholders (such as trainees and trainers), you need to apply to us for full approval.

We will send your application to the Curriculum Advisory Group (CAG), which is run by the GMC. This is made up of medical educationalists, including consultant, lay and trainee representatives, and psychometricians. They meet throughout the year according to our published schedule and make recommendations to us about whether curricula meet our standards.

We will also send your application to a subgroup of the Conference of Postgraduate Medical Deans UK (COPMeD), who will confirm whether or not the curriculum is feasible and deliverable. This will happen simultaneously with the evaluation by the Curriculum Advisory Group. Both recommendations will be considered by the GMC’s Assistant Registrar, who makes the final decision.

Completingthisform

This form is divided into three sections. Sections two and three address your curriculum purpose statement and your commitment to the principles of the Shape of Training report respectively.

The form should be completed in full – any optional fields will be clearly marked as such.

The curriculum purpose statement

In section two, you will be asked to submit the proposed purpose statement for your curriculum. We will assess this against theme one of our standards, Excellence by design: standards for postgraduate curricula.

The purpose statementin acurriculum mustmeetthe followingrequirements:

CR1.1Explain the need for the curriculum based on an analysis of patient, population, professional, workforce and service needs.

CR1.2Give the purpose and objective of the curriculum, including how it links to each stage of critical progression.

CR1.3Describe the scope of practice of those completing the curriculum, including notable exclusions.

CR1.4Specify the high level outcomes so it is clear what capabilities must be demonstrated, and to what level, to complete training.

CR1.5Demonstrate the curriculum has four-country endorsement of the purpose statement.

CR1.6Demonstrate how the key interdependencies between the curriculum and other training programmes, professions or areas of practice have been identified and addressed.

CR1.7Explain how the curriculum supports flexibility and transferability of learning outcomes and levels of performance across related specialties and disciplines.

We wouldsuggestworkingmethodically through each of the requirements when drafting your purpose statement, ensuring content covering each requirement is included. Please enter your purpose statement in the box provided under section two.

Guidance on writing learning outcomes can be found in Appendix A.

A declaration meetingrequirement1.5 can be excludedfrom your purpose statementat this stage. The COG will confirm tous if the proposal has endorsementfrom the four countries of the UK and,if successful,we willgive you aline of standardtexttoinsertinto your final purpose statement.

You may wish to submit additional supporting detail that will not be included in the curriculum itself, for example regarding specific analysis, research, or evidence of the needs of the health service and patients. This could support (for example) requirements 1.1 and 2.2 (‘explain the rationale for the learning outcomes’), and should be included in the second (optional) box in section two.

Shape of Training

When reviewing your submission, the COG will explore the work that you have undertaken toward the five principles of the Shape of Training report. The questions in section three will help you to identify how your curriculum adheres to these principles.

We recognise that not all elements of the report can be implemented within current frameworks. However, this section gives you the opportunity to demonstrate that you have considered the implications of future developments (eg credentialing) on your curriculum and that you have a clear commitment toward developing a curriculum which is in line with the principles of Shape of Training.

Submittingyourapplication

Once you have completed this form,you shouldsubmititusingarequestin GMCConnect, our secure portal.Please contact us at f you need tosetupaGMC Connectaccount.Youwill need access to the RoyalCollege/Faculty-Education user group to beable to submitapplications for curriculachanges.

You can attach supporting documents to theservice requestin GMCConnectif you like, butplease ensure theirpurpose is clear andreference to them in the second box of the form below.

Itis important thatyou complete this form in full. If anythingis missingwe won’tbe able tostartevaluatingyour application,which may mean thatit will need to be submittedtoa later COG meeting.

Belowis the requestviewin GMCConnect:

There are twodifferentrequesttypes tochoose from in GMCConnectwhen makinga change toacurriculum or assessment:

COG submission:You shoulduse this requesttype when you aresubmittinganew curriculum purpose statement for approval,or if you are making a change to an existing purpose statement or the high level outcomes of your curriculum.

CAG submission:You shoulduse this requesttype should be usedwhen you are submittingarequestfor approval of a fully developed curriculum that has received COG endorsement, or when making achange toan existingGMC approvedcurriculum or assessment that does not require strategic support as outlined above.

Please note that applications for new dual CCTpairings,trainingpathway pilots (run through training) andadmin changes followdifferentprocesses andrequire different application forms.Please make sure thatyouselectthe correctrequesttype andsubmit the relevantform and supporting documents.

Please write avery brief description of the application under ‘Details’ andinclude the name of specialty,such as ‘General surgery purposestatement approval application’.

Forfurtherhelp

We are happytosupportyouat any point in your curriculum developmentprocess and may be abletoprovide useful data,forexample around trainee progression or demographics.

You can getintouch with us by emailing rby callingus on 0161 2408324.

Section1:Contactdetails

Detailsabout thecurriculumdevelopment organisation
Name of organisation
Specialty or sub-specialty
Maincontact details
Name
Job title
Telephone number
Email address

Section 2: Purpose statement

  1. Please enter your proposed purpose statement below.
/ Referring to requirements 1.1, 1.2, 1.3, 1.4, 1.6 and 1.7
  1. (Optional) Please use the space below to provide any additional details or evidence that will not form part of the purpose statement within the curriculum itself, but should be considered when demonstrating how the purpose statement above meets the standards of Theme 1.

Section 3: Shape of Training

  1. Please explain how the proposal will better support the needs of patients and service providers by ensuring the medical workforce will be able to meet patient and population trends.

  1. Please confirm how proposed curriculum will equip doctors with the general skills to participate in the emergency and acute unselected take and to provide continuity of care. You should define the level at which these skills will be obtained and identify how they will be built upon throughout the curriculum.

  1. Where appropriate, please explain how the proposal will better support the delivery of care in the community.

  1. Please describe how the proposal will support a more flexible approach to training, such as embedding shared learning outcomes and content with other relevant specialties. You may find it useful to review our report on promoting flexibility in postgraduate training

  1. Please outline any considerations that have been given to moving optional areas of the curriculum, such as special areas of interest and sub-specialties, to post-CCT (for example, in a future framework for credentials), including:
  2. An indication of which parts of the curriculum are not mandatory for trainees to complete.
  3. Which of these optional areas would be suitable for moving to post-CCT
  4. Which areas should stay pre-CCT, including an explanation of why this is the case.

End of application

Appendix A: Writing learning outcomes

Our standards for postgraduate curricula, Excellence by design, define learning outcomes as ‘the knowledge, skills, capabilities behaviours and expected levels of performance a learner must acquire and demonstrate by the end of a period of education or training.’

Learning outcomes express the outcome of a training programme from the learner’s point of view. Your high-level learning outcomes should be statements of what a trainee is expected to know, understand and be able to demonstrate and/or do to be awarded a CCT on completion of their full postgraduate programme of learning.

High-level learning outcomes:

  • must relate to the programme aims.
  • are very broad and relate to the knowledge and skills a trainee will have developed over the whole learning programme.
  • must be clear to trainers, trainees, assessors and to the GMC.

Key points for writing learning outcomes

  • Learning outcomes don’t replace a syllabus. They are the synthesis of the most important things that trainees will have learned either at key progression points or to be qualified at CCT level in a particular specialty.Beneath this are the learning outcomes doctors in training will be expected to attain at key progression points in their learning journey, and beneath these are likely to be the outcomes they will be expected to attain for each module or sub-section of their learning during a defined period of training.
  • Learning outcomes should not be too numerous. As a guide, 8 – 12 high-level outcomes are likely to be sufficient, although whether you use fewer or more will be down to your professional judgement. We wouldn’t expect a curriculum to have more than 20 outcomes.
  • Learning outcomes may be knowledge-based (knowledge and understanding); application based (practical clinical skills), or skills based (intellectual, attitudinal and transferable skills). Some may combine several of these different dimensions into one outcome.
  • Learning outcomes should be written in the future tense and be in a consistent style throughout your curriculum document.
  • It is usual practice to introduce learning outcomes with a generic stem phrase along the lines of ‘At the end of the programme of learning, a trainee qualifying for a CCT/ready to progress to ST3 will be able to…’
  • Whether a generic stem statement is included or not, learning outcomes should be introduced by active verbs which are carefully chosen to be indicative of the level of learning expected.
  • Wherever possible, an outcome should be written to express the ‘process’ or constituent elements of learning, rather than just the product. For example, instead of ‘will be able to complete a Quality Improvement Project,’ the following would be a more considered approach: ‘will be able to plan, implement, synthesize the findings of and evaluate Quality Improvement Projects aimed at developing professional and clinical practice in the specialty.’ Try to make the outcome as ‘concrete’ as possible, indicating the context for the learning and avoiding vagueness.