Time Period Assessed: / Date of ARCP:
Reason For ARCP: / Previous Outcome:
Eportfolio Navigation / Assessment Item / Achieved / Comments
Pre curser Information / Involved in SI / Complaint
Reflection in Eportfolio
Form R completed
Educational Supervisors Report Completed
Profile – Personal Library
Asterisk vital as per RCOG matrix / MANDATORY YMTP COURSES – Regional Teaching - Completed ST3 or ST4
Antenatal & Fetal Anomalies
Medical Disorders in pregnancy
Forensic Gynaecology
Gynaecological Oncology
Stats & Research
Medicolegal & Ethics
Obstetrics Teaching Day A
Obstetrics Teaching Day B
Gynaecology Teaching Day A
Gynaecology Teaching Day B
Strat OG & eLearning
Maternal Medicine
Urology & Pelvic Floor
Gynaecological Oncology
Subfertility
Female Genital Mutilation
NOTS e-Learning
Workplace based behaviours* / Year Completed
Survey Confirmations
GMC Training Survey
HEE YH Trainee Survey
Trainee Evaluation Form
EXAM / MRCOG Part 2 / Not Mandatory in ST3
Attempted
Result
MRCOG Part 3 / Not Mandatory in ST3
Attempted
Result
Progression Summary Overview / Formative OSATS – Evidencing On Going Training – Minimum 1 for each training year
Hysteroscopy
Laparoscopy
Operative Laparoscopy -Simple Adnexal / Lap Steri
Summative OSATS- Minimum of 3 assessments by more than one assessor
( minimum of 1 by a consultant or Accredited Senior Trainer)
Basic Ultrasound Modules
TAS 8-12 Week / Completed / Assessors
Competent Rating / Consultant Rated
Comments:
Basic Ultrasound Modules
Size/ Lie / Presentation / Completed / Assessors
Competent Rating / Consultant Rated
Comments:
Basic Ultrasound Modules
LV / Completed / Assessors
Competent Rating / Consultant Rated
Comments:
Basic Ultrasound Modules
Placental Site / Completed / Assessors
Competent Rating / Consultant Rated
Comments:
Summative OSATS- Minimum of 1 Consultant observed assessments confirming continuing competence since last ARCP
Caesarean Section / Completed / Assessors
Competent Rating / Consultant Rated
Comments:
Operative Vaginal Delivery / Completed / Assessors
Competent Rating / Consultant Rated
Comments:
Surgical Management of Miscarriage / Completed / Assessors
Competent Rating / Consultant Rated
Comments:
Workplace Based Assessments
Mini-CEX Obstetrics / /4
Mini-CEX Gynaecology / /4
CbD’s Obstetrics / /4
CbD’s Gynaecology / /4
Team Observation – T02 Should not raise significant concerns to panel
Minimum of 10 Assessors including :
- Your current supervising consultant(s) – at least 3 consultants
- Senior members of nursing and midwifery staff in different clinical areas – antenatal setting, labour ward, gynaecological wards and outpatient clinics, theatres (both obstetric and gynaecological)
- Trainees – a maximum of 3 (at all levels)
- Staff from other specialties outside of O&G – must be senior medical staff
First T02 / Number of ‘ Requires Improvement’
Date
Number of Assessors / Notable Comments:
Correct Mix
Second TO2 / Number of ‘ Requires Improvement’
Date
Number of Assessors / Notable Comments:
Correct Mix
Curriculum / Log Book Progress
Progress made with signing of Log Book Competencies at intermediate level
Completions transferred to output report
Log Of Experience / Reflective Practices
8 Reflections during 12 month training period
Clinical Governance
(patient safety, audit, risk management , and quality improvement)
1 Completed and presented project
Evidence of attendance at local risk management meetings
Presentations/Publication
Departmental Presentation- as per previous annual review discussion
Teaching Experience
Evidence of teaching Organising and Delivering Departmental Teaching for Medical students/ Foundation trainees/ GPST’s / Organising
Delivering
Teaching Attendance
Locality Teaching attendance
(Not Mandatory For ARCP)
Ultrasound and Laparoscopy Training
Complete a minimum of 5 simulation sessions for Lap sim / Number Completed
Complete & Evidence a minimum of 2 Hands on Obstetric Scan Sessions / Can be evidenced in OSAT
Complete & Evidence a minimum of 2 Hands on Early Pregnancy / TOP Service Scan sessions / Can be evidenced in OSAT
Leadership and Management Experience
Evidence of Departmental Responsibility- Rota/ Clinical Administration / Correspondence
Outcome
Recommended Outcome
Justification and Panel Comments
Panel Signatures
Next ARCP / Progression Date
CCT Date
Next ARCP will take place
ESR Feedback form Completed
East & South Locality Team January 2018