This trainee is a full-time ST5 undergoing a waypoint ARCP. They plan to do the ATSM Advanced Labour Ward and ATSM Hysteroscopy when they rotate next month to a different large hospital with a two tier middle grade rota. Their last ARCP was 12 months ago when an Outcome 1 was given.
Evidence provided to the ARCP panel
- After checking the linked evidence on the clinical CiPs, the ES has signed off clinical CiPs 11 (Non-emergency gynaecology and early pregnancy) and 12 (Non-emergency obstetrics) as level 3 (can act under indirect supervision), agreeing with the trainee’s self-assessment. There is reasonable quality linked evidence including WBAs, reflections, a gynaecology elective theatre list NOTSS and a surgical log.
- The ES has signed off clinical CiPs 9 (Emergency gynaecology and early pregnancy) and CiP 10 (Emergency obstetrics) as level 3, disagreeing with the trainee’s self-assessment as being level 4 (can act independently with support).
- The ES evidences this decision for level 3 because of the lack of rotational delivery summative OSATS (there are only 2 competent), some difficulty experienced in delivering a baby at a second stage Caesarean section on 2 occasions in the last few months, requiring crash calls to the senior resident, an educational meeting which noted concerns from the gynaecology on-call consultant about the trainee’s decision-making regarding a case of ovarian torsion and a lack of appropriate follow-up for a case of pregnancy of unknown location.
- In recent TO2s, 4 “improvements needed” were recorded. A NOTSS from the labour ward mention midwifery and Early Pregnancy Unit concerns regarding the trainee's prioritisation of emergency cases and unclear advice given to junior staff when the unit was busy.
- There is limited evidence for CiP 1 emergency O&G cases (Applying knowledge, clinical skills and professional values), CiP 3 (Leadership) and CiP 5 (Human factors). The ES has signed CiP 3 and 5 as not meeting expectations for the training year.
- They passed their Part 2 & Part 3 MRCOG in the last 12 months.