Who needs Induction or Refresher training?
As a rule of thumb a formal returner training programme is not usually required if the doctor has been in a substantive GP post within the last two years. A suitable induction programme may be all that is required to allow a doctor to familiarise themselves with today’s NHS along side a personal development plan. The BMA model contract for salaried doctors allows one Continued Professional Development session a week.
There are two groups of doctors for whom the PCT may wish to arrange a formal assessment for the need for further training:
Refresher Training
Doctors out of practice for a significant time and have been identified as being in need of re-training on the basis of their application to the Performers List or other assessment. There is no “cut off” but experience shows doctors out of practice for over 5 years have the greatest retraining need, and it is unlikely to be required if less than 2 years. Employers need to be aware that simple “2 year” rules could be contrary to the Discrimination Act 1975 unless there is no supporting evidence of the learning need.
Induction to the NHS Training
Doctors applying to the Performers List who have trained and qualified outside the UK and are not familiar with the NHS. Both the RCGP and COGPED strongly advocate induction training for this group of doctors.
Salaried or voluntary
Any period of returner or induction training will require the doctor to have a salary. The BMA consider it unacceptable that PCTs discharge their duty by requiring such GPs to self-fund. Further more the Minimum Wage Act 1988 apply and the National Minimum Wage regulations 1999 could be interpreted as being illegal for a practice/employer not to pay a salary to a returning GP even if willing to work voluntarily.
The West Midlands Postgraduate Deanery will work with PCTs to provide a tailor made Induction and Refresher experience in an approved GP training practice. GPs considering returning to practice after a significant career break are advised to approach their PCT to discuss re-applying for the Performers List and if any further training would be required. The GP would need to have a West Midlands address (with proof e.g. utility bill).
The PCT would make an assessment of the need for further training and if the doctor falls under one of the two categories above approach the Deanery. On receiving an application from the PCT for an Induction and Refresher Assessment indicating the PCT would support a training package (salary and trainers grant) then the Deanery will arrange to interview the doctor and if appropriate make a referral for a formal assessment consisting of:
- Clinical knowledge test
- Simulated surgery (with or without language assessment)
The assessment takes place in London and gives an assessment of “returnability” ie the chances of returning after a 3-6 months in a training practice, plus it re-assures the PCT that the doctor is safe to work in a supervised capacity. If the doctor fails this assessment they can have a second and final attempt. The cost of this assessment is about £800 and is paid by the applicant (the doctor).
Once approved for retraining, and with the support of the PCT the Deanery can place the doctor in a GP training practice for up to 6 months.
We recommend the PCT takes responsibility for:
- The salary (locally determined, and possibly claw-back agreement to work for 2 years in that PCT)
- An educational grant to the GP (£1050)
- The trainers grant (equal to the GP Registrars trainers grant)
Once in a training practice the experience would be similar to a GP registrar in their final year, and they would be expected to work towards and pass the MRCGP Applied Knowledge Test (AKT). The cost of this assessment is approximately £450. The GP would normally fund this assessment.
We recommend the applicant (the GP) takes responsibility for:
- Entry assessments (I&R assessment)
- Exist assessments (MRCGP AKT)