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Guidance on this page applies to the School of Surgery across both sectors of NHS England – North West.
The Annual Review of Competence Progression (ARCP) takes place every year and assesses your progress against the required competencies. The information below outlines what is expected and what will be reviewed during the ARCP process.
In accordance with GMC and Gold Guide requirements, every doctor, including Less Than Full Time (LTFT) Resident Doctors, must have an ARCP at least once every 12 calendar months. For LTFT Resident Doctors this may mean you have multiple ARCPs during a single grade year.
ARCPs may not align with the end of your training grade year, unless you are approaching a 'critical progression point' where a formal progression decision is required. ARCPs at other times will assess requirements based on the amount of Whole Time Equivalent (WTE) of training time completed.
LTFT Resident Doctors are usually expected to progress in-line with their LTFT working percentage and WTE of training time worked, and ARCP requirements should usually be adjusted, pro-rata, accordingly.
Progression at a rate faster than the standard WTE rate, whether full-time or LTFT, is considered an acceleration of training and acceleration principles apply. Please see the 'Acceleration of training' section for further details.
You may be asked to attend an Interim Progress Review (IPR), this may be following your ARCP or half way through the training year. Interim Progress Reviews are 'in-person' meetings with your TPD to review and feedback about your progress, and for you to feedback about the training programme.
Please note
NHS England – North West administration teams are not involved in the organisation of IPRs - please contact your TPD for information or if you have any queries.
Surgical training programmes are divided into three phases: Phase 1, Phase 2 and Phase 3. The end of each phase represents a critical progression point, where resident doctors must demonstrate that they have achieved the required standards to progress to the next stage of training.
These standards are assessed primarily through the level of supervision achieved for the relevant Capabilities in Practice (CiPs), as evidenced in the Multiple Consultant Report (MCR). Depending on the specialty, resident doctors may also be required to achieve minimum Indicative Numbers and/or complete specified Index Procedures.
Full details of the minimum requirements for progression can be found within the relevant curriculum on the ISCP website (links in table below).
For most surgical specialties, resident doctors who successfully meet the requirements at the end of Phase 2 can be signed off to sit the FRCS examination. An exception is Neurosurgery, where an additional ARCP at the end of ST6 to confirm eligibility to sit the FRCS examination.
| Specialty | Length of Programme | Phase 1 | Phase2 | Phase 3 |
|---|---|---|---|---|
| Cardio-thoracic Surgery | 7 years | End of ST3 | End of ST5 | CCT / End of ST7 |
| Core Surgical Training (CST) | 2 years | End of CT2/ST2 | N/A | N/A |
| General Surgery | 6 years (after CST) | End of CST | End of ST6* | CCT / End of ST8 |
| Neurosurgery | 8 years | End of ST2** | End of ST7** | CCT / End of ST8 |
| Oral and maxilla-facial surgery (OMFS) | 5 years (after CST) | End of ST2 (at the latest) | End of ST5 | CCT / End of ST7 |
| Otolaryngology (ENT) | 6 years (after CST) | End of CST | End of ST6 | CCT / End of ST8 |
| Paediatric surgery | 6 years (after CST) | End of CST | End of ST6 | CCT / End of ST8 |
| Plastic surgery | 6 years (after CST) | End of CST | End of ST6 | CCT / End of ST8 |
| Trauma and orthopaedic surgery | 6 years (after CST) | End of CST | End of ST6 | CCT / End of ST8 |
| Urology | 5 years (after CST) | End of CST | End of ST5*** | CCT / End of ST7 |
| Vascular surgery | 6 years (after CST) | End of CST | End of ST6 | CCT / End of ST8 |
* General Surgery: please also refer to Appendix 4 - Index Procedures / Indicative Numbers requirements for end of Phase 2.
** Neurosurgery: please also refer to Appendix 3 - Critical conditions, and Appendix 4 - Index procedures / Indicative Numbers for requirements for end of Phase 1 and Phase 2.
*** Urology: please also refer to Appendix 3 - Critical conditions, and Appendix 4 - Index procedures / Indicative Numbers for requirements for end of Phase 2.
The standard length of a training programme is defined in the curriculum. Please see the table above for the standard lengths of surgical training programmes, as defined in their respective curricula.
Additional Training Time (ATT) awarded via an ARCP outcome 3 (or 10.2 if applicable) will be added at the point it is awarded and will extend that grade year and training phase. ATT awarded is defined at the ARCP in Whole Time Equivalent (WTE) months.
The Gold Guide (paragraph 4.106) defines the maximum amount of additional training time that can be awarded:
| Extension to training time | Exceptional ATT approved by the Postgraduate Dean | Total ATT incl exceptional ATT | |
|---|---|---|---|
| Core training | 6 months | 6 months | 1 year |
| Higher training | 1 year (incl any ATT in core training in uncoupled training programmes) | 1 year | 2 years |
| Run-through training | 1 year | 1 year | 2 years |
The length of the programme is defined in Whole Time Equivalent (WTE) years, and is used to define your CCT date. For resident doctors who work Less Than Full Time (LTFT), your CCT date will be adjusted to reflect the WTE time you will complete.
| LTFT percentage | Number of months WTE of 1 year |
|---|---|
| Full Time (100%) | 12 months |
| 80% | 15 months |
| 70% | 17 months |
| 60% | 20 months |
| 50% | 24 months |
Completion of the training programme in less than the standard WTE time is considered acceleration of training.
As above, completion of a training programme in less than the standard WTE time is considered an acceleration of training.
For further information, please refer to the following:
The Form R is a mandatory requirement from the GMC for all ARCPs.
Only 'Part B' of the Form R needs to be completed for every ARCP (the Form R is not required for Interim Progress Reviews and the Form R 'Part A' is not required for ARCPs in NHS England – North West).
The Form R must be completed within 8 weeks of the ARCP and by the deadline for evidence submission. If a 'Form R (Part B)' has not been completed within the 8 weeks prior to the ARCP Assessment panel, the panel will be unable to issue a satisfactory outcome.
It is important any ongoing or closed investigations/complaints since your last 'Form R (Part B)' are included.
You must make sure that all parts of the 'Form R (Part B)' are fully completed including the scope of practice section.
The Scope of Practice should include:
Important
From August 2022, all Form Rs must be completed via TIS Self Service (TSS). Old style form Rs (Word or PDF versions) will not be accepted.
To use TSS you must first sign up using the email address that NHS England – have recorded for you. Trying to sign up with any other email address means the sign up process will fail.
More Information on TSS and the Form R
Resident Doctors who are Out of Programme for Clinical Training (OOPT) must complete the standard requirements of the specialty curriculum as though they were in training, including Learning Agreements, MCRs, WPBAs and Form R (Part B).
For a period of OOPT to count towards the award of CCT, evidence will be required by the SAC that educational objectives have been met, including ISCP assessments for the entire period, or a satisfactory trainer's report.
Resident Doctors who are Out of Programme for Research (OOPR) will need to submit a report from their research supervisor, and a Form R (Part B) prior to each ARCP.
For Revalidation purposes, the report from your supervisor must include a declaration of whether or not they are aware that you been involved in any Serious Untoward Incidents, Significant Event Investigations or been named in any Complaints.
Resident Doctors who are Out of Programme for Experience (OOPE) will need to submit a report from their Educational supervisor, and a Form R (Part B) prior to each ARCP.
For Revalidation purposes, the report from your supervisor must include a declaration of whether or not they are aware that you been involved in any Serious Untoward Incidents, Significant Event Investigations or been named in any Complaints.
Resident Doctors who are Out of Programme for a Career Break (OOPC) only need to submit a Form R (Part B).
All resident doctors must complete a Learning Agreement (LA) on ISCP with their Assigned Educational Supervisor (AES) for each 6-month placement. All placements must be created on ISCP in 6-month blocks (or three 4-month blocks for those doctors undertaking 4-month posts) even if you are placed at the same site for a year or afre working LTFT.
Please refer to the Learning Agreement (LA) and Multi Consultant Report (MCR) timeline for suggested timings for your LA and MCRs.
It is your responsibility to arrange and complete an objective setting meeting with your AES on ISCP within two weeks of starting each placement.
A lead Clinical Supervisor (CS) for the Multiple Consultant Report (MCR) needs to be identified before starting the objective setting meeting on the LA.
A mid-point meeting with your AES should take place and be recorded on ISCP around two and a half months into each 6-month placement (two months for those in 4-month placements).
Important
Prior to every ARCP and Interim Progress Review, all parts of the Learning Agreement (objective setting, mid-point review and final meeting) MUST be fully completed and signed off by you and your AES.
The MCR is undertaken by your Clinical Supervisors (CSs), with your AES contributing as necessary to some domains (particularly GCP domains 6-9). You should have a minimum of two CSs contributing to the MCR. A lead CS for the MCR needs to be identified before starting the objective setting meeting on the LA. It is the lead CSs responsibility to initiate the MCR, but resident doctors are encouraged to remind their CS if this has not been actioned.
The MCR is undertaken twice in each 6-month placement:
The MCR must be completed at least two weeks prior to the associated AES meeting to allow sign off.
Please refer to the Learning Agreement (LA) and Multi Consultant Report (MCR) timeline for suggested timings for your LA and MCRs.
The MCR feeds into the Learning Agreement, and at the mid-point allows goals to be agreed for the second half of the placement, with an opportunity to address areas where further development is required. The MCR also helps to inform the AES report which in turn feeds into the ARCP. Additionally, the final formative MCR feeds into the LA of your next placement to facilitate discussion between the resident doctor and AES.
You will need to complete a self-assessment of your performance against the Generic Professional Capabilities (GPCs) and Capabilities in Practice (CiPs), describing self-identified areas for development with free text or by using the CiP and GCP descriptors.
Further guidance and information relating to the MCR is available on the ISCP website.
Details of the Capabilities in Practice (CiPs) and Generic Professional Capabilities (GCPs) are available on the ISCP website.
For all other ARCP requirements for your specialty, along with dates of the next scheduled ARCPs, please visit the individual ARCP page for your specialty:
Page Updated 24 September 2026