Problems During Training
Problems During Training in Hospital Placements
During your training programme you will be allocated to a GP educator as your educational supervisor. Appraisal and feedback will occur at several points during a six month post and areas that are causing concern for both parties should be flagged up at an early stage and discussed to try and solve the problem(s). Written records should be kept at each meeting. The programme director will also be in contact during each job, providing some educational sessions and support. The programme director will also liase with your clinical supervisors whilst in the hospital placements. If a problem arises that cannot be resolved or is difficult to discuss with the department, the programme director should be involved. If required, an Associate Director should be involved at an early stage.
Problems During Training in GP Placements
Your trainer will provide regular appraisal and feedback during your placement. Problems can arise within the practice and, on occasions, may be difficult to resolve (your trainer is responsible for teaching, assessing and potentially providing references).
If the problem(s) cannot be resolved in the practice, it should be discussed with your programme director. Following this discussion, you will agree with the programme director the best way forward. If the trainer has a concern, this will also be discussed with the programme director. If required, an Associate Director should be involved at an early stage.
The General Medical Council advocates that doctors refrain from treating their own illnesses. If you think that you may have a health problem, then make an appointment to have it checked out.
Do not ignore the warning signs of sub-optimal mental health. Seek guidance from your general practitioner or the BMA Wellbeing Support Services (telephone number: 0330 123 1245 email - firstname.lastname@example.org website). This is available 24 hours a day for doctors and their families to discuss personal, emotional and work related problems. The service is free, apart from the cost of the call, which is charged at local rates.
We strongly recommend that you register with a general practitioner, who is not part of the practice you will be placed in during your programme.
Changing a Placement on a Training Programme
The reason(s) for changing the placement must meet at least one of the following criteria:
a change in the rota and/or clinical experience which affects the delivery of training for general practice
duplication of clinical experience (this should be discussed and clarified at an early stage with the programme director)
breakdown of the relationship between trainee and consultant or GP educational supervisor
The proposal should not compromise the integrity of the established training programme.
The proposed change must be acceptable to the Trust and GP practices concerned. This includes the order in which the placements are undertaken. The change must not contravene equal opportunities legislation.
The proposal must be discussed with the programme director to check that the post meets the educational requirements of the individual.
If these requirements cannot be fulfilled, the programme must be completed as originally specified.
Transferring Training to Another LETB
If you have any queries, please read the
Trainee Guide to Inter Deanery Transfer and visit the IDT FAQs on the PGMDE Support Portal. If your query remains unanswered, please contact the team using an IDT query form on the portal.
The IDT Team strongly encourage all those who apply to read the new guide prior to making an application, as well as referencing it while completing the online form.
The National Inter Deanery Transfer (IDT) process has been established to support trainees who have had an unforeseen and significant change in their personal circumstances since the commencement of their current training programme which requires a move to a different region. The process is managed by the National IDT team (Health Education South London) on behalf of the Conference of Postgraduate Medical Deans (COPMeD), Health Education England (HEE) and all UK regions.
In order to provide a consistent, transparent and robust process for all trainees, the National IDT team will make all decisions on eligibility and allocations in accordance with the published guidelines and criteria. You can read these guidelines and criteria as well as find out much more about the process by visiting the National IDT webpages, which have been migrated to a new home on HEE’s specialty training website - https://specialtytraining.hee.nhs.uk/nationalIDT
All of the required documentation, supporting documents and applicant guides are hosted on the specialty training website, and that applications will now be made via the Post Graduate Medical and Dental Education (PGMDE) Support Portal. All FAQs are now hosted on the PGMDE website which can be accessed via
As part of the application process, all trainees will be required to submit a ‘Deanery Document’. This form can be found on the National IDT website above and should be sent to your current region’s administrative team for completion. For GP trainee applicaitons, this should be sent to
If you have any queries relating to the National Inter Deanery Transfer (IDT) process, please review the IDT Applicant guide and the frequently asked questions (FAQs) articles on the specialty training website: http://specialtytraining.hee.nhs.uk/National-IDT/Application-Portal in the first instance. If you do not find an FAQ that has answered your question, you can submit an enquiry form to the National IDT team via the PGMDE support portal. The PGMDE support portal can be accessed at the following link; https://lasepgmdesupport.hee.nhs.uk/support/home.
Transferring within HENW (Intra LETB Transfer)
The HENW GP School Intra LETB Transfer (NWGPILT) process is set up to support GP Specialty trainees who are required to relocate because they have had an unforeseen, significant change in personal circumstances enabling consideration to be given to a transfer to another Programme within HENW.
Spaces available for transfer are very limited and are therefore only available to trainees with a demonstrable need. This need must be based on a significant unforeseen change in personal circumstances that has occurred since the current programme was accepted. The change must also require the trainee to relocate from their current address.
You are advised to read the Policy document carefully before making an application. Please click
HERE to download.
The Application Form and supporting documents must be completed in FULL. Please ensure that you make your application under the appropriate criteria and submit the correct paperwork. Incorrect or incomplete applications will not be considered.
Documents (for INTRA LETB Transfers only) -
Application Form Supporting Document A Supporting Document B Supporting Document C Supporting Document D
If you have any questions about this process please e-mail
Travel Expenses Other Than for Educational Purposes
Travel expenses may also be claimed for travel during a general practice post, for purposes other than study, in accordance with the guidance. Information on this process can be found on the Lead Employer websites -
St Helens & Knowsley HR
Revalidation for GP Specialty Trainees
Revalidation for all doctors is likely to start in 2012. Doctors in training will revalidate every 5 years and at CCT. The GMC recognise that supervision of trainees is already to a high standard. As a trainee you will be asked to complete an enhanced form R each year which enables you to make a positive statement of your fitness to practice. As part of revalidation you also need to ensure that you keep a record in your e-portfolio of any significant incidents or complaints you are involved in.
For more information see the section on
revalidation on the website Higher Professional Education
GP Specialty training is only the start of the education that you will require as a general practitioner and the time spent as a registrar in practice can seem insufficient to cover many of the skills you will need.
Five study days held over the course of the year based on small group work where you can explore and learn about management skills and your own development. Participants are expected to attend most or all of the days.
Less Than Full Time Training
Trainees of any gender can apply for less than full-time training, but must have well founded reasons why full-time training is impractical
There are two eligibility categories:
Category 1: Those doctors in training with:-
A disability or ill health
Caring responsibilities for children up to and including the age of 16 (in line with "The Flexible Working (Amendment) Regulations 2009"
Caring responsibilities for other dependents (spouse, parents etc.)
Category 2: Those doctors in training with:-
For GP Specialty Trainees there are two different application processes for LTFTT.
LTFTT in a Hospital Placement
Please follow this link and complete the on-line eligibility form
LTFTT in a GP placement (this includes ITPs and GP+ posts)
If you are applying to train less than fulltime in a GP based post (including GP+ and ITP posts), please complete the timetable template below in conjunction with your Programme Director, Educational Supervisor and GP Trainer and return to Helen Dykstra via e-mail (
email@example.com). Guidance on calculating hours and completing the timetable is also below.
Less Than Fulltime Training in a GP Post - Guidance
Trainees that are applying for less than full time training are strongly advised to discuss their plans with their Training Programme Director at an early stage
Once you commence your less than full time training you should contact both your clinical and educational supervisors to plan each post.
In particular all trainees who are in less than full time training should familiarise themselves with the minimum assessment requirements for each review period as they are not pro-rata to full time requirements. Summary guidelines can be found via the hyperlink below.
RCGP Guidelines for LTFTT
HENW criteria for LTFTT can be found Under the Policies & Procedures link on the Home page of this website
HENW Criteria for LTFTT
All queries regarding LTFTT in a GP Programme should be directed to Helen Dykstra - e-mail:
Out of Programme
here are a number of circumstances in which trainees may wish to take time out of their GP specialty training programme. There may be educational benefits to trainees in doing this but it poses problems for the GP School and GPSTs in ensuring continuity of service and of training for all trainees. As a consequence taking time out of programme is a privilege that can only be granted to a minority of trainees and therefore will only be granted when clear need is demonstrated. T
When considering OOP for whatever reason you should be aware that you need to apply at least 6 months in advance of the date you would wish the OOP to commence. This is applied very strictly and applications made within a shorter timescale will not be considered unless there are significant exceptional circumstances which cannot be met by other means. Supporting evidence will need to be submitted for all applications.
All applications for OOP should be discussed in advance with your Programme Director and lead employer where appropriate.
The Gold Guide outlines the circumstances under which trainees are able to apply for time out of programme
Approved clinical training (OOPT) – this is to spend time in a post outside HENW that has been prospectively approved by the GMC for GP specialty training. As GP training programmes are fixed 3 year programmes such a request represents a change of programme and is dealt with under that policy.
Additional clinical or related experience (OOPE) – this is to spend time gaining clinical experience in non approved posts in the UK or overseas. This time is not part of the formal 3 year programme leading to CCT.
Research (OOPR) – this is time to undertake research, normally for a higher registerable degree e.g. Masters Degree. This time is not part of the approved 3 year programme leading to CCT.
Career break (OOPC) – this is time out for personal reasons such as health problems, carer responsibilities or to pursue outside interests.
This policy does not include statutory leave such as maternity, paternity or parental leave, which are dealt with through the Lead Employer.
The Guidelines for OOP in a GPST post can be downloaded
The national HEE Policy regarding the Step On Step Off Training Process should be read in conjunction with the OOP guidelines -
click here. An FAQ sheet is also provided - here
and the application form
Please submit the GP OOP application form to
Any queries regarding the OOP process for GPSTs should be directed to
Undertaking Additional Work During Training
Trainees may undertake locum or other work outside of their employed training programme provided certain conditions are met. Please see the Policy document for guidance and contact the GP School for clarification if required.
Suspension of e-portfolio during maternity leave
Trainees are advised agianst suspending their RCGP e-portfolio during maternity leave. Please seee the advice below
When a trainee plans to go on maternity leave they should let their employer know (hospital trust or GP Practice) as well as their Educational Supervisor, local GP Training Patch Office and GP School team who can then advise on the various administrative steps that need to take place.
As soon as the Educational Supervisor is informed about a trainee’s proposed maternity leave, he/she should contact the trainee and arrange a date for an Educational Supervisor (ES) Review to be performed just before the leave commences. This review allows the ES to write a report on the trainee’s progress since the previous ES report up until the date of starting maternity leave.
Before starting Maternity leave the trainee must make sure that they continue to record their educational activity (assessments, learning log entries etc.) even though this might be the last thing on their mind. If the trainee is leaving for maternity leave after only a few months of, for example, a hospital post it is essential that the trainee does some assessments and records their learning even in these months.
The RCGP is very careful to make sure that all periods of time in GP Training counts for educational purposes as well as service provision. If there is no evidence of any learning i.e. no log entries and no assessments, the RCGP certification department may regard this time as having no educational value at all to the trainee and ask that the GP School give the trainee an extension to compensate for this lost time.
Prior to Maternity leave Learning Log and PDP entries should be recorded at the usual rate appropriate for the trainee’s phase of training (ST1,2 or 3) and the number of assessments that need to be done for the ES review is pro-rata for the duration of the Educational Review period.
Keep in Touch Days - KIT Days
When trainees go on maternity leave they are regarded as being “Out of Post” (OOP) and as such there is no legal obligation for the trainee to maintain their e-Portfolio or do any work towards passing the WPBA part of the MRCGP. However they can take the CSA and/or the AKT parts of the MRCGP if they so wish To do so the trainee must sit the examination during a “Keep in touch”(KIT) day.
A trainee may work for up to a maximum of 10 keeping in touch days during her maternity leave. The work does not have to be consecutive and can include training or other activities that enable the employee to keep in touch with the workplace. These keeping in touch days do not normally count towards the 36 months training requirement. It should be noted that there is no central funding or reimbursements to support KIT days.
Although there is no obligation to maintain the e-portfolio it is considered beneficial if some entries are added – reading, professional conversations from KIT days etc – this would demonstrate ongoing engagement in the learning process, whatever decision the trainee makes about their future.
http://www.wessexdeanery.nhs.uk/pdf/Maternity%20Guidance%20Complete%20Final%20Format.pdf for further guidance.
(Credit: HEE Wessex and Dr Peter Johnson, TPD St Helens & Knowsley)
Return to Training Guidance
Trainees who have been off work for more than 3 months will be required to attend a Return To Training meeting with their Training Programme Director and Educational Supervisor. The policy is attached below.
Return to Training Guidance Document
Certificate of attendance
Certificate of Attendance