Further to the MEE Evaluation of the Foundation Programme Curriculum, the Academy of Medical Royal College’s Foundation Programme Committee are revising the Foundation Programme Curriculum which will be in use for the 2012 cohort. The Draft revised Foundation Programme Curriculum was circulated to Academy members for review.
The changes include:
- Alterations to the assessment process (The proposed Supervised Learning Events forms – mini-CEX Draft SLE template mini-CEX)
- Inclusion of the purpose of foundation
- Inclusion of high level descriptors, differentiating between F1 and F2 outcomes
- Revision and updating of competences and all other sections.
The review was open to colleagues and others who wished to comment.
Introduction:
The Foundation Programme Curriculum (the Curriculum) sets out the framework for educational progression that will support the first two years of professional development after graduation from medical school.
Good medical practice and the foundation doctor:
The Curriculum is based on The General Medical Council's (GMC) documents Good Medical Practice, 2006 (GMP) and The Trainee Doctor, 2011 (TTD). All foundation doctors and trainers are expected to be familiar with GMP and TTD and to follow the guidance contained therein on the principles and standards of clinical care, competence and conduct.
The companion document, the Foundation Programme Reference Guide provides guidance to deaneries and foundation schools about the structures and systems required to support the delivery of the Curriculum.
Outcomes of foundation training:
Satisfactory completion of Foundation Year 1 (F1) will satisfy the needs of the GMC, making the foundation doctor eligible to apply for full registration. Satisfactory performance in Foundation Year 2 (F2) will lead to award of a Foundation Achievement of Competence Document (FACD) which will indicate that the foundation doctor is ready to enter a core, specialty or general practice training programme.
Who should use the Curriculum:
The Curriculum is intended to be used by foundation doctors, deliverers of their education and those responsible for quality assurance (nationally), quality management (deanery) and quality control (locally). It is also intended to inform medical schools of the outcomes and competences required by foundation doctors. Some areas of the document are more appropriate for particular groups, for example, Syllabus and competences for foundation doctors and their supervisors. It is highly recommended that the section How to use the Curriculum is read thoroughly by all.
Key messages of the Curriculum:
The purpose of the Foundation Training is clearly stated and is underpinned by two central concepts:
Patient safety must be put at the centre of healthcare and depends both on individual practice and also effective multidisciplinary team working
- Patient safety
Throughout their careers, doctors should strive to improve their performance to ensure their progression from competence, through proficiency to expertise, with the aspiration always to provide the highest possible quality of healthcare.
- Personal development
Foundation doctors must continuously work to improve performance. They are expected to develop critical thinking and professional judgement, especially where there is clinical uncertainty. Foundation doctors should regularly reflect on what they perform well and which aspects of performance could be improved in order to develop skills, understanding and clinical acumen.
Comments on Academy of Medical Royal Colleges in the UK
Draft revised foundation programme curriculum
The Royal College of Physicians of Edinburgh is pleased to respond to the draft revised Foundation Curriculum and notes that our Director of CPD, Dr Alan Connacher, was a member of both Academy working groups (on assessment and syllabus and competences). Our comments follow and are based on the changes listed in Appendix D of the consultation document.
There are a number of typos that require correction (see para 6 below).
The increased emphasis on acute conditions is helpful.
The standardised listing of the core procedures, and the explanation of their place in F1 and F2, are much clearer.
The absence of an academic curriculum and e-portfolio is noted and perhaps should be acknowledged in this document with reference to the UKFPO review of this issue.
The use of a Placement Faculty to assess day-to-day performance is to be welcomed. Deaneries and Local Education Providers will need to identify and agree a clear mechanism for trainers to feed back to the named Clinical Supervisor, particularly in large Departments.
Although the shift from workplace based assessment to learning events is useful, the proformas for these should document whether the doctor gave a competent performance (at F1 or F2 level) or not. This could be kept as a final confirmation at the end of the form to ensure that the primary emphasis remains on feedback. If no comment is made on competence, the educational supervisor can only surmise from the event that feedback took place, and will not have objective information on outcomes that can be used for an end of placement assessment.
P32: Valid consent – 3rd bullet ‘Listens to patient concerns and either answer their questions regarding treatment’ – remove ‘either’ or add a phrase providing the alternative.
P36: Infection control, bullet 14 – ‘Applies the principles of infection control to long term conditions managed in put patients’ - clarify.
P60: Fig 6: ‘Expections’ should presumably be ‘Expectations’.
- Purpose of Foundation training: this is now clear.
- The value of F2 training: this is now transparent, and is well supported by the changes to the structure of the syllabus to separate the outcomes of F1 and F2.
- Long term disease management: this is now appropriately highlighted, but under 5.2 (Discharge planning: p28), competence 10 would be clearer if altered as follows: ‘Understands the criteria for specialist rehabilitation, care home placement and respite care.’
- Assessments within the Foundation Programme: the shift in emphasis from workplace based ‘assessments’ to supervised learning events is welcome, and largely meets the concern over their value. However, it might be argued that, as the same number of events is still required, the concern that there are currently too many has not been met.
- Structural changes in the Curriculum: the Syllabus and Competences are much clearer, but the competences seem over-exhaustive and on occasion repeat material already in the outcomes. Some editing would be useful.
- Assessment: This is very clear and much improved. It would be worth emphasising the statement that ‘Foundation doctors do not have to demonstrate that they have achieved every competence, but will be expected to discuss or demonstrate achievement in each of the outcomes’ by adding it to the Introduction of the Syllabus and Competences.
- Typos: