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Approved curricula and the role of UK and overseas exams

Please find a copy of our position paper Approved curricula and the role of UK and overseas exams (PDF). You can also view a summary of each of the sections most relevant to you by clicking below.

Purpose

This paper clarifies the position of exams within GMC approved curricula, in particular exams undertaken outside the UK, both in other European countries and outside Europe and the subsequent eligibility for GP/Specialist Registration.

Who is covered by this position statement?

  • All doctors in training following a Certificate of Completion of Training (CCT) or Certificate of Eligibility for Specialist Registration (CESR) combined programme and those applying for a full CESR.
  • Doctors in training undertaking recruitment into specialty training, at the beginning of core or specialty training (CT/ST1), at the beginning of “higher” specialty training (ST3) or at any points further into the training programme.
  • Royal Colleges and Faculties when considering exams that form part assessments for curricula, exemptions from parts of exams and when providing guidance to prospective trainees.
  • Educational Supervisors

Who is not covered by this position statement?

  • General Practice doctors in training

Background

The GMC took over responsibility for the approval of curricula and assessment systems, including exams, with the merger of the GMC and the Postgraduate Medical and Education Training Board (PMETB) in April 2010. 

A number of Colleges had exams from outside the UK within their curricula as part of the assessment system.  With the evaluation of curricula and assessment systems in 2010 the majority of these exams from outside the UK were not able to demonstrate fulfilment of the required standards and as such were removed from the approved assessment system. 

What does this mean

Doctors who were appointed onto 2010 and any subsequent curricula MUST pass the relevant UK College exams in full (no non UK exemptions) that have been approved by PMETB or the GMC as part of the curriculum and assessment system in order to be eligible to be awarded a CCT.  Doctors who have an exam that is not approved within the curriculum ARE NOT eligible for a CCT.

To reduce confusion in relation to the statutory requirements, the paper outlines possible scenarios:-

a     Doctors entering UK training at ST1/CT1 not passing relevant UK end of core / early years training exam.  Not eligible for appointment to ST3 (or above) or to continue in run-through training.

b     Doctors entering UK training at ST1/CT1 not passing relevant UK end of core / early years training exam.  Taking an exam outside the UK and applying for entry into ST3 (or above), or continuing in run-through training. Not eligible for a CCT, not eligible for CESR(CP), not eligible for appointment to ST3 (or above) or to continue in run-through training.

c     Doctors entering UK training at ST3 or above from approved European training without a European exam.  Not eligible for a CCT, Not eligible for appointment to ST3 (or above).

d     Doctors entering UK training at ST3 (or above) from approved European training with a European exam considered equivalent/similar  to the UK exam.  Eligible for a CESR(CP)

e     Doctors entering UK training at ST3 (or above) from approved European training with the UK exam (or who gain the UK exam at a later point but prior to end of training).  Eligible for a CCT

f      Doctors entering UK training at ST3 (or above) from training outside the UK with an outside UK exam considered equivalent/similar to the UK exam.  Eligible for a CESR(CP)

g     Doctors entering UK training at ST3 (or above) from training outside the UK with an outside UK exam not equivalent/similar to the UK exam. Not eligible for appointment to ST3 – possible full CESR

h     Doctors entering UK training at ST3 (or above) from training outside Europe  with the UK exam.  Eligible for a CESR(CP)

We are aware that a number of overseas exams; in particular those from Ireland; were included within the pre 2010 curriculum and assessment system.  We are also aware that a number of Colleges accept or have accepted exams from outside the UK for exemptions from parts of the UK exam. 

 Under the GMCs position statement, Moving to the Current Curriculum requiring all doctors to move to the current curriculum from no later than January 2016, there may be a small number of doctors in training who will be required to move from pre 2010 curricula into post 2010 curricula where they will not have the relevant approved exam ie the UK exam.  As outlined in the abovementioned paper, it will be for each individual College to determine how they will manage this transfer.

Next steps

We will be asking Colleges to review their exam regulations for exemptions from outside the UK. To enable those who are given these exemptions to be eligible for a CCT, GMC approval will need to be sought. 

  •  Colleges work with Deaneries/LETBs to ensure that eligibility for recruitment and the route to registration is understood.
  • Colleges review their curricula and ensure that wording around exams is clear, for example usage of terminology “or equivalent”.
  • Colleges review their transfer to the current curriculum plans.
  • Gold guide is amended to reflect this paper.

Key dates

In order to not disadvantage doctors in training the following implementation plan has been agreed:

1 June 2015

  • Exams from outside the UK taken from this date onwards are not acceptable
  • Colleges review exam regulations and where exemptions exist, provide a plan to the GMC for approval as to the phasing out of the exemption or the request for approval

31 December 2015

  • Requests for approval of exemptions to have been submitted to GMC
  • Colleges provide clarification on transfer to the current curriculum for those with exams from outside the UK if necessary.

31 December 2016

  •  Exams taken outside of the UK prior to 1 June 2015 cease to be acceptable for entry or re-entry into training.

Frequently Asked Questions

Colleges/ Recruiters

Q1: We would like to retain the existing exemptions but the exams do not fulfil the GMCs standards. What should we do?

A: It is important that the College is regularly satisfying itself that it continues to be appropriate for an exemption to remain.  The GMC is not in a position to approve exemptions where the exams do not fulfil our standards. It will be necessary therefore if the College wishes to continue with accepting exemptions that you ensure candidates are aware of their position with respect to future employment in the UK within training and also that it is clear to those undertaking recruitment which doctors have been granted exemptions and therefore the limitations on their eligibility for appointment/ restrictions on routes of training.

Q2: Our curricula/person specifications for recruitment use the terminology “or equivalent”.  What should we do?

A: Any exam that is accepted within a curriculum must be approved by the GMC, therefore the terminology “or equivalent” within a curriculum needs to be removed.  In a person specification however it is for each College to consider what they consider is equivalent/similar and ensure this is clear to those undertaking recruitment.  The requirements under the position statement above however must be followed in relation to eligibility for recruitment and the route to registration which will differ for each individual doctor in training.

Q3: When we produced our transfer to the current curriculum implementation plan we did not make a reference to exams from outside the UK – what should we do?

A: You will need to review which exams your pool of doctors in training hold, map the syllabus, entry requirements and assessment standards against your current curriculum and judge whether any further assessment is required.  Colleges are encouraged to be flexible in their approach.

Q4: Our exam is not a stand-alone one but includes the demonstration of competences achieved through successful completion of training – what does this mean for us?

A: The position paper remains relevant, however when you are considering equivalence/ similarity of a non UK examination you would also be considering the evidence of demonstration of competences achieved through training.

Doctors in training

Q5: I took an exam outside the UK in 2013 – will I be eligible for entry into ST3 or higher?

A: From 31 December 2016 you will not be eligible for entry or re-entry (except where training is deferred – see FAQ 11) into UK training unless you are a European or overseas doctor who passed the exam as part of your non UK European training programme where you may be eligible for entry following the CESR(CP) route to specialist registration (see para  11 above for eligibility).

Q6: Why are trainees who have undertaken training in non UK countries treated differently to those who have trained in the UK?

A: Training in the UK is defined in the relevant curriculum and assessment system. In order to demonstrate satisfactory completion of training the relevant assessments, such as the approved UK exam, must be passed. Therefore if you have not passed the exam approved within the curriculum and assessment system you will not have demonstrated satisfactory completion of training and therefore would not be eligible for further training in the UK.

Q7: Why am I not eligible for a CCT if my European training and exam is approved by the relevant competent authority?

A: European training where the doctor in training is able to provide evidence that it has been approved by the relevant competent authority may be considered towards the UK curriculum, however the assessments within the UK curriculum must be passed to confirm satisfactory completion of the curriculum and subsequently for a CCT to be awarded.  Without this the evaluation is to determine equivalence and the possibility of award of a CESR(CP).

Q8: I have been transferred to the current curriculum and I don’t have the UK exam, will I be required to pass it?

A: Each College will have produced a plan for the transfer of doctors in training onto the current curriculum.  This will detail the requirements with respect to exams.  If there is no specific statement about those holding exams from outside the UK Colleges will be clarifying the position for you by 31 December 2015.

Q9: I have passed part 1 of the exam outside the UK prior to 1 June 2015 but not part 2, will I be eligible for entry into ST3 or above training if I pass part 2 either in the UK or not?

A: From 31 December 2016 you will not be eligible for entry or re-entry into UK training unless you are a European or overseas doctor who passed the complete[1] exam outside the UK as part of your non UK training programme.  If you fall into this group, you may be eligible for entry to UK training following the CESR(CP) route to specialist registration (see para 11 above for eligibility).

Q10: I am in UK training but have the exam from Ireland – what does this mean for me?

A: If you hold an NTN (ie you are in run through training or have entered from ST3 or above) then whatever programme you have had confirmed whether it is CESR(CP)or CCT will not be rescinded.  If you are not in run through training and have not yet re-entered specialty training (including being in a Locum appointment for Training) then you have until 31 December 2016 to gain entry to substantive training and remain eligible for a CESR(CP). If you do not re-enter training by 31 December 2016 you will need to pass the UK college exam in its entirety to be eligible for appointment.

Q11: I have been appointed to UK training and have deferred my entry - what does this mean for me?

A: We will continue to accept the decision made in relation to your eligibility for entry to training but only for one additional year ie until 31 December 2017 where the deferment is for one of the reasons outlined in the Gold Guide and approved by the relevant Dean.

Q12: I have been told by my College that I have an exemption because I have passed a non UK exam.  What does this mean for me?

Any exemptions due to non UK exams after 1 June 2015 will not be acceptable for the purposes of award of a CCT.  If your College continues to accept exemptions then you may be eligible for appointment to UK training – see para 11 of the position statement.  Colleges are required to inform candidates of the restrictions on their eligibility for appointment, ensure that those undertaking recruitment are aware of a doctor’s eligibility status and doctors must ensure they do not apply for posts they are not eligible for. 

If you have been given an exemption by your College prior to 1 June 2015, then you have until 31 December 2015 in which to enter specialty training. If you do not do so by that date then you may not be eligible for appointment or continuing in training (see para 11 above).



[1] Some exams are in a single part but the same principle applies