How can postgraduate training organisations apply their duties?
Key messages from this chapter
- Disabled doctors in training must be supported to participate in clinical practice, education and training.
- All doctors in training should have access to occupational health advice. Doctors may acquire a condition or disability at any stage of their career. If a doctor in training has a long-term health condition or disability, they may need specialist occupational health advice through an accredited occupational health physician, to make decisions about training and working
- It is a matter for postgraduate educators and employers to assess how they approach each individual case. One approach we encourage to consider as good practice is the case management model. Postgraduate educators and employers can use a stepwise process to develop an action plan for supporting each doctor in training. This process gives an overview of what can be done - not all steps will be appropriate for all doctors in training, but it can be adapted to each individual case at the organisations' discretion.
- Step 1: Sharing information - Doctors in training share information about how their condition or disability affects them with their deanery/HEE local team and employer.
- Step 2: Postgraduate dean as gatekeeper - Postgraduate dean or nominated representative to arrange the consideration for what support is needed.
- Step 3: Form doctor's support network. Depending on decision by postgraduate dean or nominated representative, they can gather individuals to provide advice on how the doctor in training can be supported
- Step 4: Decide key contact(s)
- Step 5: Further confidentiality arrangements.
- Step 6: Occupational health assessment. It may be helpful for a disabled doctor in training to have an occupational health assessment.
- Step 7: Case conference /joint meeting. The support network may discuss any recommendations from the occupational health assessment, to form an action plan on how the doctor in training will be supported going forward.
- Step 8: Action plan. The action plan could address a number of areas where the doctor in training can be supported. The purpose of any support implemented is to help the doctor achieve the level of competence required by the Foundation Programme curriculum or the specialty curricula - and not to alter or reduce the standard required. It is good practice for the action plan to be developed in collaboration with the doctor in training as much as possible.
- Step 9: Monitoring and review. There is a shared responsibility for implementing the action plan between the employer, deanery or HEE local team and the doctor in training.
- The educational review process can help monitor the support a doctor in training is receiving, record any relevant conversations in the educational portfolio or escalate concerns to the support network as needed.
- The preparation and evidence submitted by disabled doctors in training for the Annual Review of Competence Progression (ARCP) can be an opportunity to raise something about the support they are receiving and the environment in which they are training. The ARCP process is also a way to decide whether a doctor in training can be supported to meet the competence standards at their stage of training.
- Colleges and faculties should remove or revise any redundant aspects of the curriculum, not crucial to meeting the required standard that may disadvantage disabled doctors.
- Organisations designing assessments have a duty to anticipate the needs of disabled candidates.
- All doctors in training must have an educational supervisor who should provide, through constructive and regular dialogue, feedback on performance and assistance in career progression.