How will credentialing affect postgraduate training?

We will ensure credentials will not be used to undermine or devalue the quality of postgraduate training. Our approval process, focusing on patient safety as the primary indicator for a credential, will limit GMC credentials to where they are a proportionate response. We will ensure the quality of the training or approach to delivering the credential through our quality assurance processes. We will evaluate the impact of the credential, including its impact on relevant postgraduate training, through our data collection and monitoring mechanisms.

The standards and outcomes required for award of a CCT will not change. The content of postgraduate curricula will continue to be updated to reflect emergent patient and service need, but this is an existing process which will happen independently of credentialing.

Credentials will operate separately from CCTs and will present specific opportunities for doctors to gain more expertise and experience in particular areas. Clear entry requirements will be required for credentials. We anticipate that in many clinical areas, doctors will access GMC credentials in areas that build on the knowledge, skills and capabilities gained through their general, specialty or subspecialty training or experience.

In most cases, we do not expect doctors in training to take credentials, since most credentials will be aimed at doctors who are not in training. However, if a doctor in training wanted to gain a credential while they are out of programme, or in an area not provided within their training programme, they would not be excluded from competing for that opportunity provided they met the relevant entry criteria.

If there is an area that is a requirement for all doctors in a specialty, it must be included in the postgraduate training curriculum. We will specifically seek this assurance through our approval process. As part of the process we will also require organisations proposing credentials to:

  • identify and address the likely impact and risks of the credential on patients
  • the service it will be supporting
  • relevant postgraduate training
  • and the current medical workforce in the area of practice.

Some large optional areas that are part of a training programme may be developed as credentials to support doctors who did not take that optional area as part of their training - but want to or need to develop in the area to meet patient or service needs. Doctors who met the outcomes of the discrete area of practice as part of their postgraduate training would be able to gain recognition if they choose to, by demonstrating they meet the outcomes for the credential.

What is the difference between GMC credentials and subspecialties?

GMC credentials are being introduced to address areas of patient safety need, whether that is due to a lack of regulation in a particular area of practice or because the existing training pathways do not meet the level of demand in the service. In the latter cases, it may be appropriate to introduce a GMC credential to help increase the number of doctors in an area of practice. They will be standalone qualifications, and as such are different from subspecialties and special interest areas included in specialty training.

We will continue to review and monitor the interaction between GMC credentials and subspecialties as GMC credentials start being recognised and are operational.

How will GMC credentials be reviewed and evaluated?

Our standards require organisations designing curricula to have processes in place to evaluate and continuously improve their curricula, and this will apply equally to credentials. We will review these approaches and updates through our postgraduate quality assurance processes.

How will doctors maintain their GMC credential?

As with recognition on the specialist register, most credentials will not have an ongoing maintenance process, although they may be necessary where there are fewer existing clinical governance systems in place. As with all doctors, those with credentials will need to continue to demonstrate competence within their whole scope of practice as part of existing processes within their appraisal and revalidation.

In earlier stages of developing our credentialing model, we explored how an ongoing maintenance process may provide an up-to-date statement about the currency of a doctor's credential. For some credentials, where there is a demonstrable patient safety need, we will consider how such an additional process will work.