SPECIALTY TRAINING CURRICULUM FOR NEUROLOGY AUGUST 2010

Joint Royal Colleges of Physicians Training Board
5 St Andrews Place Regent’s Park London NW1 4LB Telephone: (020) 79351174 Facsimile: (020)7486 4160 Email: ptb@jrcptb.org.uk Website: www.jrcptb.org.uk

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Table of Contents
1 2 Introduction........................................................................................................ 3 Rationale ........................................................................................................... 3 2.1 Purpose of the Curriculum .......................................................................... 3 2.2 Development............................................................................................... 3 2.3 Training Pathway ........................................................................................ 3 2.4 Enrolment with JRCPTB ............................................................................. 4 2.5 Duration of Training .................................................................................... 4 2.6 Less Than Full Time Training (LTFT) .......................................................... 4 2.7 Dual CCT .................................................................................................... 5 Content of Learning ........................................................................................... 5 3.1 Programme Content and Objectives ........................................................... 5 3.2 Good Medical Practice ................................................................................ 5 3.3 Syllabus ...................................................................................................... 6 Learning and Teaching .................................................................................... 33 4.1 The Training Programme .......................................................................... 33 4.2 Teaching and Learning Methods ............................................................... 33 4.3 Research .................................................................................................. 35 4.4 Academic Training .................................................................................... 36 Assessment ..................................................................................................... 37 5.1 The Assessment System .......................................................................... 37 5.2 Assessment Blueprint ............................................................................... 38 5.3 Assessment Methods................................................................................ 38 5.4 Decisions on Progress (ARCP) ................................................................. 40 5.5 ARCP Decision Aid ................................................................................... 42 5.6 Penultimate Year Assessment (PYA) ........................................................ 43 5.7 Complaints and Appeals ........................................................................... 43 Supervision and Feedback .............................................................................. 43 6.1 Supervision ............................................................................................... 43 6.2 Appraisal................................................................................................... 44 Managing Curriculum Implementation ............................................................. 45 7.1 Intended Use of Curriculum by Trainers and Trainees .............................. 45 7.2 Recording Progress .................................................................................. 46 Curriculum Review and Updating .................................................................... 46 Equality and Diversity ...................................................................................... 46

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1

Introduction

Neurology is the specialty encompassing the diagnosis, investigation and long term management of adults with neurological symptoms and diseases. The specialty also involves the care of patients with stroke disease and some trainees may elect to undertake an additional one year training scheme in stroke medicine to achieve subspecialty recognition. Some neurology trainees may also elect to undertake dual training in neurology and neurophysiology or other subspecialty. Equally neurophysiology trainees complete 12 months training in neurology within the neurophysiology training programme.

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2.1

Rationale
Purpose of the Curriculum

The purpose of this curriculum is to define the process of training and the competencies needed for the award of a certificate of completion of training (CCT) in neurology. This curriculum covers the period of training following successful completion of both a two year Foundation Programme and a two year Core Medical Training (CMT) Programme, through to the recognised award of CCT. The curriculum covers training for all four nations of the UK.

2.2

Development

This curriculum was developed in 2009 by the Specialty Advisory Committee (SAC) for neurology under the direction of the Joint Royal Colleges of Physicians Training Board (JRCPTB). It was written by the curriculum sub-committee, which included both a lay and trainee representative, and reviewed by the full SAC. It replaces the previous version of the curriculum dated 2007, with changes to ensure the curriculum meets GMC’s standards for Curricula and Assessment, and to incorporate revisions to the content and delivery of the training programme. Major changes from the previous curriculum include the incorporation of leadership, health inequalities and common competencies.

2.3

Training Pathway

Specialty training in Neurology consists of core and higher speciality training. Core training provides physicians with: the ability to investigate, treat and diagnose patients with acute and chronic medical symptoms; and with high quality review skills for managing inpatients and outpatients. Higher speciality training then builds on these core skills to develop the specific competencies required to practise independently as a consultant Neurologist. Core training may be completed in a Core Medical Training (CMT) or Acute Care Common Stem (ACCS) programme. The full curriculum for specialty training in Neurology therefore consists of the curriculum for either CMT or ACCS plus this specialty training curriculum for Neurology. The approved curriculum for CMT is a sub-set of the Curriculum for General Internal Medicine (GIM). A “Framework for CMT” has been created for the convenience of trainees, supervisors, tutors and programme directors. The body of the Framework document has been extracted from the approved curriculum but only includes the

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syllabus requirements for CMT and not the further requirements for acquiring a CCT in GIM. For those trainees undertaking CMT or ACCS, acquisition of full MRCP (UK) will be required before entry into Specialty training at ST3 (2011 onwards).

2.4

Enrolment with JRCPTB

Trainees are required to register for specialist training with JRCPTB at the start of their training programmes. Enrolment with JRCPTB, including the complete payment of enrolment fees, is required before JRCPTB will be able to recommend trainees for a CCT. Trainees can enrol online at www.jrcptb.org.uk.

2.5

Duration of Training

Although this curriculum is competency based, the duration of training must meet the European minimum of 4 years for full time specialty training adjusted accordingly for flexible training (EU directive 2005/36/EC). However the SAC has advised that training from ST1 will usually be completed in 7 years in full time training (2 years core plus 5 years specialty training). This is because the SAC believe it will take 5 years of full time specialty training for trainees to achieve all the competencies set out in this curriculum particularly in light of changes in training opportunities as the result of the European Working Time Directives. If trainees are undertaking sub-speciality training in Stroke Medicine, the SAC has advised a further 12 months training will be required to complete all the necessary competencies.
CCT after 84 months

Selection

Selection

FY2

Core Medical Training or ACCS

Neurology Specialty Training

MRCP
Work place based assessments

SCE

2.6

Less Than Full Time Training (LTFT)

Trainees who are unable to work full-time are entitled to opt for less than full time training programmes. EC Directive 2005/36/EC requires that: • LTFT shall meet the same requirements as full-time training, from which it will differ only in the possibility of limiting participation in medical activities.

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as described in both the neurology and second curricula. It is not guaranteed that post JRCPTB enrolment requests will be granted. Ideally therefore 2 LTFT trainees should share one post to provide appropriate service cover. less than full time trainees would still normally be expected to work a minimum of 50% of full time. in addition to acquiring new skills. If you are returning or converting to training at less than full time please complete the LTFT application form on the JRCPTB website www. has been exceeded. Trainees will need to achieve the competencies.2 Good Medical Practice In preparation for the introduction of licensing and revalidation. Funding for LTFT is from deaneries and these posts are not supernumerary. the General Medical Council has translated Good Medical Practice into a Framework for Appraisal and Neurology August 2010 Page 5 of 47 . Less than full time trainees should assume that their clinical training will be of a duration pro-rata with the time indicated/recommended. but this should be reviewed during annual appraisal by their TPD and chair of STC and Deanery Associate Dean for LTFT training.1 Content of Learning Programme Content and Objectives The neurology syllabus below sets out the general and professional content. with assessment evidence.jrcptb. Demonstration of completion of all these competencies is required to achieve a CCT in neurology. this will need approval of the deanery. then indicative training times as stated in curricula may be adjusted in line with the achievement of all stated competencies. 2. EC Directive 2005/36/EC states that there is no longer a minimum time requirement on training for LTFT trainees.org. 3. LTFT trainees should undertake a pro rata share of the out-of-hours duties (including on-call and other out-of-hours commitments) required of their full-time colleagues in the same programme and at the equivalent stage. Postgraduate Deans wishing to advertise such programmes should ensure that they meet the requirements of both SACs.uk . The above provisions must be adhered to. 3 3. in order to retain competence. Individual assessments may provide evidence towards competencies from both curricula. less than full time trainees were required to work a minimum of 50% of full time. STC Chair/TPD and SAC. In the past.7 Dual CCT Trainees who wish to achieve a CCT in another speciality as well as neurology must have applied for and successfully entered a training programme which was advertised openly as a dual training programme. As long as the statutory European Minimum Training Time (if relevant). as well as specialty specific (major topics and allied topics) content that need to be mastered. With competence-based training.• The competent authorities shall ensure that the competencies achieved and the quality of part-time training are not less than those of full-time trainees. If trainees wish to register for dual CCT following appointment to a ST3 post.

org/Framework_4_3. but in reviewing these we identified a need for more specific methods. as well as the Case Conference Assessment Tool currently being piloted. Neurology August 2010 Page 6 of 47 . Skills and Performance Domain 2 – Safety and Quality Domain 3 – Communication. See section 5. The Medical Leadership Competency Framework. The Framework can be accessed at http://www.pdf_25396256. These may include variants of CbD and ACAT. “GMP” defines which of the 4 domains of the Good Medical Practice Framework for Appraisal and Assessment are addressed by each competency. the “Assessment Methods” shown are those that are appropriate as possible methods that could be used to assess each competency.3 Syllabus In the tables below. has informed the inclusion of leadership competencies in this curriculum.2 for more details. It is expected trainees produce evidence of at least one satisfactory assessment from all the mandatory topics for the attainment of a CCT in neurology. This reflects the need for trainees to show competencies across the breadth of the curriculum with particular emphasis on the most important topics within the curriculum. JRCPTB and the RCP Education Department have established a working group to develop and evaluate leadership assessment methods. The assessments are marked as mandatory (M) or recommended (R) within the syllabus.Assessment which provides a foundation for the development of the appraisal and assessment system for revalidation. Partnership and Teamwork Domain 4 – Maintaining Trust The “GMP” column in the syllabus defines which of the 4 domains of the Good Medical Practice Framework for Appraisal and Assessment are addressed by each competency.2 for more details. 3. Most parts of the syllabus relate to “Knowledge. The Framework identified possible assessment methods. It is not expected that all competencies will be assessed and that where they are assessed not every method will be used. Skills and Performance” but some parts will also relate to other domains.pdf The Framework for Appraisal and Assessment covers the following domains: Domain 1 – Knowledge.gmc-uk. See section 3. developed by the Academy of Medical Royal Colleges and the NHS Institute for Innovation and Improvement.

9 1....3 Neurogenetics ....................................... 16 1.......................................................................................................................................................................16 Disorders of the Visual System ............. 25 2....................................... 11 1.............. Roots and Spinal Injury .................................. 16 2.........................11 Demyelination & Vasculitis ...............................2 Headache ....................... 28 3....... 19 2.......................8 Tumours of the NS.........5 Personal qualities ....................20 Disorders of Autonomic Nervous System ...........................................................................1 Head Injury ....................3 Disorders of Consciousness .........................................................1 Clinical Neurophysiology............................12 Special Interest Groups: Women & Pregnancy .................................... 24 2......... 19 2..............................................14 Special Interest Groups: Elderly............................................................. 12 1...................... 23 2.........19 Disorders of Peripheral Nerve .......................................................................Syllabus Content 1....................................................................................15 Toxic & Metabolic States .................. 22 2................................................................. 18 2...................................................... 21 2..........................................7 Neuropathology ................................ 29 3....................................................... General and Professional Content .....................................................2 Neurological Examination ...................................................................................................9 Infections of Nervous System ........ 21 2...................................... 30 3......... 23 2...............................................................22 Pain .... 9 1...9 Setting Direction ................. 15 1............................................................ 24 2........................................4 Disorders of Sleep ............. 27 3.. 30 3.................................................................................... 9 1............................................................................... 22 2.....5 Neuro-otology ............ 24 2....14 Motor Neuron Disease .............................4 Differential Diagnosis...................................................17 Disorders of Cranial Nerves ............. 28 3... 26 3..........8 Neuropsychiatry .......................................... 29 3.................. 14 1...............................6 Epilepsy and Loss of Consciousness .......... 14 1....................................................13 Special Interest Groups: Teenagers..............................................1 History Taking........7 Managing Services ............................ Neurological Complications of Systemic Cancer................................................................................. 10 1................................ 12 1....................................................................11 Presentation and Audit Skills ................. 27 3...............................9 Neuropsychology .................................. Investigation and Initial Management ....... 20 2... Spinal Cord...................... 20 2........12 The Neurological Complications of Immunosuppression ............................................................... Allied Topics within Neurology Curriculum ................................18 Disorders of Spine................ 18 2..... 18 2..6 Neuropaediatrics .....................10 CSF Disorders ...................................... 25 2.........................................................................................13 Parkinsonism & Movement Disorders ................................................................................................................................................................................................................... 26 2.........................................................15 Special Interest Groups: Learning Disabilities ...................................................... 29 3.........................................................................................3 Communication Skills ......... 16 1....... 10 1...............................................................10 Neuroradiology ......... 30 Neurology August 2010 Page 7 of 47 .................................... 18 2.......... 13 1.......................7 Cerebrovascular Disease.............. Major Topics within Neurology Curriculum.......................................................................................2 Neuroendocrinology....................................................8 Improving Services ..........................10 Clinical Pharmacology of Neurological Disorders .... 9 1......................5 Disorders of Higher Function & Behaviour ........... 22 2........ Complications of Treatment of Cancer .... 23 2........................ 15 1.......6 Working with others .......................16 Special Interest Groups: Terminally Ill........21 Disorders of Muscle ...................................................4 Neurointensive Care ............ 27 3..........

................................................................11 Neurorehabilitation.................................................................................................... 31 3................................... 31 3...............13 Neurourology ......................... 31 Neurology August 2010 Page 8 of 47 ........................12 Neurosurgery ....3..

3. legibility of case notes. respectful of diversity and patient-centred. and sensitively include questions about. mini-CEX. CbD. respect for patient’s personal dignity. socio-economic status. MSF 1.2. Skills Able to undertake an appropriate. Understand the differences between open and closed questioning.2. CbD.4 mini-CEX.4 1.2 Neurological Examination Knowledge A thorough working knowledge of neuroanatomy.4 Assessment Methods mini-CEX. General and Professional Content 1. Be aware of one’s own behaviour and how it might impact on patients’ health issues. PS 1. CbD (R) 1. CbD 1. CbD mini-CEX.2. CbD (R) 1. and communicate this verbally or in writing and in summary form.2. focussed and comprehensive history.4 mini-CEX. CbD. Ability to negotiate with patients. relatives and fellow healthcare professionals. CbD. CbD GMP 1. CbD GMP 1.4 mini-CEX.3.3.3. CbD.2. MSF. Communicate effectively with patients from diverse backgrounds and mini-CEX. including where appropriate information from others. MSF mini-CEX.4 Assessment Methods SCE.3 mini-CEX.2.4 1.1 History Taking Knowledge Ability to take a medical and neurological history. PS 1.3 1. Behaviours Ability to listen and deal with complex patients (e. discharge summaries.3. Be aware of the possible influence of. Adopt assessments and interventions that are inclusive.2. focussed and comprehensive examination of mental and physical state and communicate this verbally or in writing and in summary form. Appropriate use of an interpreter for patients & families when English is not their first language. mini-CEX.4 Assessment Methods mini-CEX. MSF 1.3. household poverty.3.4 mini-CEX.3. Behaviours Use of chaperone where appropriate. CbD GMP 1. CbD.3 Neurology August 2010 Page 9 of 47 . Skills Use of a Dictaphone. employment status and social capital in taking a medical history.2.2.3. 2. angry or distressed patient).3.g. Skills Able to take an appropriate. CbD 1.3 Communication Skills Knowledge Ability to communicate in English language verbally and in writing. Consideration and time shown to those with visual and auditory impairments.3.4 1.4 1. MSF mini-CEX.1. mini-CEX.

Adopt assessments and interventions that are inclusive. CbD GMP 1.3. their family and carers and other staff in relation to the individual needs of the patient and with appropriate regard for confidentiality.5 Personal qualities Identify own strengths.4 MSF MSF 1.3. CbD 1. develop an overall plan for the individual patient. Skills MSF.2. Understanding of the roles and usefulness of investigations including neuroimaging and neurophysiology. MSF 1.4 Differential Diagnosis. Behaviours Able to communicate effectively with the patient. Demonstrate leadership skills including mentorship of junior medical colleagues.2. Skills Able to formulate an appropriately ordered differential diagnosis based on an appreciation of the patient. their past history and current problems and their likely causes. respectful of diversity and patient-centred.2.3.4 1. Able to summarise clinical case in a coherent manner to clinical colleagues. CbD Assessment Methods GMP 1 1. CbD SCE. limitations and the impact of their behaviour and is able to change their behaviour in light of feedback and reflection Knowledge Demonstrates different methods of obtaining feedback. to obtain full and informed consent for investigations and treatment.4 MSF 1. to explain the patient’s condition. Able to give a prognosis.4 Assessment Methods SCE.2. mini-CEX. Investigation and Initial Management Knowledge Knowledge of the different presentations of common and less common neurological diseases.3.3.3. mini-CEX.4 1 Neurology August 2010 Page 10 of 47 .4 1. social & ethnic groups. Able to formulate a focussed and relevant series of investigations. Able to inform concerning patient support groups and relevant charities.2.2.3.3.2. such as the need for interpreters. MSF 1. religious & educational parameters must be taken into consideration.4 1.4 mini-CEX. seek appropriate opinions and interventions and with others. determine and prescribe immediate treatment. Consideration given for different racial.2.those with special communication needs. etc.4 MSF 1. Individual cultural. CbD mini-CEX.2.4 1.4 mini-CEX. Behaviours Able to plan and order appropriate observations.3. liaise with members of the MDT.3.2. Awareness of the trainee’s own values and principles and how these may differ from those of other individuals and groups. CbD 1. The importance of best practice transparency and consistency. to break bad news.3.

groups and agencies to implement plans and make decisions. Behaviours Recognising and showing respect for diversity and differences in others. CbD. Able to liaise with and understand the role of specialist nurses.4 MSF MSF 3 1. Assessment and appraisal of more junior clinical colleagues or students. Behaviours Showing recognition of a team approach. gaining trust and showing understanding.3.3 1.3.4 Neurology August 2010 Page 11 of 47 .6 Working with others Adopt a team approach. mentor. Continue to recognise the common purpose of the team and respect their decisions Knowledge Demonstrates a wide range of leadership styles and approaches and the applicability to different situations and people. supporting others.4 1.4 MSF 1.3 MSF 1. Demonstrate self management: organising and managing themselves while taking account of the needs and priorities of others. Organise and manage workload effectively and flexibly. PS MSF 1 1. 3 3 MSF Assessment Methods GMP 1 1. Shown willingness to act as a leader. complaints and other feedback to discuss and develop an understanding of own development needs. Shows commitment to continuing professional development which involves seeking training and self development opportunities. Able to contribute to or lead a MDT meeting.3. Able to liaise with.3 1.2. Use assessment.2. Build and maintain relationships by listening. respecting colleagues.Maintain and routinely practice critical self awareness. Identify own strengths and weaknesses. Knowledge of the roles and importance of different members of the MDT. learning from colleagues and accepting criticism. PS 1.2. 3 1 1.3 1. MSF MSF. including being able to discuss strengths and weaknesses with supervisor and recognising external influences and changing behaviour accordingly. educator and role model.2. Respect diversity of status and values in patients and colleagues.3 1. Skills Enable individuals. refer to and communicate with all members of the MDT in a constructive and professional manner in the interests of the patient and their carers. contributions and compromises.3. including non-medical professionals.3 3 1. acknowledging and appreciating efforts. appraisal.

including person specification and short listing criteria. Demonstrates understanding of how healthcare governance influences patient care. safe prescribing. Demonstrates knowledge of individual performance review.3 1.3 1. needlestick injury. reviewing performance and motivating others. sharps disposal. Skills Continue to contribute towards staff development and training.2 1.3 1 1 Assessment Methods GMP 1 1 1 1. competences and capabilities of other professionals and support workers. Identify risk management guidance e. risk management etc). Behaviours Commitment to good communication whilst also inspiring confidence and trust.3 1 1. rights and responsibilities of an employer and co-worker. Manage resources: know what resources are available and use influence to ensure that resources are used efficiently and safely. Manage performance: hold oneself and others accountable for service outcomes. Skills Assessment Methods GMP 1. 1. continue to encourage innovation and facilitate transformation Knowledge Demonstrate knowledge of risk management issues and risk management tools.2 1.8 Improving Services Ensure patient safety at all times.4 1 1 1. supervision and appraisal. Able to write a job description. Manage people: providing direction.2 1 1. Demonstrates a knowledge of a variety of methodologies for developing creative solutions to improving services.3. Understand the role of audit (improving patient care and services. Recall principles of risk assessment and management.g. Understand the roles. Contribute to the development of an organisational response to emerging health policy. Understand the steps involved in completing the audit cycle.1. Show knowledge of the duties. including mentoring.7 Managing Services Support team members to develop their roles and responsibilities and continue to review performance of the team members to ensure that planned service outcomes are met Knowledge Demonstrate knowledge of relevant legislation and HR policies.2 Neurology August 2010 Page 12 of 47 .

College and faculties. Is able to run committee meetings and work collegiately and collaboratively with a wide range of people outside the immediate clinical setting. Questions existing practice in order to improve the services.3 1. regulatory bodies.Reports clinical incidents. Behaviours Willingness to articulate strategic ideas and use effective influencing skills.2 1. Monitors the quality of equipment and safety of the environment relevant to the specialty.9 Setting Direction Is able to identify the contexts for change and is able to make decisions Knowledge Demonstrates knowledge of the functions and responsibilities of national bodies. Behaviours Seeks advice and or assistance whenever concerned about patient safety. Willingness to participate in decision making processes beyond the immediate clinical care setting. Be able to assess and manage risk to patients. 1. Apply knowledge and evidence: gathering information to produce an evidence-based challenge to systems and processes in order to identify opportunities for service improvements.3 1. ensuring faulty equipment is reported appropriately.2. representatives.3 1 1 Assessment Methods GMP 1 1 1.3 1. 3 Neurology August 2010 Page 13 of 47 . 1. Supports colleagues to voice new ideas and is open minded to new thoughts. Ensure the correct and safe use of medical equipment.2 2 1. Skills The ability to discuss the local. Demonstrates effective communication strategies within organisations.3 1.2 2 1. Make decisions: integrating values with evidence to inform decisions. national and UK health priorities and how they impact on the delivery of health care relevant to the specialty.

3. motor neuron disease.2. Ability to reflect upon changes in patient management as the result of a completed audit project. TO AA 1.3. CbD (R) mini-CEX.3 Assessment Methods AA GMP 1. CbD (R) 1. CbD 1.11 Presentation and Audit Skills Knowledge An understanding of the importance and processes of audit.4 1.3.10 Clinical Pharmacology of Neurological Disorders Knowledge Principles of neuro-pharmacokinetics and pharmacodynamics. audits or research papers.2. Skills Ability to give a range of oral presentations with the use of appropriate audio-visual aids including Powerpoint presentations. autoimmune disorders.3.3 Neurology August 2010 Page 14 of 47 . Presentations may involve clinical cases. multiple sclerosis. CbD 1. Understand limitations: compliance. CbD SCE.2.2.3.3 TO 1.3 AA TO 1. interactions. cost implications. dementia. infections.4 SCE. pain.2. epilepsy. Able to refer to local and national guidelines (NICE) and sources of evidence and information about treatments. movement disorders. Behaviours Utilise reporting mechanisms for adverse events. Understand principles of treatment especially vascular disease.2.3.4 1.4 mini-CEX.2. Behaviours Ability to adjust level of presentation dependent upon the anticipated audience. CbD GMP 1.4 1. migraine.1. Skills Able to plan and administer pharmacological treatments safely and effectively. adverse effects.3 1. Understand information needs of patients and others. both within an organisation and to national bodies.4 1. psychiatric disorders.4 Assessment Methods SCE.2. Ability to instigate and collate an audit project.2.3.2. Ability to answer questions from members of the audience. CbD (R) mini-CEX.

4 1. teratogenic risks of commonly prescribed drugs (especially AEDs) and genetic risks of neurological diseases. MSF 1. and transition disorders. Skills Ability to evaluate.2 1. Ability to evaluate. British National Formulary etc. For example.12 Special Interest Groups: Women & Pregnancy Knowledge Understand the effects of menarche. disability.4 1.3.3. culture.2. failure rate and interaction with drugs (especially antiepileptic drugs). CbD (R) mini-CEX.3. Knowledge of childhood neurological disorders presenting in early adulthood.4 mini-CEX.2 1. spirituality. diagnose and manage women with neurological disease. CbD SCE. CbD (R) 1. diagnose and manage teenagers with neurological disease.2 SCE.4 Assessment Methods SCE. CbD (R) 1. Behaviours Adherence to national guidelines (e.3. religion and sexuality 1.2 1. CbD 1. (see neuropaediatric section) Skills Understand the special needs of teenagers. race. effects of drugs on pregnancy (foetus and mother) and pregnancy on drugs.4 Assessment Methods SCE.Recognise how health systems can discriminate against patients from diverse backgrounds.13 Special Interest Groups: Teenagers Knowledge Knowledge of neurological disorders presenting in adolescence. Knowledge of the neonatal complications in offspring of affected women with neurological conditions.2 1.4 mini-CEX.2. particular issues of confidentiality. CbD SCE. Knowledge of methods of contraception. MSF MSF 1. CbD SCE.2.2.2 Neurology August 2010 Page 15 of 47 .2. Ability to interface with obstetricians. psychosexual dysfunction in neurological illness (especially epilepsy). presymptomatic/prenatal diagnosis of neurological conditions.3. Understand the effect of pregnancy on existing neurological disorders and neurological disorders as complications of pregnancy. gender. menstrual cycle and menopause on common neurological disorders. CbD GMP 1.3. Behaviours Ability to interface with paediatricians in the handover of patients from paediatric to adult neurological practice. CbD GMP 1.g. in respect of age. NICE guidelines for epilepsy. and how to work to minimise this discrimination.2.

3.3.4 Assessment Methods SCE.16 Special Interest Groups: Terminally Ill Knowledge Understand end of life issues in neurological disorders and the role of palliative care services and specialist nurses. Understand the specific issues of the Mental Capacity Act in relation to this patient group.2 1. Ability to evaluate. CbD (R) mini-CEX. CbD 1.4 Assessment Methods SCE.2.4 mini-CEX.3.3.2 1.3.15 Special Interest Groups: Learning Disabilities Knowledge Understanding of the common causes of learning disabilities and the different presentation of symptoms in this group. role of departments of medicine for the elderly. Skills Understand the needs of patients with special educational needs with neurological disorders.2.3.2 Neurology August 2010 Page 16 of 47 .3. Skills Understand the specific issues of the Mental Capacity Act in relation to this patient group.4 1.4 1. CbD (R) 1. Behaviours Ability to interface with geriatricians and care agencies dealing with the elderly population.4 mini-CEX. Skills Ability to communicate end of life issues including the withdrawal of treatment and organ donation with patients and relatives.2.4 Assessment Methods SCE.2. investigation and management of dementia. Ability to discuss Advanced Directives to Refuse Treatment (ADRT) with patients and relatives Behaviours mini-CEX. CbD 1.3. CbD GMP 1. communication with relatives and care agencies. CbD (R) mini-CEX.4 mini-CEX. CbD (R) 1.2. (see neuropaediatric section) Recognise the stigmatising effects of some illnesses and work to help in overcoming stigma. hospital based & community services. CbD GMP 1. MSF 1. diagnose and manage the elderly with neurological disease.2.2. Behaviours Ability to interface with fellow professionals and care agencies dealing with patients with learning disabilities. effects of drugs in the elderly.2. ethical and legal aspects of terminal care.1. special presentations of neurological disease in the elderly.14 Special Interest Groups: Elderly Knowledge Understand the normal clinical and radiological findings in the elderly. CbD GMP 1. diagnosis. MSF 1.

4 Neurology August 2010 Page 17 of 47 .3.Ability to interface with fellow professionals and care agencies dealing with patients with end of life issues. MSF 1.2.

2 Headache Knowledge Knowledge of the clinical features.3. CbD (R) 1. Ability to interface with neurosurgeons and ITU staff.2. MSF 1. MSF 1. urgent blood tests.3. clinical features and prognosis of permanent vegetative state. CbD GMP 1. definitions. Behaviours Demonstration of relevant general and professional content competencies. CbD (M) 1. CbD (R) 1.1 Head Injury Knowledge Knowledge of symptoms and signs of head injury and its complications.3. differential diagnosis and specific pharmacological and general treatment of the causes of headache and facial pain.2. formulate a strategy for immediate and short term management.2.3.2 mini-CEX. Skills Ability to evaluate and manage people with acute head injury: perform immediate resuscitative measures. Ability to evaluate and manage post traumatic change in consciousness. behaviour and cognition. indications for medical interventions. Skills Ability to assess the unresponsive patient and to formulate plan of investigation and management. CbD (R) 1. indications for investigations. causes. CbD GMP 1. Major Topics within Neurology Curriculum 2. and the pathophysiology of disorders of consciousness. CbD (M) 1.4 Assessment Methods SCE. CbD 1.2.2.2 1. pathophysiology.4 mini-CEX.3.2.2. An understanding of the role of relevant investigations: brain scanning. locked in state and brainstem death.2 SCE. Skills Ability to evaluate and manage people with headache & facial pains.4 mini-CEX.4 Assessment Methods SCE.3 Disorders of Consciousness Knowledge Knowledge of anatomy and physiology of consciousness. CbD GMP 1.4 Neurology August 2010 Page 18 of 47 . urgent and delayed neurosurgery. ITU referral.2. lumbar puncture.4 2. primary and secondary effects of head injury. CbD SCE. Behaviours Demonstration of relevant general and professional content competencies.2 mini-CEX. Assessment Methods SCE. and other post-traumatic symptoms (including epilepsy).4 mini-CEX.3.3. An understanding of the legal issues relating to disorders of consciousness.2 2.

5 Disorders of Higher Function & Behaviour Knowledge An understanding of memory.2. indications.g.3.4 Disorders of Sleep Knowledge Knowledge of narcolepsy.2.4 MSF 1.4 1.2 1. effects of neurological conditions on sleep.2. role of neuropsychological evaluation (inc. An understanding of the effects of sleep on the EEG.3. Ability to work with community and support services.2. Skills Ability to evaluate and manage people with sleep disorders. MSF 1.3. CbD (M) mini-CEX.4 Assessment Methods SCE. enduring power of attorney). Mental Capacity Act. CbD 1. CbD GMP 1.3. Knowledge of driving regulations and the consequences and complications of sleep disorders.2 Neurology August 2010 Page 19 of 47 . visuospatial function & behaviour.4 mini-CEX. Skills Ability to evaluate and manage people with disordered higher function & behaviour. Development of interpersonal skills for relating to management of the family of people with disorders of consciousness.2 2.2. specific treatments.4 Assessment Methods SCE.3. risks and costs of investigations. Behaviours Demonstration of relevant general and professional content competencies.4 1. definition and epidemiology of dementia. Behaviours Demonstration of relevant general and professional content competencies. daytime hypersomnolence. CbD (R) 1. CbD (R) mini-CEX. CbD (R) 1. genetic aspects. parasomnias. Behaviours Demonstration of relevant general and professional content competencies. mini-CEX.3.3.2. CbD (M) 1. Evaluation of competency (e. pathology and clinical features of individual dementias.4 2. language. obstructive sleep apnoea. dementia and mood scales).2 SCE. principles of physical and pharmacological treatment.2. MSF 1.2. CbD SCE.4 mini-CEX.Use of tests for brainstem death.4 1.3. scope and limitations of the sleep laboratory.3. CbD GMP 1. CbD (R) mini-CEX.2. relevant investigations.

2 SCE. An understanding of the role and limitation of imaging (e. Knowledge of the epidemiology.2 1.g.2.3.6 Epilepsy and Loss of Consciousness Knowledge Knowledge of the differential diagnosis of paroxysmal and transient events. endartectomy). role of epilepsy surgery. Knowledge and management of other causes of loss of consciousness including syncope. vocation and sudden death. Multidisciplinary stroke care. MSF 1.4 1. mini-CEX (M) 1.2. CTA. CbD 1.g. CbD 1. intracranial haemorrhage and venous thrombosis.4 Assessment Methods SCE.2 SCE. Awareness of issues related to women and pregnancy.2.2 SCE. risk factors and their management. recognition and management of non-epileptic seizures. Cerebral aneurysm and AVM. CbD 1. surgical and radiotherapy treatment. CbD 1. CbD 1.3. Skills Ability to work competently within a stroke MDT and on-call setting. driving. the role of medical secondary prevention and surgical interventions (e. Knowledge. nutrition after stroke.7 Cerebrovascular Disease Knowledge Knowledge of the cerebral circulation and its determinants. CbD (M) mini-CEX.2 2.4 mini-CEX. cerebral haemorrhage. organisation of stroke units. CbD GMP 1.3. treatment of refractory seizures. Ability to evaluate and mange people with stroke disease Behaviours MSF CbD. Skills Ability to evaluate and manage people with epilepsy. Recognise that people can be denied employment opportunities unnecessarily through myths.4 1. rehabilitation techniques. features of stroke /TIA. CbD SCE. role of evaluation scales. psychological and social consequences of epilepsy especially teenagers. hemicraniectomy.2 SCE.2. serial seizures and status epilepticus.3.4 Assessment Methods SCE.2. Behaviours Demonstration of relevant general and professional content competencies. be aware of the role of doctors and other services in combating this inequality. cerebral venous thrombosis and vascular dementia. CbD 1.2 1. CbD SCE. use of anti-epileptic drugs.3. stigma. drop attacks and vaso-vagal episodes. community stroke care. investigation and management of acute stroke (including thrombolysis) and TIA as medical emergencies. CbD GMP 1. DWI). scope and limitations of investigations.2 SCE. interventional.2 Neurology August 2010 Page 20 of 47 . dogma and insufficient advocacy and support. pathophysiology of cerebral infarction. subarachnoid haemorrhage.

2.4 mini-CEX. Skills Ability to evaluate and manage people with infections of NS. CbD 1. Demonstrate appropriate history and communication skills (i. CbD (R) 1. Based on an understanding of risk.3. Knowledge of prion disorders and its wider implications. MSF 1.2 SCE. Complications of Treatment of Cancer Knowledge Neuropathological classification of brain tumours.2.2. sexual and travel history.4 2. benefits and risks of therapies including surgery and radiotherapy. neurosyphilis). encephalitis. CbD GMP 1.4 2.3.9 Infections of Nervous System Knowledge Principles of neurological infectious disease. or need for HIV testing) in a patient with suspected NS infection. such as infection control risk. clinical features of the common tumours of the nervous system including malignant meningitis.4 Assessment Methods SCE.2. CbD 1.Demonstration of relevant general and professional content competencies.8 Tumours of the NS.e. MSF 1.2 SCE. neurological complications of chemotherapy and radiotherapy.4 Assessment Methods SCE. CbD (R) 1. anti-microbial therapies and their use. Skills Ability to evaluate and manage people with primary tumours of the NS or effects of systemic tumours or their treatment. HIV. microbiologists. Understanding the role of the neuro-oncology MDT.3.4 Neurology August 2010 Page 21 of 47 . clinical features of these diseases and their causes (including meningitis.2 mini-CEX. the importance of liaison with infectious disease physicians.2 SCE. CbD 1. Clinical features and immunology of paraneoplastic syndromes. Diagnostic techniques and their appropriate use.3. CbD GMP 1. Behaviours Demonstration of relevant general and professional content competencies. TB.3. CbD (R) 1. MSF 1.2 SCE.2 mini-CEX. CbD 1. be able to apply epidemiological principles and public health approaches so as to reduce and prevent disease and improve the health of populations.3.2. public health and occupational health medicine in relation to neurological infections. Behaviours Demonstration of relevant general and professional content competencies.2. Neurological Complications of Systemic Cancer.

Skills Ability to evaluate & manage people with demyelinating & vasculitic disorders.2 mini-CEX. Management of specific impairments and disabilities arising in MS. techniques. clinical features of these diseases. role of disease modifying drugs. Skills Ability to evaluate and manage people with immunological disorders caused by disease or treatment. CbD 1. MSF 1. biochemistry and immunology of CSF. Immunosuppressive and immunomodulatory therapies. management of shunts. Behaviours Demonstration of relevant general and professional content competencies.2. CbD (M) 1. CbD 1.2. their actions. treatments of raised intracranial pressure.4 2.4 mini-CEX.2.2 SCE.3. and contraindications of CSF examination.4 mini-CEX. related demyelinating disorders and vasculitic and arteritic disorders.11 Demyelination & Vasculitis Knowledge Biology of demyelination & vasculitis. CbD GMP 1. indications. Skills Able to evaluate and manage people with disorders of CSF including diagnostic and therapeutic lumbar punctures. Use of disability rating scales. CbD GMP 1. Methods of intracranial pressure monitoring.4 Assessment Methods SCE.2 SCE.2 2.2 SCE. CbD (R) DOPS (R) 1.12 The Neurological Complications of Immunosuppression Knowledge Principles of immune responses in relation to the NS.2. CbD GMP 1.2.3. clinical features of multiple sclerosis.4 Assessment Methods SCE. blood brain barrier.10 CSF Disorders Knowledge CSF composition and dynamics. CbD 1.3. diagnostic techniques and their appropriate use.3.3. symptomatic treatments and therapies. CbD (R) 1.2. anatomy and radiology of the ventricular system.3.2 Neurology August 2010 Page 22 of 47 .4 Assessment Methods SCE. immunological basis underlying auto-immune neurological disease. MSF 1. Behaviours Demonstration of relevant general and professional content MSF 1.2 SCE. genesis of hydrocephalus.2. side effects and indications. Behaviours Demonstration of relevant general and professional content competencies. CbD 1.

2 mini-CEX. Neurological presentations of renal & hepatic failure. CO. calcium and acid base disorders.2. heavy metals.4 2. lithium. Skills Ability to evaluate and manage people with Parkinsonism and Movement Disorders. CbD SCE.4 Assessment Methods SCE.2 SCE.2 1. radiation). PD specialist nurse). CbD 1. CbD (M) mini-CEX.2 2.4 1.4 mini-CEX. 2. Psychiatric morbidity associated with substance abuse. disease modifying and symptomatic treatments (e. NO and organophosphate poisoning. cocaine. Treatment (and complications of treatment) of movement disorders. Skills Ability to evaluate and manage people with motor neuron disease.2. amphetamine neurotoxicity. Ability to liaise with other members of MDT (e.4 Assessment Methods SCE. clinical features and management of hyper/hypo-thermia. CbD (M) 1. of therapeutic agent neurotoxicity (e.2 Neurology August 2010 Page 23 of 47 . MSF 1.2. nutritional deficiencies and porphyria. NIV). Role and value of blood and urine toxicology.2. dystonia.2 SCE. Special issues of breaking bad news and prognosis.2. chorea/athetosis. opiates).g.2 SCE. CbD GMP 1. assessment of other organ damage.g. sodium.g. Behaviours Demonstration of relevant general and professional content competencies.competencies. CbD GMP 1. Behaviours Demonstration of relevant general and professional content competencies. of heavy metal.15 Toxic & Metabolic States Knowledge Biochemistry and neuropathology of exposure to alcohol and other recreational drugs (cocaine.3. knowledge of advanced directives and living wills.3. vincristine. Assessment Methods SCE.3.13 Parkinsonism & Movement Disorders Knowledge Clinical features and differential diagnosis of parkinsonism. CbD SCE.2 1. palliative care aspects. amphetamine.14 Motor Neuron Disease Knowledge Clinical features and differential diagnosis of motor neuron syndromes. CbD GMP 1. pesticides and therapeutic agents. tics and tremor. role of neurosurgical interventions. CbD 1. clinical features of alcohol. CbD (M) 1. potassium. imaging and neurophysiology.3.3. role of investigations in diagnosis (including DAT scans). MSF 1. CbD 1. opiate.

Skills Ability to evaluate and manage people with metabolic/toxic states. pituitary fossa.2. Spinal Cord. spinal cord. MSF 1.2 mini-CEX. CbD (M) 1. pathological processes involving cranial nerves and their central connections.2.2 2.2 SCE. Skills Ability to evaluate and manage people with disorders of cranial nerve function. Emergency management of spinal cord or root compression. clinical features & clinical assessment of cranial nerve function. CbD GMP 1. Behaviours Demonstration of relevant general and professional content competencies. hearing & balance. particularly the orbit.2.4 mini-CEX. Behaviours Demonstration of relevant general and professional content competencies.17 Disorders of Cranial Nerves Knowledge Anatomy of the skull base.2 SCE.2. speech & swallowing disorders. Assessment Methods SCE. oculomotor disorders & pituitary disease.4 2. CbD (R) 1. Assessment Methods SCE. CbD (R) 1. fields and higher function).2 SCE. cavernous sinus.3. CbD GMP 1. clinical evaluation of the eye and adnexae. clinical features and conditions which may affect these systems. management of neck and low back pain and sciatica. Driving regulations. MRI.3.4 mini-CEX. clinical features of spinal cord. vision (acuity. CbD 1. root and cauda equina syndromes. foramen magnum and jugular foramen.2.18 Disorders of Spine. Management of cranial nerve disorders including multidisciplinary approaches to visual. roots. Skills Ability to evaluate and manage people with disorders of the visual system including visual failure. CbD 1.3.16 Disorders of the Visual System Knowledge Applied anatomy and physiology of the visual and oculomotor systems. of spinal injury. Behaviours Demonstration of relevant general and professional content competencies.3. MSF 1. Roots and Spinal Injury Knowledge Anatomy of the spine.3.4 MSF 1. myelography and spinal angiography.4 Assessment Methods SCE.2 Neurology August 2010 Page 24 of 47 . CbD GMP 1.3.2. CbD 1. potential and limitations of spinal CT.4 2. indications for urgent investigation.

MSF 1. MSF 1.4 2. CbD (M) 1. general management of acute neuromuscular paralysis.3.3.2. Skills Ability to evaluate and manage people with disorders of peripheral nerves (including plexus lesions).4 mini-CEX. constipation. traumatic & entrapment neuropathies. autonomic dysfunction and sensory loss.2.3. Skills Ability to evaluate and manage people with disorders of the autonomic nervous system.20 Disorders of Autonomic Nervous System Knowledge Anatomy and physiology of ANS. MSF 1. spinal cord and roots.3. and the acute & chronic consequences of acute spinal cord injury including effects of paralysis. CbD GMP 1.3. Behaviours Demonstration of relevant general and professional content competencies. clinical features of ANS disorders alone and as part of other condition e. multi-system atrophy. erectile disorder.g. clinical features & investigation of genetic and acquired axonal and demyelinating neuropathies. Behaviours Demonstration of relevant general and professional content competencies.2. CbD (R) 1. investigations including autonomic function tests.4 Assessment Methods SCE.4 Assessment Methods SCE. autonomic dysreflexia.2. CbD GMP 1.4 mini-CEX.2 Neurology August 2010 Page 25 of 47 . Behaviours Demonstration of relevant general and professional content competencies.2.Skills Ability to evaluate and manage people with disorders of the spine.19 Disorders of Peripheral Nerve Knowledge Anatomy and pathology of peripheral nerves. plexopathies and mononeuritis multiplex. Pharmacological and physical managements of urinary retention. CbD (M) 1.4 mini-CEX. CbD 1. postural hypotension.2 2. management of Guillain-Barré syndrome and other severe paralysing neuropathies.3.2 SCE.2.

4 Assessment Methods SCE. Role of Pain Clinic. CbD (R) 1.4 mini-CEX.2.3. CbD (R) 1.3. effective use of pharmacological agents and other measures for pain relief including nerve blocks.22 Pain Knowledge Theories of pain generation. Behaviours Demonstration of relevant general and professional content competencies.2. CbD 1. CbD 1. understanding of MDT approach.g.2.2.2 2.4 mini-CEX. TNS.2 SCE.3.21 Disorders of Muscle Knowledge Clinical features and investigation of genetic and acquired disorders of the neuromuscular junction and voluntary muscle including periodic disorders and disorders of energy metabolism (e.3.4 Assessment Methods SCE. Behaviours Demonstration of relevant general and professional content competencies. MSF 1. Management including cardio-respiratory and anaesthetic considerations.2 SCE. Skills Ability to evaluate and manage people with neurological disorders causing pain and common non neurological causes of pain including musculoskeletal disease. MSF 1. psychological and social effects of chronic pain.2 Neurology August 2010 Page 26 of 47 . CbD GMP 1.2. Skills Ability to evaluate and manage people with disorders of muscle. pain patterns in neurological and systemic diseases. acupuncture and neurosurgical interventions. CbD GMP 1. mitochondrial disorders).

2. capabilities and limitations in neurological disorders. ability to interpret a neurophysiology report. neurological emergencies.3.2 SCE.3. Skills Understand the principles of the NS in endocrine function and neurological features of endocrine disorder particularly pituitary disease.2.2 mini-CEX. EMG/NCS/repetitive stimulation – principles of techniques.3. Behaviours Demonstration of relevant general and professional content competencies.3.3. muscle disease. CbD (M) 1.common abnormalities in neurological diseases. CbD 1. CbD 1.2 SCE.2. CbD GMP 1. evaluation of sleep disorders. Evoked potentials . emergency management of disorders. Ability to interface with neurophysiology colleagues. relationships with neurological disorders.2 mini-CEX.4 Assessment Methods SCE. MSF 1. sleep disorders.3. Allied Topics within Neurology Curriculum 3. CbD GMP 1.2.2.2 SCE. role of monitoring techniques (telemetry.4 Neurology August 2010 Page 27 of 47 .2 Neuroendocrinology Knowledge Clinical features and investigations in endocrine disorders.4 3.4 mini-CEX.3. particularly demyelination.4 mini-CEX. abnormalities in common nerve entrapments. CbD 1.1 Clinical Neurophysiology Knowledge EEG . Ability to interface with endocrinological colleagues. (see sections on epilepsy. ambulatory). common epileptiform abnormalities. Behaviours Demonstration of relevant general and professional content competencies. peripheral neuropathies. Skills Understand role and practice of neurophysiological investigations in disorders of the nervous system.normal range of EEG findings. MSF 1. role of intraoperative EP. disorders of neuromuscular junction. motor neuron disease. CbD (R) 1.4 Assessment Methods SCE. CbD (R) 1. Steroid therapy and its complications. CbD (M) 1.2. peripheral nerve and muscle).

2 1. failure to regain consciousness and paralysis.4 Neurology August 2010 Page 28 of 47 .3. multiple sclerosis.2.3. legal and ethical issues in brain death. CbD (M) mini-CEX. stroke.2 SCE. indications for and methods of artificial nutrition.4 Assessment Methods SCE. Clinical.4 1. causes. the principles of cardiovascular and respiratory support.2 mini-CEX. and neurocutaneous syndromes).g. Behaviours Demonstration of relevant general and professional content competencies. (see sections on epilepsy.3. MSF 1. coma and vegetative state. roles of a detailed family history and of DNA based diagnostic tests. CbD (M) 1. CbD 1.2 SCE. Genetic contribution to multifactorial neurological disease (e.4 1. Huntington’s disease.2.3. muscle diseases. Ability to interface with genetic colleagues.2 1. Behaviours Demonstration of relevant general and professional content competencies. relatives and staff in ICU.2. epilepsy). CbD SCE.3. An understanding of the role of bioinformatic databases of human disease.3.3. ICU neurological complications of major surgery. drugs & medical disorders.2.4 Assessment Methods SCE.3 Neurogenetics Knowledge Basic genetic principles including inheritance patterns and common diagnostic methods. Skills Ability to evaluate and manage (with others) people in ICU. CbD (M) mini-CEX. MSF 1.4 1. CbD 1. CbD SCE. CbD GMP 1. investigation and management of coma (including epilepsy and raised intracranial pressure).2.3.2. CbD SCE.2 1. head injury & disorders of consciousness). Clinical features of common genetic conditions (hereditary ataxias. CbD GMP 1. CbD (M) 1.4 Neurointensive Care Knowledge Clinical features. ability to interpret a genetics report. sepsis. Ability to interface and communicate with patients. Ability to counsel and consent patients and families prior to undergoing genetic testing. Skills Understand the principles of genetics as applied to neurological disorder.2. CbD (M) mini-CEX.4 mini-CEX. subarachnoid haemorrhage. diagnosis of and ability to define the vegetative state. hereditary neuropathies.2 3. management of status epilepticus.

techniques. CbD GMP 1. histological. CbD (R) mini-CEX. history and examination techniques including vestibular manoeuvres.2. metabolic conditions. MSF 1. Ability to examine teenage children.3.2 3. MSF 1. role of and consent process for necropsy examination: role of a coroner.3.2. Ability to perform diagnostic and therapeutic vestibular manoeuvres. immunological & microbiological techniques. brain preparation. Behaviours Demonstration of relevant general and professional content MSF 1. Skills Ability to evaluate the deaf and / or dizzy person and interpret reports including audiograms. histochemical. CbD GMP 1.4 3.3.5 Neuro-otology Knowledge Applied anatomy and physiology of hearing and balance. biochemical.3.4 mini-CEX. CbD (R) mini-CEX.2. CbD (R) 1. Ability to interface with ENT and audiological colleagues. learning disability and autism.4 Neurology August 2010 Page 29 of 47 . CbD (R) mini-CEX.M.2.3. CbD GMP 1. Skills Ability to evaluate and manage neurological disorders in teenagers in liaison with paediatric neurologists. immunocytochemical and E. cerebral palsy. Behaviours Demonstration of relevant general and professional content competencies. Skills Ability to appropriately request pathological investigations and interpret pathology reports.3.6 Neuropaediatrics Knowledge Understanding of neurological disorders in intrauterine life and childhood.2. anatomy of brain sections.4 1. CbD (R) 1. understand and interpret reports issued.3. knowledge of developmental disorders (including effects of intrauterine and perinatal factors on neural development).4 Assessment Methods SCE. CbD 1.4 1.2.2. Understand the importance of clinico-pathological conferences. Knowledge of paediatric conditions that can present in adulthood.7 Neuropathology Knowledge Understand the pathological and biochemical basis of neurological disorders.2.2 mini-CEX. Behaviours Demonstration of relevant general and professional content competencies. key stages of development and range of normality.2 SCE.4 Assessment Methods SCE.3.2 mini-CEX.3. CbD (R) mini-CEX.4 Assessment Methods SCE. CbD (R) 1. conditions affecting the vestibulocochlear system.

2. Skills Ability to utilise basic clinical tests of cognitive function. CbD GMP 1. CbD (R) 1. CbD GMP 1.2 Neurology August 2010 Page 30 of 47 . understand the mini-CEX. catheter angiography diagnostic/interventional.2. myelography. WAIS. other special investigations e. CbD GMP 1.2 mini-CEX. understand mini-mental state examination and basic neuropsychological tests employed by Clinical Psychologists.8 Neuropsychiatry Knowledge Understanding of common psychiatric disorders (including learning disability). CbD (M) 1. attention.3. Behaviours Demonstration of relevant general and professional content competencies. PET. CbD (R) 1.2. Assessment Methods SCE.4 3.2 mini-CEX. Behaviours Demonstration of relevant general and professional content competencies. explain the nature.9 Neuropsychology Knowledge Understanding of neuroanatomical and neurophysiological basis of memory.g. interpret and utilise neuro-radiological investigations appropriately. somatisation). the mental health act and when it can be used.3. ultrasound carotid/transcranial/cardiac.2. Ability to evaluate and manage acute organic brain syndromes.3. NART.2. language and perception.4 MSF 1. psychiatric consequences of neurological disease and neurological features in people with psychiatric disorders. and to interpret reports. CbD (R) 1. MSF 1.g.3. MR scan cranial/spinal/angiography. Skills Ability to request and evaluate neuroradiological investigations and reports. to understand the need to refer to and the role of the Clinical Neuropsychologist.competencies.10 Neuroradiology Knowledge Request. liaise effectively with the neuroradiologist. risks and benefits of neuroradiological investigations (CT scan cranial/angiography. understand the value and limitations of neuropsychological interventions such as Cognitive Behavioural Therapy.4 Assessment Methods SCE. neurological features which may have psychiatric causes (including medically unexplained symptoms. conversion disorder.3. Skills Ability to evaluate and interpret psychiatric symptoms in and as presentations of neurological disorders.2. 3.4 Assessment Methods SCE.3.4 mini-CEX.4 3. e. SPECT) to patients. Ability to liaise effectively and appropriately with psychiatry services.

risks and limitations of common techniques. Behaviours Demonstration of relevant general and professional content competencies. MSF 1. head injury. intracranial haemorrhage and ischaemic stroke. limitations.4 MSF 1. differential diagnosis of causes of disordered micturition and erectile dysfunction.and hyper-sexuality.3. CbD SCE. process and complications of biopsy procedures (brain. CbD GMP 1. relevant social work legislation and availability of care in the community. CbD (M) 1.2.4 mini-CEX. Skills Ability to evaluate the requirement for neurosurgical interventions in people with neurological disorders and to liaise effectively with the neurosurgeon.3.4 3. vascular malformation and tumours. spinal cord and root disorder and peripheral nerve lesions.2. Skills Ability to evaluate the requirement for rehabilitation in people with neurological disorders (including stroke.4 Assessment Methods SCE. raised intracranial pressure.2 Neurology August 2010 Page 31 of 47 .3.4 3.2. lead an MDT meeting being aware of the different roles. activity & participation.2 mini-CEX.3. Understanding of the principles of general and specific risks and complications of neurosurgical interventions. if appropriate. approach and agenda of rehabilitation teams.2. CbD GMP 1. Contribute to and.2 1. Ability to perform and utilise a functional assessment.2. nerve). Understand the purpose. skills. Assessment Methods SCE. aneurysm. muscle. CbD (M) 1. MSF 1. impairment.12 Neurosurgery Knowledge Understand the role of neurosurgery in the management of head injury.2 mini-CEX.2 SCE. spinal injury and MS) in the context of a multidisciplinary team and make appropriate referrals.2.3.role. understand the potential and limitations of neurorehabilitation. Behaviours Demonstration of relevant general and professional content competencies. CbD 1.3.4 3. Behaviours Demonstration of relevant general and professional content competencies. CbD GMP 1. understand the social perspective.13 Neurourology Knowledge Understand normal control of micturition and sexual function. understand hypo. understand Assessment Methods SCE.11 Neurorehabilitation Knowledge Understand the difference between pathology. CbD (M) 1.

manage and or refer people with disordered micturition and sexual function due to neurological disorder.2.3.treatment strategies for disorders of micturition and sexual function.4 MSF 1.2. CbD (R) 1.4 1. Genitourinary Medicine or Uroneurologist. Skills Ability to evaluate.3. Ability to refer appropriately to Urology.2.3. Behaviours Demonstration of relevant general and professional content competencies. CbD (R) mini-CEX.4 Neurology August 2010 Page 32 of 47 . mini-CEX.

their educational supervisor and STC Chair/TPD. neuropsychology and neuropathology. the remit of the regional neurology STC. However.1 Learning and Teaching The Training Programme The organisation and delivery of postgraduate training is the statutory responsibility of the General Medical Council (GMC) which devolves responsibility for the local organisation and delivery of training to the deaneries. Neurology August 2010 Page 33 of 47 . There will be a balance of different modes of learning from formal teaching programmes to experiential learning ‘on the job’. clinical skills appropriate to their level of training and to their attachment within the department. therefore. The training to be provided at each training site is defined to ensure that. during the programme. This section identifies the types of situations in which a trainee will learn. At least one site must include the allied specialties of neurosurgery. Trainees will learn from practice. Prospective approval should be sought from GMC/JRCPTB to determine if time spent. All trainees should have exposure to a ‘DGH type’ setting for the minimum of a 12 month period or equivalent total time period. The proportion of time allocated to different learning methods may vary depending on the nature of the attachment within a rotation. but for the purpose of this document is defined as a training site with unselected neurological exposure and training opportunities. Each deanery oversees a “School of Medicine” which is comprised of the regional Specialty Training Committees (STCs) in each medical specialty. Responsibility for the organisation and delivery of specialty training in neurology in each deanery is. Clinical placements will usually be for between 3 and 12 months as directed by the STC Chair/TPD and all trainees will spend time in a minimum of two neurological training sites. This setting may vary between different training programmes. the sequence of training should ideally be flexible enough to allow the trainee to develop a special interest. during an OOPE can be counted towards the attainment of a CCT in neurology. neurophysiology. 4.4 4. neuroradiology. The sequence of training should ensure appropriate progression in experience and responsibility. This may include time spent in research or experience in other deaneries or overseas and will be determined following discussions between the trainee.2 Teaching and Learning Methods The curriculum will be delivered through a variety of learning experiences. Trainees will achieve the competencies described in the curriculum through a variety of learning methods. Each STC has a Training Programme Director who coordinates the training programme in the specialty. the entire curriculum is covered and also that unnecessary duplication and educationally unrewarding experiences are avoided. and experience gained. All trainees will have the option of Out Of Programme Experience (OOPE) appropriate to their training needs and aspirations.

• Specialty-specific takes • Post-take consultant ward-rounds • Personal ward rounds and provision of ongoing clinical care on specialist medical ward attachments. including those post-take. It is expected trainees keep a record of all ward referrals and on call emergency admissions seen within their portfolios. should be led by a consultant and include feedback on clinical and decision-making skills. This includes day-to-day review (i. 2 of these per week will be general neurology clinics and the remainder will allow opportunities to attend sub-specialty clinics. note keeping. It is expected trainees will complete the equivalence of 2. The complexity of these will vary enormously and close supervision from consultants will ensure every training opportunity is realised. These provide excellent opportunities for observation of clinical reasoning. These include trainee led journal clubs. and the initial management of the acutely ill patient with referral to and liaison with clinical colleagues as necessary.e.Learning with Peers . It is expected trainees attend a minimum of 2 consultant-led ward rounds per week throughout the majority of time in training. Trainees will be encouraged to create local forums for peer learning opportunities. • Consultant-led ward rounds.There are many opportunities for trainees to learn with their peers.5 out patient clinics per week (max 4 per week) throughout the full training programme. As experience and clinical competence increase trainees will assess ‘new’ and ‘review’ patients and present their findings to their clinical supervisor. under direct supervision. The degree of responsibility taken by the trainee will increase as competency increases. Every time a trainee observes another doctor. There are many situations where clinical problems are discussed with clinicians in other disciplines. • Provision of a ward referral service for the in-patients of other hospital specialties. • Multi-disciplinary team meetings. The degree of responsibility taken by the trainee will increase as competency increases. seeing a patient or their relatives there is an opportunity for learning. After initial induction.1 Supervision and Feedback). trainees will review patients in outpatient clinics. consultant or fellow trainee. Patients seen should provide the basis for critical reading and reflection of clinical problems.The content of work-based experiential learning is decided by the local faculty for education but includes active participation in: • Medical clinics including specialty clinics. which will be enhanced by following the patient through the course of their illness: the experience of the evolution of patients’ problems over time is a critical part both of the diagnostic process as well as management. Local postgraduate teaching opportunities allow trainees of varied levels of experience to come together for small group sessions. on the ward or in out-patients. discussion of cases and participation in regional or departmental grand round presentations Work-based Experiential Learning . Trainees have supervised responsibility for the care of in-patients for a minimum of 2 out of the 5 years training programme. Neurology August 2010 Page 34 of 47 . providing continuity of care) of clinical conditions. Every patient seen. There should be appropriate levels of clinical supervision throughout training with increasing clinical independence and responsibility as learning outcomes are achieved (see Section 6. Examination preparation encourages the formation of self-help groups and learning sets. Ward rounds. provides a learning opportunity.

Trainees will also be encouraged to attend relevant national training courses covering the major topics within the curriculum utilising their study leave entitlements.Formal Postgraduate Teaching – The content of these sessions are determined by the local faculty of medical education and will be based on the curriculum. For those in specialty training. a weekly core training hour of teaching within a Trust) • Case presentations • Journal clubs • Research and audit projects • Lectures and small group teaching • Grand Rounds • Clinical skills demonstrations and teaching • Critical appraisal and evidence based medicine and journal clubs • Joint specialty meetings • Attendance at training programmes organised on a deanery or regional basis. subject to local conditions of service. reflective learning. the deanery (via an OOPR form) and the JRCPTB (via a Research Application Form) are necessary steps. national and international meetings. Applications to research bodies. Suggested activities include: • Reading. including web-based material • Maintenance of personal portfolio (self-assessment. It is expected a register of attendance at these training will be collated for the STC Chair/TPD. may undertake a research project as an ideal way of obtaining those competencies. There are many opportunities throughout the year for formal teaching in the local postgraduate teaching sessions and at regional. The frequency. All trainees will be expected to attend the regional training days for neurology trainees. core curriculum Formal Study Courses . personal development plan) • Audit and research projects • Reading journals • Achieving personal learning goals beyond the essential. 4. Examples include management courses and communication courses. format and range of formal postgraduate teaching opportunities will vary between different training programmes and different clinical placements. Independent Self-Directed Learning -Trainees will use this time in a variety of ways depending upon their stage of learning.Time to be made available for formal courses is encouraged. It requires an estimate of the competencies that Neurology August 2010 Page 35 of 47 . which are the responsibility of the trainee. Suggested activities include: • A programme of formal bleep-free regular teaching sessions to cohorts of trainees (e. The JRCPTB Research Application Form can be accessed via the JRCPTB website. in addition to those specified in their specialty curriculum. one option to be considered is that of taking time out of programme to complete a specified project or research degree. which are designed to cover aspects of the training programme outlined in this curriculum.3 Research Trainees who wish to acquire research competencies. Many of these are organised by the Royal Colleges of Physicians.g.

A maximum period of 3 years out of programme is allowed and the SACs will recognise up to 12 months towards the minimum training times. The deanery will make an application to the GMC for approval of the out of programme research.will be achieved and. 12 month Masters. 3-Year PhD).g. once completed. Upon completion of the research period the competencies achieved will be agreed by the OOP Supervisor. entirely laboratorybased or strong clinical commitment). This process is shown in the diagram below: OOPR Applicant seeks approval from Deanery Deanery grant time to go OOP SAC decide on research content OOPR Applicant applies to JRCPTB for OOP approval OOPR Applicant obtains competencies whilst OOP SAC decide how many competencies can be counted towards minimum training time OOP applicant returns to programme at appropriate competency level Funding will need to be identified for the duration of the research period. Educational Supervisor and communicated to the SAC. The JRCPTB will submit applications to the relevant SACs for review of the research content including an indicative assessment of the amount of clinical credit (competence acquisition) which might be achieved. 4. it should be returned to JRCPTB together with a job description and an up to date CV. The competencies achieved will determine the trainee’s position on return to programme. there are now well-defined posts at all levels in the Integrated Academic Training Pathway (IATP) involving the Neurology August 2010 Page 36 of 47 .4 Academic Training For those contemplating an academic career path. All applications for out of programme research must be prospectively approved. This is likely to be influenced by the nature of the research (e. On approval by the SAC. accessing the facilities available on the JRCPTB ePortfolio. the JRCPTB will advise the trainee and the deanery of the decision. This would be corroborated by the subsequent ARCP. for example if an ST3 trainee obtains all ST4 competencies then 12 months will be recognised towards the minimum training time and the trainee will return to the programme at ST5.g. as well as duration (e. 2year MD. Trainees need not count research experience or its clinical component towards a CCT programme but must decide whether or not they wish it to be counted on application to the deanery and the JRCPTB.

uk/intetacatrain and http://www.ac.pdf). see http://www.1 Assessment The Assessment System The purpose of the assessment system is to: • enhance learning by providing formative assessment. • inform the Annual Review of Competence Progression (ARCP).uk/careersacademicmedicine. 5 5.nccrcd. and recommendations to allow completion of clinical training would be made (assuming other progress to be satisfactory). • ensure trainees are acquiring competencies within the domains of Good Medical Practice.uk/forms/Documents/GoldGuide2009. Academic trainees may wish to focus on education or research and are united by the target of a consultant-level post in a university and/or teaching hospital.jrcptb.aspx.jrcptb.pdf. A postgraduate degree will usually be essential (see “out of programme experience”) and academic mentorship is advised (see section 6. typically starting as a senior lecturer and aiming to progress to readership and professor. • provide robust. enabling trainees to receive immediate feedback.academicmedicine.uk/uploads/A-pocket-guide. whereas a trainee whose project is strongly clinically oriented may complete within the “normal” time (see the guidelines for monitoring training and progress) http://www. • assess trainees’ actual performance in the workplace.ac. Academic integrated pathways to CCT are a) considered fulltime CCTs as the default position and b) are run through in nature. For full details see http://www. measure their own performance and identify areas for development.nhs.1).National Institute for Health Research (NIHR) and the Academy of Medical Sciences (AMS). The academic programmes are CCT programmes and the indicative time academic trainees to achieve the CCT is the same as the time set for non-academic trainees. Neurology August 2010 Page 37 of 47 .uk for details of the process. summative evidence that trainees are meeting the curriculum standards during the training programme.org. An academic trainee working in an entirely laboratory-based project would be likely to require additional clinical training.org. • ensure that trainees possess the essential underlying knowledge required for their specialty. • identify trainees who should be advised to consider changes of career direction. If a trainee fails to achieve all the required competencies within the notional time period for the programme. identifying any requirements for targeted or additional training where necessary and facilitating decisions regarding progression through the training programme. Academic competencies have been defined by the JRCPTB in association with AMS and the Colleges and modes of assessment have been incorporated in the latest edition of the Gold Guide (section 7. this would be considered at the ARCP. All applications for research must be prospectively approved by the SAC and the regulator. • drive learning and enhance the training process by making it clear what is required of trainees and motivating them to ensure they receive suitable training and experience. Extension of a CCT date will be in proportion depending upon the nature of the research and will ensure full capture of the specialty outcomes set down by the Royal College and approved by GMC. see www.academicmedicine.

Workplace-based assessments will take place throughout the training programme to allow trainees to continually gather evidence of learning and to provide trainees with formative feedback.2 Assessment Blueprint In the syllabus (3. More information about these methods including guidance for trainees and assessors is available in the ePortfolio and on the JRCPTB website www.The integrated assessment system comprises workplace-based assessments and knowledge – based assessments. Individual assessment methods are described in more detail below. in association with the Association of British Neurologists (ABN) has developed a Specialty Certificate Examination. is available on the MRCP(UK) website www. 5. Workplace-based assessments should be recorded in the trainee’s ePortfolio. This is explained in the guidance notes provided for the techniques. The workplace-based assessment methods include feedback opportunities as an integral part of the assessment process. Information about the SCE in neurology.org. It is not expected that all competencies will be assessed and that where they are assessed not every method will be used.uk. 5.3) the “Assessment Methods” shown are those that are appropriate as possible methods that could be used to assess each competency. Multisource Feedback (MSF) Neurology August 2010 Page 38 of 47 . The number and range of these will ensure a reliable assessment of the training relevant to their stage of training and achieve coverage of the curriculum.jrcptb. The SCE in neurology is a summative assessment that is a prerequisite for attainment of the CCT. including guidance for candidates. They are not individually summative but overall outcomes from a number of such assessments provide evidence for summative decision making.3 Assessment Methods The following assessment methods are used in the integrated assessment system: Examinations The Federation of Royal Colleges of Physicians of the UK. The aim of this national assessment is to assess a trainee’s knowledge and understanding of the clinical sciences relevant to specialist medical practice and of common or important disorders to a level appropriate for a newly appointed consultant.mrcpuk.org Workplace-based assessments • Multi-Source Feedback (MSF) • mini-Clinical Evaluation Exercise (mini-CEX) • Direct Observation of Procedural Skills (DOPS) • Case-Based Discussion (CbD) • Patient Survey (PS) • Audit Assessment (AA) • Teaching Observation (TO) These methods are described briefly below.

The trainee receives immediate feedback to identify strengths and areas for development. and includes doctors. administration staff. The CbD should include discussion about a written record (such as written case notes. The complexity of each mini-CEX should relate to the level of training and the breadth should cover the full curriculum over the 5 years training programme. derived from a number of colleagues. out-patient letter. These assessments are not mandatory within the neurology curriculum although trainees may wish to incorporate lumbar puncture as a recommended DOPS. and presentations of. ‘Raters’ are individuals with whom the trainee works. Direct Observation of Procedural Skills (DOPS) A DOPS is an assessment tool designed to assess the performance of a trainee in undertaking a practical procedure. decisionmaking and application of medical knowledge in relation to patient care. cases by trainees. This decision will be made in response to educational supervisor reports or the decisions from an ARCP.This tool is a method of assessing generic skills such as communication. A minimum of 4 satisfactory assessments per year with the use of at least two assessors is a mandatory requirement. team working.3. It also serves as a method to document conversations about. A typical encounter might be when presenting newly referred patients in the out-patient department. against a structured checklist.3. These should complement the mini-CEX assessments. The trainee receives immediate feedback to aid learning. leadership. These are highlighted as mandatory (M) or recommended (R) in the syllabus section 3. The trainee will not see the individual responses by raters but feedback is given to the trainee by the Educational Supervisor. All trainees must complete a minimum of 4 satisfactory mini-CEX assessments per year with a maximum of 2 per year per assessor as a mandatory requirement. This provides objective systematic collection and feedback of performance data on a trainee. examination and clinical reasoning. Patient Survey (PS)* Neurology August 2010 Page 39 of 47 . across the domains of Good Medical Practice. but the STC Chair/TPD may stipulate additional MSF assessments for all or some trainees within a training programme. These are highlighted as mandatory (M) or recommended (R) in the syllabus section 3. All trainees will need to complete a minimum of two MSF assessments during the 5 years training programme as a mandatory requirement. The mini-CEX can be used at any time and in any setting when there is a trainee and patient interaction and an assessor is available. The complexity of each CbD should relate to the level of training and the breadth should cover the full curriculum over the 5 years training programme. Case based Discussion (CbD) The CbD assesses the performance of a trainee in their management of a patient to provide an indication of competence in areas such as clinical reasoning. discharge summary). reliability etc. The complexity of the lumbar puncture procedure (for example therapeutic rather than diagnostic) should be greater than that achieved during CMT. mini-Clinical Evaluation Exercise (mini-CEX) This tool evaluates a clinical encounter with a patient to provide an indication of competence in skills essential for good clinical care such as history taking. and other allied professionals.

The ARCP Decision Aid is included in section 5. Trainees should show how they have instigated. as well as representatives from the deanery including lay membership. It is not currently used as a mandatory or recommended assessment but its use and inclusion will be reviewed on a regular basis at times of curriculum review. which are important to patients. Teaching Observation (TO)* The Teaching Observation form is designed to provide structured. The evidence to be reviewed by ARCP panels should be collected in the trainee’s ePortfolio. Neurology August 2010 Page 40 of 47 .uk). giving details of the evidence required of trainees for submission to the ARCP panels. The Audit Assessment can be based on review of audit documentation or on a presentation of the audit at a meeting. It is intended to assess the trainee’s performance in areas such as interpersonal skills.4 Decisions on Progress (ARCP) The Annual Review of Competence Progression (ARCP) is the formal method by which a trainee’s progression through her/his training programme is monitored and recorded. *Optional assessment method Audit Assessment Tool (AA) The Audit Assessment Tool is designed to assess a trainee’s competence in completing an audit. The ARCP panel will include the STC Chair in neurology (or his/her nominated deputy). ARCP is not an assessment – it is the review of evidence of training and assessment.Patient Survey address issues. as outlined below in the ARCP Decision Aid at least 2 weeks before the ARCP date.5. If possible the trainee should be assessed on the same audit by more than one assessor. including behaviour of the doctor and effectiveness of the consultation. It is expected that this assessment will form part of required assessments in the future. The Teaching Observation can be based on any instance of formalised teaching by the trainee that has been observed by the assessor. formative feedback to trainees on their competence at teaching. All trainees are expected to complete 2 audit projects within the 5 years training programme. All trainees should receive a minimum of 3 months notice of the date of the ARCP. Deaneries are responsible for organising and conducting ARCPs. All trainees will be expected to ensure that their ePortfolio is up-to-date with all the necessary evidence. The ARCP process is described in A Reference Guide for Postgraduate Specialty Training in the UK (the “Gold Guide” – available from www.mmc. This assessment has been piloted by some neurology trainees and supervisors in conjunction with the JRCPTB. *Optional assessment method 5. communication skills and professionalism by concentrating solely on their performance during one consultation. as well as reflected upon any changes in clinical management as a result of work completed. The process should be trainee-led (identifying appropriate teaching sessions and assessors).nhs. a minimum of 1 other neurology educational supervisor. collated and presented a piece of work.

All trainees in OOPE will also undergo an ARCP and need a satisfactory report from their educational or research supervisor.Trainees are not expected to attend the ARCP meeting but will be notified of the panel’s conclusions. Neurology August 2010 Page 41 of 47 .

(R) Recommended Multisource Feedback (M) mini-CEX (M) Satisfactory MSF Minimum 4 satisfactory spread across curriculum. As ST3 with broadening curriculum coverage and complexity. ST6 SCE passed/attempted Satisfactory MSF As ST3 with broadening curriculum coverage and complexity. Case based Discussion (M) Teaching Observation* Patient Survey* Direct Observation of Procedural Skills (R) ePortfolio (M) Minimum 4 satisfactory. ST7 Specialty Certificate Examination passed to achieve CCT (M) Mandatory. As ST3 Evidence of breadth of coverage of the curriculum.5 ARCP Decision Aid ST 3 Examinations (M) ST4 and ST5 Specialty Certificate Examination (SCE) attempted As ST3 with broadening curriculum coverage and complexity. * Optional assessment method Neurology August 2010 Page 42 of 47 . As ST3 Satisfactory PS As ST3 with broadening curriculum coverage and complexity to include all mandatory topics within curriculum. As ST3 with broadening curriculum coverage and complexity. As ST3 Evidence of experience across the whole curriculum. As ST3 with broadening curriculum coverage and complexity to include all mandatory topics within curriculum. As ST3 but with increasing coverage of the curriculum. spread across curriculum and complementary to mini-CEX. To provide triangulation of ePortfolio evidence and context for interpretation of CbD and mini-CEX.5. Satisfactory TO Educational and Clinical Supervisor’s Reports (M) Audit Assessment Tool (M) Minimum of 2 completed audits in 5 years training programme. Satisfactory TO Satisfactory PS Lumbar Puncture Evidence of clinical experience commensurate with clinical attachments during ST3.

Whilst the ARCP will be a review of evidence.6 Penultimate Year Assessment (PYA) The penultimate ARCP prior to the anticipated CCT date will include an external assessor from outside the training programme. responsible for overseeing their education. the Academy of Medical Royal Colleges and the Gold Guide team at MMC. Appeals against decisions concerning in-year assessments will be handled at deanery level and deaneries are responsible for setting up and reviewing suitable processes. All workplace-based assessment methods incorporate direct feedback from the assessor to the trainee and the opportunity to discuss the outcome. If a trainee has a complaint about the outcome from a specific assessment this is their first opportunity to raise it. The responsibilities of supervisors have been defined by GMC in the document “Operational Guide for the PMETB Quality Framework”.5. consistent with safe and effective care for the patient. If a formal complaint about assessment is to be pursued this should be referred in the first instance to the chair of the Specialty Training Committee who is accountable to the regional deanery. Trainees may have more than one educational supervisor dependent upon the geography of a local training programme.7 Complaints and Appeals The MRCP(UK) office has complaints procedures and appeals regulations documented in its website which apply to all examinations run by the Royal Colleges of Physicians including the specialty certificate examination (SCE). JRCPTB and the deanery will coordinate the appointment of this assessor. Royal Colleges of Physicians or hospital trust led. and are reproduced below: Neurology August 2010 Page 43 of 47 . Trainees will at all times have a named educational supervisor throughout the 5 years training programme (or longer if time is spent for OOPE) in addition to clinical supervisors in each placement. 6 6. 5. These definitions have been agreed with the National Association of Clinical Tutors. All educational supervisors will have undergone appropriate training and a record of this will be collected by the STC Chair/TPD in each deanery and forwarded to the SAC in neurology Chair. the PYA will include a face to face component. Continuing concerns should be referred to the Associate Dean. This training may be deanery. Outpatient and referral supervision must routinely include the opportunity to personally discuss all cases if required.1 Supervision and Feedback Supervision All elements of work in training posts must be supervised with the level of supervision varying depending on the experience of the trainee and the clinical exposure and case mix undertaken. Depending on local arrangements these roles may be combined into a single role of educational supervisor. This is known as “PYA”. As training progresses the trainee should have the opportunity for increasing autonomy.

The Educational Supervisor should be part of the clinical specialty team. This process ensures adequate supervision during training provides continuity between posts and different supervisors and is one of the main ways of providing feedback to trainees. Some training schemes appoint an Educational Supervisor for each placement. and feedback from ARCP. All appraisals should be recorded in the ePortfolio Induction Appraisal The trainee and clinical/educational supervisor should have an appraisal meeting at the beginning of each post to review the trainee’s progress so far. and attendance at Neurology August 2010 Page 44 of 47 . these would be discussed with the Educational Supervisor. regular appraisal meetings with supervisors. other meetings and discussions with supervisors and colleagues. Thus if the clinical directorate (clinical director) have any concerns about the performance of the trainee. but is encouraged particularly if either the trainee or educational or clinical supervisor has training concerns or the trainee has been set specific targeted training objectives at their ARCP. 6. Workplace-based assessments and progress through the curriculum can be reviewed to ensure trainees are progressing satisfactorily. Reviewing progress through the curriculum will help trainees to compile an effective Personal Development Plan (PDP) of objectives for the upcoming post. recording their commitment to the training process. Clinical supervisor A trainer who is selected and appropriately trained to be responsible for overseeing a specified trainee’s clinical work and providing constructive feedback during a training placement. which are integral to trainee development. Mid-point Review This meeting between trainee and educational supervisor is mandatory (except when an attachment is shorter than 6 months). or there were issues of doctor or patient safety. The trainee and supervisor should also both sign the educational agreement in the e-portfolio at this time. when meeting with the trainee. must not detract from the statutory duty of the trust to deliver effective clinical governance through its management systems.2 Appraisal A formal process of appraisals and reviews underpins training. These processes. risk management and any report of any untoward clinical incidents involving the trainee. The roles of Clinical and Educational Supervisor may then be merged. This PDP should be agreed during the Induction Appraisal.Educational supervisor A trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a specified trainee’s educational progress during a training placement or series of placements. agree learning objectives for the post ahead and identify the learning opportunities presented by the post. The Educational Supervisor. At this meeting trainees should review their PDP with their supervisor using evidence from the e-portfolio. Opportunities for feedback to trainees about their performance will arise through the use of the workplace-based assessments. The Educational Supervisor is responsible for the trainee’s Educational Agreement. should discuss issues of clinical governance.

educational events should also be reviewed. If there are significant concerns following the end of attachment appraisal then the programme director should be informed. such as planned workplace-based assessments. Developments in the curriculum will be fed to STC Chairs/TPDs from the deanery. End of Attachment Appraisal Trainees should review the PDP and curriculum progress with their clinical/educational supervisor using evidence from the e-portfolio. All trainees should meet their educational supervisor approximately 1-2 months before the ARCP date to review the progress in training since the last ARCP. This training may be deanery. This training should include diversity training and a record of training undertaken will be collected by the STC Chair/TPD in each deanery and forwarded to the SAC in neurology Chair. The trainee will use the curriculum to develop learning objectives and reflect on learning experiences. 7 7. and this should be recorded. appraisal and teaching techniques (e.uk. It is expected that the educational supervisor will feedback the results of any MSF assessments or any other relevant reports to the trainee and a summary of this assessment will be available to the ARCP panel in the ePortfolio. study days from the Physicians as Educators Course run by the Royal College of Physicians of London). It is Neurology August 2010 Page 45 of 47 .1 Managing Curriculum Implementation Intended Use of Curriculum by Trainers and Trainees This curriculum and ePortfolio are web-based documents which are available from the Joint Royal Colleges of Physicians Training Board (JRCPTB) website www. Both trainers and trainees are expected to have a good knowledge of the curriculum and should use it as a guide for their training programme. Royal Colleges of Physicians or hospital trust led. The trainee and educational supervisor should summarise the progress formally in writing in the Educational Supervisor’s Report in the ePortfolio to help inform the ARCP process.jrcptb. Further evidence of competence in certain areas may be needed.g.org. The educational supervisors and trainers can access the up-to-date curriculum from the JRCPTB website and will be expected to use this as the basis of their discussion with trainees. The PDP can be amended at this review. All educational supervisors will have undergone appropriate training on how to be effective educational supervisor. The training of STC Chairs/TPDs will be expected to be more comprehensive than educational supervisors and include sessions on trainees in difficulty (TID). Each trainee will engage with the curriculum by maintaining an ePortfolio. SAC or JRCPTB and it will be the responsibility of the STC Chairs/TPDs to disseminate this information to all the educational and clinical supervisors. Specific concerns may be highlighted from this appraisal. The end of attachment appraisal form should record the areas where further work is required to overcome any shortcomings.

Any changes made will then be sent to the JRCPTB and GMC for approval. prepare drafts of appraisal forms. Changes in neurological practice as the result of changes in NHS services and treatments will be incorporated. arrange assessments and ensure they are recorded. it warmly welcomes contributors and applicants from as diverse a population as possible. They are also expected to update the trainee’s record of progress through the curriculum. with the requirements of equality and diversity legislation. Deanery quality assurance will ensure that each training programme complies with the equality and diversity standards in postgraduate medical training as set by GMC. disability. The ePortfolio allows evidence to be built up to inform decisions on a trainee’s progress and provides tools to support trainees’ education and development. age. 9 Equality and Diversity The Royal Colleges of Physicians will comply. Accordingly. either as members of staff and Officers.suggested that each STC Chair/TPD hold regular review meetings with all the supervisors to review the local training programme. record their reflections on learning and record their progress through the curriculum. reflections and personal development plans to inform appraisal meetings. as advisers from the medical profession. Neurology August 2010 Page 46 of 47 .2 Recording Progress On enrolling with JRCPTB trainees will be given access to the ePortfolio for neurology. such as the: • Race Relations (Amendment) Act 2000 • Disability Discrimination Act 1995 • Human Rights Act 1998 • Employment Equality (Age) Regulation 2006 • Special Educational Needs and Disabilities Act 2001 • Data Protection Acts 1984 and 1998 The Federation of the Royal Colleges of Physicians believes that equality of opportunity is fundamental to the many and varied ways in which individuals become involved with the Colleges. 8 Curriculum Review and Updating The curriculum will be reviewed every 2 years by the curriculum subcommittee of the SAC (including the trainee and lay membership). write end-of-attachment appraisals and supervisor’s reports. ethnic origin. maintain their personal development plan. gender or sexual orientation. The trainee’s main responsibilities are to ensure the ePortfolio is kept up to date. and ensure compliance. religion. The supervisor’s main responsibilities are to use ePortfolio evidence such as outcomes of assessments. Compliance with anti-discriminatory practice will be assured through: • monitoring of recruitment processes. as members of the Colleges' professional bodies or as doctors in training and examination candidates. and actively seeks to recruit people to all its activities regardless of race. 7.

which has now been published. This will complement procedures on the consideration of special needs which have been in existence since 1999 and were last updated by the MRCP(UK) Management Board in January 2005. Chronic progressive condition. Blind/Partially sighted. Autism Spectrum Disorder (including Asperger Syndrome). All efforts shall be made to ensure the participation of people with a disability in training. The Academic Committee would be responsible for policy and regulations in respect of decisions on accommodations to be offered to candidates with disabilities. asthma. such as the Race Relations (Amendment) Act 2000. as amended by the Race Relations (Amendment) Act 2000. ethnicity. Upper limb or back problem. ensuring trainees have an appropriate. Deaneries and Programme Directors must ensure that on appointment trainees are made aware of the route in which inappropriate or discriminatory behaviour can be reported and supplied with contact names and numbers. MRCP(UK) has introduced standard operating procedures to deal with the common problems e.” In order to meet its obligations under the relevant equal opportunities legislation such as the Disability Discrimination Acts 1995 and 2005. Neurology August 2010 Page 47 of 47 . the MRCP(UK) Central Office. Deaneries must ensure that educational supervisors have had equality and diversity training (at least as an e learning module) every 3 years Deaneries must ensure that any specialist participating in trainee interview/appointments committees or processes has had equality and diversity training (at least as an e module) every 3 years. monitoring of College Examinations. All Examiner nominees are required to sign up to the following statement in the Examiner application form “I have read and accept the conditions with regard to the UK Race Relations Act 1976. Mental Health difficulty. and the Disabilities Discrimination Acts of 1995 and 2005 as documented above. the Colleges’ Examinations Departments and the panel of Examiners have adopted an Examination Race Equality Action Plan. sexual orientation or disability (other than that which would make it impossible to practise safely as a physician). This ensures that all staff involved in examination delivery will have received appropriate briefing on the implications of race equality in the treatment of candidates. In order to meet its obligations under the relevant equal opportunities legislation. confidential and supportive route to report examples of inappropriate behaviour of a discriminatory nature. epilepsy). Mobility difficulties. External advice was sought in the preparation of the updated Equality Discrimination Plan. Deaneries must also ensure contingency mechanisms are in place if trainees feel unhappy with the response or uncomfortable with the contact individual.g. Repetitive Strain Injury (RSI).g. Chronic recurrent condition (e. The Regulations introduced to update the Disability Discrimination Acts and to ensure that they are in line with EU Directives have been considered by the MRCP(UK) Management Board. and others as appropriate. ensuring all assessments discriminate on objective and appropriate criteria and do not unfairly disadvantage trainees because of gender. Deaf/Hearing loss. Dyslexia/Learning disability. the MRCP(UK) Management Board is formulating an Equality Discrimination Plan to deal with issues of disability.• • • • • • ensuring all College representatives and Programme Directors have attended appropriate training sessions prior to appointment or within 12 months of taking up post.

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