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

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

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

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

Communicate effectively with patients from diverse backgrounds and mini-CEX.4 1. CbD. household poverty. respect for patient’s personal dignity. CbD (R) 1.4 1. Be aware of the possible influence of.4 mini-CEX.1 History Taking Knowledge Ability to take a medical and neurological history. mini-CEX. CbD mini-CEX. Consideration and time shown to those with visual and auditory impairments.3 mini-CEX.2. focussed and comprehensive examination of mental and physical state and communicate this verbally or in writing and in summary form.3.4 mini-CEX.3.2 Neurological Examination Knowledge A thorough working knowledge of neuroanatomy. CbD GMP 1.3. MSF 1.2.2. MSF 1.2. socio-economic status. CbD GMP 1.1. CbD.4 Assessment Methods mini-CEX. CbD. mini-CEX. Understand the differences between open and closed questioning.2. Appropriate use of an interpreter for patients & families when English is not their first language. PS 1.g. Skills Use of a Dictaphone.2.3. CbD 1.3. General and Professional Content 1. including where appropriate information from others. CbD 1.3 Communication Skills Knowledge Ability to communicate in English language verbally and in writing. discharge summaries.4 mini-CEX.4 1.3. Skills Able to take an appropriate. and communicate this verbally or in writing and in summary form. Behaviours Ability to listen and deal with complex patients (e. CbD. legibility of case notes. Adopt assessments and interventions that are inclusive.3 1. focussed and comprehensive history.4 Assessment Methods mini-CEX. angry or distressed patient).3.2. CbD.4 1. Behaviours Use of chaperone where appropriate. employment status and social capital in taking a medical history. respectful of diversity and patient-centred.2.4 Assessment Methods SCE. and sensitively include questions about. Be aware of one’s own behaviour and how it might impact on patients’ health issues. PS 1. Skills Able to undertake an appropriate. MSF mini-CEX. CbD.4 mini-CEX. CbD GMP 1.3. relatives and fellow healthcare professionals. 2. MSF. CbD (R) 1. mini-CEX.2. Ability to negotiate with patients.3.3 Neurology August 2010 Page 9 of 47 .3.3. MSF mini-CEX.

2.2.3. 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.3. CbD SCE. to explain the patient’s condition.2. CbD GMP 1. CbD 1. their past history and current problems and their likely causes.4 1.4 Assessment Methods SCE. MSF 1. The importance of best practice transparency and consistency. such as the need for interpreters. MSF 1. Understanding of the roles and usefulness of investigations including neuroimaging and neurophysiology.4 mini-CEX.2. CbD Assessment Methods GMP 1 1. Adopt assessments and interventions that are inclusive. Consideration given for different racial.3. CbD 1.2. mini-CEX.3.4 MSF 1.4 1. religious & educational parameters must be taken into consideration. Able to give a prognosis. etc. Behaviours Able to plan and order appropriate observations.3.2.5 Personal qualities Identify own strengths.3.3.3. Skills MSF.3.2. liaise with members of the MDT.4 1.4 1.4 1 Neurology August 2010 Page 10 of 47 .4 MSF 1. their family and carers and other staff in relation to the individual needs of the patient and with appropriate regard for confidentiality.3.4 MSF MSF 1.2. Able to summarise clinical case in a coherent manner to clinical colleagues. Able to inform concerning patient support groups and relevant charities. Investigation and Initial Management Knowledge Knowledge of the different presentations of common and less common neurological diseases.4 Differential Diagnosis. Able to formulate a focussed and relevant series of investigations. Skills Able to formulate an appropriately ordered differential diagnosis based on an appreciation of the patient. CbD mini-CEX. Demonstrate leadership skills including mentorship of junior medical colleagues. to obtain full and informed consent for investigations and treatment. seek appropriate opinions and interventions and with others.4 mini-CEX. determine and prescribe immediate treatment.those with special communication needs. mini-CEX.2. respectful of diversity and patient-centred. develop an overall plan for the individual patient. Individual cultural. to break bad news.3. Awareness of the trainee’s own values and principles and how these may differ from those of other individuals and groups. social & ethnic groups.2. Behaviours Able to communicate effectively with the patient.

Skills Enable individuals. Identify own strengths and weaknesses. Knowledge of the roles and importance of different members of the MDT. CbD.6 Working with others Adopt a team approach. including being able to discuss strengths and weaknesses with supervisor and recognising external influences and changing behaviour accordingly. Demonstrate self management: organising and managing themselves while taking account of the needs and priorities of others. MSF MSF.2. respecting colleagues. complaints and other feedback to discuss and develop an understanding of own development needs. 3 1 1.3 1. learning from colleagues and accepting criticism. contributions and compromises. groups and agencies to implement plans and make decisions. PS MSF 1 1. PS 1. appraisal. Behaviours Showing recognition of a team approach. Behaviours Recognising and showing respect for diversity and differences in others.3.3 1.4 Neurology August 2010 Page 11 of 47 .4 MSF 1. 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. acknowledging and appreciating efforts. Respect diversity of status and values in patients and colleagues. Able to liaise with.3. supporting others.4 1. 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.2. Assessment and appraisal of more junior clinical colleagues or students. educator and role model. mentor. Build and maintain relationships by listening.2.Maintain and routinely practice critical self awareness. 3 3 MSF Assessment Methods GMP 1 1.3 3 1. Use assessment. Organise and manage workload effectively and flexibly.3. Shown willingness to act as a leader. Able to contribute to or lead a MDT meeting.2.3 MSF 1. Shows commitment to continuing professional development which involves seeking training and self development opportunities.3. Able to liaise with and understand the role of specialist nurses. including non-medical professionals.3 1.4 MSF MSF 3 1.3 1. gaining trust and showing understanding.

Manage resources: know what resources are available and use influence to ensure that resources are used efficiently and safely. Manage people: providing direction. 1. reviewing performance and motivating others. Show knowledge of the duties.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.1.2 1. needlestick injury. safe prescribing.2 1 1. Skills Assessment Methods GMP 1. Demonstrates knowledge of individual performance review. competences and capabilities of other professionals and support workers. Manage performance: hold oneself and others accountable for service outcomes. Understand the role of audit (improving patient care and services.2 1. Understand the steps involved in completing the audit cycle.3 1 1. Able to write a job description.2 Neurology August 2010 Page 12 of 47 .8 Improving Services Ensure patient safety at all times. risk management etc). Demonstrates understanding of how healthcare governance influences patient care. Recall principles of risk assessment and management. rights and responsibilities of an employer and co-worker. including mentoring.g.3 1. Identify risk management guidance e. including person specification and short listing criteria. Understand the roles. supervision and appraisal. Contribute to the development of an organisational response to emerging health policy.3. Demonstrates a knowledge of a variety of methodologies for developing creative solutions to improving services.3 1.3 1 1 Assessment Methods GMP 1 1 1 1. Behaviours Commitment to good communication whilst also inspiring confidence and trust. Skills Continue to contribute towards staff development and training. sharps disposal. continue to encourage innovation and facilitate transformation Knowledge Demonstrate knowledge of risk management issues and risk management tools.4 1 1 1.

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

11 Presentation and Audit Skills Knowledge An understanding of the importance and processes of audit.4 mini-CEX.4 SCE. Ability to reflect upon changes in patient management as the result of a completed audit project. Behaviours Ability to adjust level of presentation dependent upon the anticipated audience. epilepsy. CbD (R) 1. migraine. dementia. autoimmune disorders.3. Presentations may involve clinical cases.3. Able to refer to local and national guidelines (NICE) and sources of evidence and information about treatments. CbD (R) mini-CEX. motor neuron disease. Understand limitations: compliance. Understand principles of treatment especially vascular disease.4 1.2.2.3 TO 1.2. movement disorders.3 AA TO 1.10 Clinical Pharmacology of Neurological Disorders Knowledge Principles of neuro-pharmacokinetics and pharmacodynamics.2.2.2.3.3.3. both within an organisation and to national bodies.2.2.3 1. psychiatric disorders. Skills Able to plan and administer pharmacological treatments safely and effectively. CbD (R) mini-CEX. CbD 1.3 Neurology August 2010 Page 14 of 47 . infections.4 Assessment Methods SCE. Skills Ability to give a range of oral presentations with the use of appropriate audio-visual aids including Powerpoint presentations. Ability to instigate and collate an audit project.2.2.4 1.3. CbD SCE.1. cost implications. TO AA 1.4 1. Ability to answer questions from members of the audience. multiple sclerosis.3.4 1. CbD GMP 1. Understand information needs of patients and others. pain. Behaviours Utilise reporting mechanisms for adverse events. interactions. CbD 1. adverse effects. audits or research papers.3 Assessment Methods AA GMP 1.

2 Neurology August 2010 Page 15 of 47 .2 1.3.13 Special Interest Groups: Teenagers Knowledge Knowledge of neurological disorders presenting in adolescence. CbD SCE.4 mini-CEX.3. race.3. diagnose and manage women with neurological disease. and transition disorders. (see neuropaediatric section) Skills Understand the special needs of teenagers.2. Understand the effect of pregnancy on existing neurological disorders and neurological disorders as complications of pregnancy.12 Special Interest Groups: Women & Pregnancy Knowledge Understand the effects of menarche. diagnose and manage teenagers with neurological disease. CbD (R) 1. Behaviours Ability to interface with paediatricians in the handover of patients from paediatric to adult neurological practice.4 1. and how to work to minimise this discrimination. Skills Ability to evaluate.4 1. Knowledge of methods of contraception. failure rate and interaction with drugs (especially antiepileptic drugs). MSF 1.g. CbD (R) mini-CEX. CbD GMP 1.4 Assessment Methods SCE. psychosexual dysfunction in neurological illness (especially epilepsy).2.3.2.2 SCE. effects of drugs on pregnancy (foetus and mother) and pregnancy on drugs. Knowledge of the neonatal complications in offspring of affected women with neurological conditions. British National Formulary etc. Ability to interface with obstetricians. NICE guidelines for epilepsy. CbD GMP 1. religion and sexuality 1.2 1. Knowledge of childhood neurological disorders presenting in early adulthood.2 1.3.3. CbD SCE. presymptomatic/prenatal diagnosis of neurological conditions. gender. culture.4 Assessment Methods SCE.2.2 1. particular issues of confidentiality. Behaviours Adherence to national guidelines (e. CbD 1. For example. Ability to evaluate. spirituality.2. CbD SCE.4 mini-CEX. menstrual cycle and menopause on common neurological disorders.2. disability. MSF MSF 1.Recognise how health systems can discriminate against patients from diverse backgrounds. teratogenic risks of commonly prescribed drugs (especially AEDs) and genetic risks of neurological diseases. in respect of age. CbD (R) 1.

effects of drugs in the elderly.3.4 Assessment Methods SCE. Skills Ability to communicate end of life issues including the withdrawal of treatment and organ donation with patients and relatives. special presentations of neurological disease in the elderly. ethical and legal aspects of terminal care. role of departments of medicine for the elderly.3. CbD (R) 1.3. Ability to evaluate. Behaviours Ability to interface with fellow professionals and care agencies dealing with patients with learning disabilities.3. CbD GMP 1. Skills Understand the specific issues of the Mental Capacity Act in relation to this patient group.2. communication with relatives and care agencies.14 Special Interest Groups: Elderly Knowledge Understand the normal clinical and radiological findings in the elderly.4 1. CbD (R) mini-CEX.2.4 mini-CEX.2.4 Assessment Methods SCE. CbD GMP 1.2.4 1. CbD (R) mini-CEX. CbD 1.3.2. diagnosis.2.1. MSF 1. hospital based & community services. CbD GMP 1. Ability to discuss Advanced Directives to Refuse Treatment (ADRT) with patients and relatives Behaviours mini-CEX.2. MSF 1.2. Behaviours Ability to interface with geriatricians and care agencies dealing with the elderly population.2 1. diagnose and manage the elderly with neurological disease. investigation and management of dementia. Skills Understand the needs of patients with special educational needs with neurological disorders.4 mini-CEX.15 Special Interest Groups: Learning Disabilities Knowledge Understanding of the common causes of learning disabilities and the different presentation of symptoms in this group.4 mini-CEX.3.3. CbD (R) 1. CbD 1. (see neuropaediatric section) Recognise the stigmatising effects of some illnesses and work to help in overcoming stigma.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.4 Assessment Methods SCE. Understand the specific issues of the Mental Capacity Act in relation to this patient group.2 1.2 Neurology August 2010 Page 16 of 47 .3.

Ability to interface with fellow professionals and care agencies dealing with patients with end of life issues.3. MSF 1.2.4 Neurology August 2010 Page 17 of 47 .

urgent blood tests. CbD 1. Skills Ability to evaluate and manage people with acute head injury: perform immediate resuscitative measures. and other post-traumatic symptoms (including epilepsy). primary and secondary effects of head injury.2.3. locked in state and brainstem death. Behaviours Demonstration of relevant general and professional content competencies.4 Neurology August 2010 Page 18 of 47 . pathophysiology. definitions. CbD (R) 1.2 1.2.4 mini-CEX.3. ITU referral.2.3. Behaviours Demonstration of relevant general and professional content competencies.4 Assessment Methods SCE.4 Assessment Methods SCE.3 Disorders of Consciousness Knowledge Knowledge of anatomy and physiology of consciousness.2 mini-CEX. Assessment Methods SCE.4 mini-CEX. CbD (R) 1.2.2.2 2.2. clinical features and prognosis of permanent vegetative state. Skills Ability to evaluate and manage people with headache & facial pains. Ability to evaluate and manage post traumatic change in consciousness. MSF 1.3. CbD (R) 1. Major Topics within Neurology Curriculum 2. formulate a strategy for immediate and short term management. causes.3. CbD GMP 1.4 mini-CEX. indications for investigations. CbD GMP 1. Skills Ability to assess the unresponsive patient and to formulate plan of investigation and management. Ability to interface with neurosurgeons and ITU staff. CbD (M) 1. CbD SCE. CbD (M) 1.2.2.2 SCE.3. behaviour and cognition.2 mini-CEX. and the pathophysiology of disorders of consciousness. lumbar puncture.2 Headache Knowledge Knowledge of the clinical features. urgent and delayed neurosurgery. MSF 1.3. An understanding of the role of relevant investigations: brain scanning. differential diagnosis and specific pharmacological and general treatment of the causes of headache and facial pain. An understanding of the legal issues relating to disorders of consciousness.1 Head Injury Knowledge Knowledge of symptoms and signs of head injury and its complications. indications for medical interventions. CbD GMP 1.4 2.

3. dementia and mood scales).4 1.4 1. MSF 1. CbD (R) 1. enduring power of attorney).2. pathology and clinical features of individual dementias.2. daytime hypersomnolence. risks and costs of investigations. CbD (R) mini-CEX. CbD (R) mini-CEX. scope and limitations of the sleep laboratory.3. parasomnias. Evaluation of competency (e.Use of tests for brainstem death. MSF 1. CbD 1. principles of physical and pharmacological treatment.2.5 Disorders of Higher Function & Behaviour Knowledge An understanding of memory.4 Assessment Methods SCE. Mental Capacity Act. CbD GMP 1.2. Skills Ability to evaluate and manage people with disordered higher function & behaviour. Behaviours Demonstration of relevant general and professional content competencies.2. Ability to work with community and support services. CbD (R) 1.4 Assessment Methods SCE. specific treatments.3. definition and epidemiology of dementia.3. Behaviours Demonstration of relevant general and professional content competencies. role of neuropsychological evaluation (inc. indications.2. CbD (M) 1.4 mini-CEX.4 MSF 1. Knowledge of driving regulations and the consequences and complications of sleep disorders. CbD GMP 1.3. relevant investigations. Behaviours Demonstration of relevant general and professional content competencies.2.2 SCE.3. genetic aspects. effects of neurological conditions on sleep. Skills Ability to evaluate and manage people with sleep disorders.3.3.2. obstructive sleep apnoea.2 Neurology August 2010 Page 19 of 47 . CbD (M) mini-CEX.g. visuospatial function & behaviour.4 2. An understanding of the effects of sleep on the EEG.3. language.2. mini-CEX.4 mini-CEX. Development of interpersonal skills for relating to management of the family of people with disorders of consciousness.4 Disorders of Sleep Knowledge Knowledge of narcolepsy.2 2.2 1.4 1. CbD SCE.

4 mini-CEX. role of evaluation scales. Ability to evaluate and mange people with stroke disease Behaviours MSF CbD. CbD 1.3. intracranial haemorrhage and venous thrombosis.2 1.2. organisation of stroke units.2 2. Behaviours Demonstration of relevant general and professional content competencies. risk factors and their management.4 1. driving. vocation and sudden death. nutrition after stroke. DWI).4 Assessment Methods SCE.2 1.3. psychological and social consequences of epilepsy especially teenagers. CbD GMP 1. CbD 1.3. Knowledge.7 Cerebrovascular Disease Knowledge Knowledge of the cerebral circulation and its determinants.g.2 SCE. stigma.2 SCE.2 Neurology August 2010 Page 20 of 47 .6 Epilepsy and Loss of Consciousness Knowledge Knowledge of the differential diagnosis of paroxysmal and transient events. Recognise that people can be denied employment opportunities unnecessarily through myths.2. drop attacks and vaso-vagal episodes. CbD 1. use of anti-epileptic drugs. scope and limitations of investigations. Knowledge and management of other causes of loss of consciousness including syncope. be aware of the role of doctors and other services in combating this inequality.2. CbD 1.2. investigation and management of acute stroke (including thrombolysis) and TIA as medical emergencies. CbD SCE. An understanding of the role and limitation of imaging (e. community stroke care. CbD 1. features of stroke /TIA. recognition and management of non-epileptic seizures. the role of medical secondary prevention and surgical interventions (e. CbD GMP 1.2 SCE. Cerebral aneurysm and AVM. role of epilepsy surgery. CTA. surgical and radiotherapy treatment. Knowledge of the epidemiology. Awareness of issues related to women and pregnancy. treatment of refractory seizures. cerebral haemorrhage. CbD 1. rehabilitation techniques.4 Assessment Methods SCE. subarachnoid haemorrhage.3. interventional.2 SCE. Multidisciplinary stroke care. serial seizures and status epilepticus.3. pathophysiology of cerebral infarction. CbD SCE.4 1. dogma and insufficient advocacy and support. hemicraniectomy. CbD (M) mini-CEX. cerebral venous thrombosis and vascular dementia.2 SCE.2. Skills Ability to evaluate and manage people with epilepsy. endartectomy). Skills Ability to work competently within a stroke MDT and on-call setting. MSF 1. mini-CEX (M) 1.g.

MSF 1.2 SCE. HIV.e.2. neurosyphilis). clinical features of the common tumours of the nervous system including malignant meningitis. sexual and travel history. such as infection control risk. CbD 1.2 SCE. Knowledge of prion disorders and its wider implications. CbD (R) 1. MSF 1. benefits and risks of therapies including surgery and radiotherapy. Behaviours Demonstration of relevant general and professional content competencies.4 mini-CEX. Based on an understanding of risk.4 Neurology August 2010 Page 21 of 47 .Demonstration of relevant general and professional content competencies. microbiologists. CbD 1. MSF 1.4 2. encephalitis. CbD 1.2.4 Assessment Methods SCE.8 Tumours of the NS. CbD (R) 1.3.3. Complications of Treatment of Cancer Knowledge Neuropathological classification of brain tumours. Clinical features and immunology of paraneoplastic syndromes. Understanding the role of the neuro-oncology MDT. be able to apply epidemiological principles and public health approaches so as to reduce and prevent disease and improve the health of populations. CbD GMP 1. CbD GMP 1. clinical features of these diseases and their causes (including meningitis.2. or need for HIV testing) in a patient with suspected NS infection. public health and occupational health medicine in relation to neurological infections. Neurological Complications of Systemic Cancer.3. Skills Ability to evaluate and manage people with primary tumours of the NS or effects of systemic tumours or their treatment. CbD (R) 1. Demonstrate appropriate history and communication skills (i. Diagnostic techniques and their appropriate use.2 SCE.4 2.2.2 mini-CEX.2 SCE. Skills Ability to evaluate and manage people with infections of NS. Behaviours Demonstration of relevant general and professional content competencies.2 mini-CEX. TB.2.4 Assessment Methods SCE.3.9 Infections of Nervous System Knowledge Principles of neurological infectious disease. neurological complications of chemotherapy and radiotherapy. the importance of liaison with infectious disease physicians. anti-microbial therapies and their use.3.3. CbD 1.2.

Behaviours Demonstration of relevant general and professional content competencies. CbD 1. CbD 1. biochemistry and immunology of CSF. MSF 1.2 SCE. symptomatic treatments and therapies.4 mini-CEX. Immunosuppressive and immunomodulatory therapies. CbD 1. their actions.2 2. treatments of raised intracranial pressure. Behaviours Demonstration of relevant general and professional content competencies.12 The Neurological Complications of Immunosuppression Knowledge Principles of immune responses in relation to the NS.2. indications. techniques. Methods of intracranial pressure monitoring.2 mini-CEX.2. CbD (R) 1.3. MSF 1. clinical features of these diseases.2 SCE.3. role of disease modifying drugs. genesis of hydrocephalus. CbD GMP 1.3. immunological basis underlying auto-immune neurological disease. Management of specific impairments and disabilities arising in MS.2.2. clinical features of multiple sclerosis.10 CSF Disorders Knowledge CSF composition and dynamics. Skills Ability to evaluate & manage people with demyelinating & vasculitic disorders. Skills Able to evaluate and manage people with disorders of CSF including diagnostic and therapeutic lumbar punctures.4 Assessment Methods SCE.2.2 SCE.2.4 Assessment Methods SCE. Skills Ability to evaluate and manage people with immunological disorders caused by disease or treatment. Behaviours Demonstration of relevant general and professional content MSF 1.4 2. CbD 1. CbD (R) DOPS (R) 1.4 Assessment Methods SCE. CbD (M) 1.11 Demyelination & Vasculitis Knowledge Biology of demyelination & vasculitis. management of shunts. diagnostic techniques and their appropriate use. CbD GMP 1.4 mini-CEX.2 SCE. Use of disability rating scales. anatomy and radiology of the ventricular system.3. and contraindications of CSF examination. side effects and indications. related demyelinating disorders and vasculitic and arteritic disorders. blood brain barrier. CbD GMP 1.2.3.2 Neurology August 2010 Page 22 of 47 .3.

Neurological presentations of renal & hepatic failure.2 Neurology August 2010 Page 23 of 47 .2 2. clinical features of alcohol. CbD 1. CbD GMP 1. calcium and acid base disorders.4 1. opiate. CbD GMP 1.g. clinical features and management of hyper/hypo-thermia. of therapeutic agent neurotoxicity (e.4 Assessment Methods SCE.4 mini-CEX. cocaine. CbD (M) 1.2. palliative care aspects. lithium. chorea/athetosis.2 1. CbD (M) 1.2 SCE. CbD 1.g.14 Motor Neuron Disease Knowledge Clinical features and differential diagnosis of motor neuron syndromes.2.4 2.3. tics and tremor. CbD 1. pesticides and therapeutic agents.3. sodium. Role and value of blood and urine toxicology. CO. of heavy metal. Psychiatric morbidity associated with substance abuse. Skills Ability to evaluate and manage people with Parkinsonism and Movement Disorders.4 Assessment Methods SCE. assessment of other organ damage.competencies. vincristine.13 Parkinsonism & Movement Disorders Knowledge Clinical features and differential diagnosis of parkinsonism. Assessment Methods SCE.2. PD specialist nurse). CbD SCE. disease modifying and symptomatic treatments (e. heavy metals.3. Skills Ability to evaluate and manage people with motor neuron disease.2 SCE. MSF 1. NO and organophosphate poisoning.3. CbD SCE. knowledge of advanced directives and living wills. radiation). Behaviours Demonstration of relevant general and professional content competencies.2. amphetamine.15 Toxic & Metabolic States Knowledge Biochemistry and neuropathology of exposure to alcohol and other recreational drugs (cocaine. imaging and neurophysiology. Special issues of breaking bad news and prognosis. Ability to liaise with other members of MDT (e. Treatment (and complications of treatment) of movement disorders. CbD GMP 1.2 1. potassium. amphetamine neurotoxicity. dystonia.2 mini-CEX.g. role of investigations in diagnosis (including DAT scans). NIV).2. MSF 1.2 SCE. nutritional deficiencies and porphyria. role of neurosurgical interventions. 2. opiates).3. CbD (M) mini-CEX. Behaviours Demonstration of relevant general and professional content competencies.

CbD 1. Behaviours Demonstration of relevant general and professional content competencies. MSF 1. potential and limitations of spinal CT. Roots and Spinal Injury Knowledge Anatomy of the spine. management of neck and low back pain and sciatica. cavernous sinus. Behaviours Demonstration of relevant general and professional content competencies.18 Disorders of Spine.4 MSF 1.2 SCE.16 Disorders of the Visual System Knowledge Applied anatomy and physiology of the visual and oculomotor systems. vision (acuity. root and cauda equina syndromes. MRI.2 Neurology August 2010 Page 24 of 47 .3. clinical features and conditions which may affect these systems. Management of cranial nerve disorders including multidisciplinary approaches to visual.4 mini-CEX. oculomotor disorders & pituitary disease. foramen magnum and jugular foramen.2. MSF 1. particularly the orbit.2. CbD GMP 1. clinical features & clinical assessment of cranial nerve function. Spinal Cord. CbD (R) 1.4 Assessment Methods SCE.2. Behaviours Demonstration of relevant general and professional content competencies. pituitary fossa.2 mini-CEX. roots. hearing & balance. speech & swallowing disorders.4 mini-CEX. Assessment Methods SCE. CbD (M) 1. CbD 1. pathological processes involving cranial nerves and their central connections.3. CbD GMP 1.17 Disorders of Cranial Nerves Knowledge Anatomy of the skull base.2 SCE. CbD (R) 1. of spinal injury.2 SCE.2. myelography and spinal angiography.3. Emergency management of spinal cord or root compression.2 2. clinical evaluation of the eye and adnexae. Skills Ability to evaluate and manage people with disorders of the visual system including visual failure.2. CbD GMP 1.2.4 2. spinal cord. fields and higher function). clinical features of spinal cord. Skills Ability to evaluate and manage people with disorders of cranial nerve function. Driving regulations.3.3.4 2. CbD 1.3.Skills Ability to evaluate and manage people with metabolic/toxic states. indications for urgent investigation. Assessment Methods SCE.

2. CbD 1. clinical features & investigation of genetic and acquired axonal and demyelinating neuropathies.3.2. traumatic & entrapment neuropathies.4 Assessment Methods SCE.3.3. CbD (M) 1. general management of acute neuromuscular paralysis.2 Neurology August 2010 Page 25 of 47 .4 2. Pharmacological and physical managements of urinary retention.Skills Ability to evaluate and manage people with disorders of the spine.2.3.2 2. plexopathies and mononeuritis multiplex. MSF 1.4 Assessment Methods SCE.2. and the acute & chronic consequences of acute spinal cord injury including effects of paralysis. Behaviours Demonstration of relevant general and professional content competencies. clinical features of ANS disorders alone and as part of other condition e. MSF 1. autonomic dysfunction and sensory loss. management of Guillain-Barré syndrome and other severe paralysing neuropathies. Behaviours Demonstration of relevant general and professional content competencies. autonomic dysreflexia.2. erectile disorder.4 mini-CEX.4 mini-CEX.19 Disorders of Peripheral Nerve Knowledge Anatomy and pathology of peripheral nerves. MSF 1.g. CbD GMP 1. constipation. postural hypotension. Skills Ability to evaluate and manage people with disorders of the autonomic nervous system.4 mini-CEX. investigations including autonomic function tests. CbD GMP 1. multi-system atrophy.20 Disorders of Autonomic Nervous System Knowledge Anatomy and physiology of ANS. spinal cord and roots. Behaviours Demonstration of relevant general and professional content competencies.2 SCE. Skills Ability to evaluate and manage people with disorders of peripheral nerves (including plexus lesions). CbD (M) 1. CbD (R) 1.2.3.3.

CbD 1.2.3.4 mini-CEX.2 SCE. CbD GMP 1. Behaviours Demonstration of relevant general and professional content competencies. Management including cardio-respiratory and anaesthetic considerations.2. Role of Pain Clinic. CbD GMP 1.2.g.2 2.3. Skills Ability to evaluate and manage people with neurological disorders causing pain and common non neurological causes of pain including musculoskeletal disease. CbD 1.3. pain patterns in neurological and systemic diseases.4 Assessment Methods SCE. Skills Ability to evaluate and manage people with disorders of muscle.4 Assessment Methods SCE. Behaviours Demonstration of relevant general and professional content competencies.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. effective use of pharmacological agents and other measures for pain relief including nerve blocks. MSF 1. understanding of MDT approach. TNS.2 Neurology August 2010 Page 26 of 47 . mitochondrial disorders). acupuncture and neurosurgical interventions. CbD (R) 1.4 mini-CEX. MSF 1. CbD (R) 1.22 Pain Knowledge Theories of pain generation.3. psychological and social effects of chronic pain.2.2.2 SCE.

peripheral nerve and muscle). Skills Understand role and practice of neurophysiological investigations in disorders of the nervous system.3.2. neurological emergencies.2 SCE. CbD 1. CbD (M) 1.2 Neuroendocrinology Knowledge Clinical features and investigations in endocrine disorders. CbD (R) 1. emergency management of disorders. Steroid therapy and its complications. sleep disorders. CbD 1. EMG/NCS/repetitive stimulation – principles of techniques. Ability to interface with endocrinological colleagues. Ability to interface with neurophysiology colleagues.4 Assessment Methods SCE. muscle disease.3. role of intraoperative EP. motor neuron disease.2. CbD 1. CbD (M) 1. Evoked potentials .4 3. evaluation of sleep disorders.2.3. disorders of neuromuscular junction.3. CbD GMP 1. peripheral neuropathies. common epileptiform abnormalities. CbD (R) 1.4 mini-CEX. relationships with neurological disorders.4 mini-CEX. MSF 1.2.normal range of EEG findings. ability to interpret a neurophysiology report. Allied Topics within Neurology Curriculum 3. role of monitoring techniques (telemetry. ambulatory).1 Clinical Neurophysiology Knowledge EEG . MSF 1.2 SCE.2 mini-CEX.common abnormalities in neurological diseases. particularly demyelination.3. Behaviours Demonstration of relevant general and professional content competencies. capabilities and limitations in neurological disorders.4 Assessment Methods SCE. CbD GMP 1.3.2. (see sections on epilepsy.3. abnormalities in common nerve entrapments.2.4 Neurology August 2010 Page 27 of 47 . Behaviours Demonstration of relevant general and professional content competencies.2 SCE. Skills Understand the principles of the NS in endocrine function and neurological features of endocrine disorder particularly pituitary disease.2 mini-CEX.

and neurocutaneous syndromes). head injury & disorders of consciousness).3. relatives and staff in ICU. Huntington’s disease. drugs & medical disorders. Clinical.3. epilepsy).2.2. CbD SCE.4 1. subarachnoid haemorrhage.2 1. multiple sclerosis. CbD (M) 1.2. CbD GMP 1.3 Neurogenetics Knowledge Basic genetic principles including inheritance patterns and common diagnostic methods.2.3. Skills Understand the principles of genetics as applied to neurological disorder. muscle diseases. CbD (M) mini-CEX. causes.3.2 mini-CEX.2.4 Neurology August 2010 Page 28 of 47 . the principles of cardiovascular and respiratory support. Genetic contribution to multifactorial neurological disease (e.4 Neurointensive Care Knowledge Clinical features.g. CbD SCE. ability to interpret a genetics report. Clinical features of common genetic conditions (hereditary ataxias.4 1. Ability to interface with genetic colleagues.2. management of status epilepticus.2 1.4 Assessment Methods SCE. sepsis.4 mini-CEX.2 SCE. CbD 1. MSF 1.2 3. hereditary neuropathies.3. ICU neurological complications of major surgery. coma and vegetative state. roles of a detailed family history and of DNA based diagnostic tests.4 1.2 SCE. CbD (M) 1. An understanding of the role of bioinformatic databases of human disease. CbD 1. indications for and methods of artificial nutrition. CbD (M) mini-CEX. Ability to counsel and consent patients and families prior to undergoing genetic testing. stroke. CbD (M) mini-CEX. Ability to interface and communicate with patients.2 1. Behaviours Demonstration of relevant general and professional content competencies. legal and ethical issues in brain death.4 Assessment Methods SCE.2. diagnosis of and ability to define the vegetative state.3. CbD SCE. (see sections on epilepsy.3. Behaviours Demonstration of relevant general and professional content competencies. Skills Ability to evaluate and manage (with others) people in ICU. CbD GMP 1. investigation and management of coma (including epilepsy and raised intracranial pressure). MSF 1.3. failure to regain consciousness and paralysis.

2.2. histochemical.M.2. CbD (R) mini-CEX.3.2. role of and consent process for necropsy examination: role of a coroner.2. CbD (R) mini-CEX. learning disability and autism. brain preparation.2 SCE.5 Neuro-otology Knowledge Applied anatomy and physiology of hearing and balance. techniques.2.6 Neuropaediatrics Knowledge Understanding of neurological disorders in intrauterine life and childhood. knowledge of developmental disorders (including effects of intrauterine and perinatal factors on neural development).3. Knowledge of paediatric conditions that can present in adulthood.3. Skills Ability to evaluate the deaf and / or dizzy person and interpret reports including audiograms.3.2.3.3.3. biochemical. CbD (R) mini-CEX. metabolic conditions. MSF 1.2 mini-CEX. conditions affecting the vestibulocochlear system.4 Assessment Methods SCE. Ability to examine teenage children. Understand the importance of clinico-pathological conferences. Ability to interface with ENT and audiological colleagues. Behaviours Demonstration of relevant general and professional content competencies. CbD (R) mini-CEX.4 Neurology August 2010 Page 29 of 47 . immunological & microbiological techniques. CbD (R) 1.4 3.4 1. cerebral palsy.2 3. Skills Ability to evaluate and manage neurological disorders in teenagers in liaison with paediatric neurologists. MSF 1. CbD GMP 1. Behaviours Demonstration of relevant general and professional content MSF 1. CbD 1. key stages of development and range of normality. CbD (R) 1.2 mini-CEX. CbD GMP 1.4 1. anatomy of brain sections.7 Neuropathology Knowledge Understand the pathological and biochemical basis of neurological disorders. CbD (R) 1. understand and interpret reports issued.4 Assessment Methods SCE. histological. history and examination techniques including vestibular manoeuvres. immunocytochemical and E.4 Assessment Methods SCE.2. Skills Ability to appropriately request pathological investigations and interpret pathology reports.3. Ability to perform diagnostic and therapeutic vestibular manoeuvres.4 mini-CEX. CbD GMP 1. Behaviours Demonstration of relevant general and professional content competencies.3.

4 3.3.4 MSF 1. Skills Ability to utilise basic clinical tests of cognitive function. the mental health act and when it can be used. Ability to evaluate and manage acute organic brain syndromes. neurological features which may have psychiatric causes (including medically unexplained symptoms.3.3. CbD GMP 1. PET. psychiatric consequences of neurological disease and neurological features in people with psychiatric disorders. CbD (R) 1. CbD GMP 1. understand the mini-CEX. CbD (R) 1. somatisation). ultrasound carotid/transcranial/cardiac.8 Neuropsychiatry Knowledge Understanding of common psychiatric disorders (including learning disability).2 mini-CEX.competencies. CbD (R) 1. understand the value and limitations of neuropsychological interventions such as Cognitive Behavioural Therapy. and to interpret reports.3.2. attention.4 Assessment Methods SCE. CbD GMP 1.2. Behaviours Demonstration of relevant general and professional content competencies. 3.9 Neuropsychology Knowledge Understanding of neuroanatomical and neurophysiological basis of memory. Skills Ability to evaluate and interpret psychiatric symptoms in and as presentations of neurological disorders.4 mini-CEX.g.4 Assessment Methods SCE. understand mini-mental state examination and basic neuropsychological tests employed by Clinical Psychologists. interpret and utilise neuro-radiological investigations appropriately. other special investigations e.3. to understand the need to refer to and the role of the Clinical Neuropsychologist. MSF 1. language and perception.10 Neuroradiology Knowledge Request. risks and benefits of neuroradiological investigations (CT scan cranial/angiography. catheter angiography diagnostic/interventional. conversion disorder.4 3. liaise effectively with the neuroradiologist.2 mini-CEX. explain the nature. Assessment Methods SCE.3.2. Skills Ability to request and evaluate neuroradiological investigations and reports.2. Behaviours Demonstration of relevant general and professional content competencies.2 Neurology August 2010 Page 30 of 47 . NART. CbD (M) 1.2.g. WAIS.2. SPECT) to patients. e. MR scan cranial/spinal/angiography. Ability to liaise effectively and appropriately with psychiatry services. myelography.

2. if appropriate. Contribute to and. Skills Ability to evaluate the requirement for neurosurgical interventions in people with neurological disorders and to liaise effectively with the neurosurgeon.3. relevant social work legislation and availability of care in the community. CbD (M) 1. process and complications of biopsy procedures (brain. approach and agenda of rehabilitation teams.3.role.4 3. CbD 1. Skills Ability to evaluate the requirement for rehabilitation in people with neurological disorders (including stroke.12 Neurosurgery Knowledge Understand the role of neurosurgery in the management of head injury.2. CbD SCE.4 mini-CEX. limitations. raised intracranial pressure. MSF 1. CbD (M) 1.2 SCE. CbD GMP 1.3. lead an MDT meeting being aware of the different roles. differential diagnosis of causes of disordered micturition and erectile dysfunction. spinal cord and root disorder and peripheral nerve lesions. Understand the purpose. risks and limitations of common techniques. CbD GMP 1.2 Neurology August 2010 Page 31 of 47 .3. skills. spinal injury and MS) in the context of a multidisciplinary team and make appropriate referrals. nerve). intracranial haemorrhage and ischaemic stroke. muscle. vascular malformation and tumours.2. activity & participation.2 mini-CEX. Behaviours Demonstration of relevant general and professional content competencies. understand the potential and limitations of neurorehabilitation.4 MSF 1.and hyper-sexuality. Behaviours Demonstration of relevant general and professional content competencies. Understanding of the principles of general and specific risks and complications of neurosurgical interventions. understand Assessment Methods SCE.3.4 3.2. Assessment Methods SCE.2. CbD GMP 1. Ability to perform and utilise a functional assessment.13 Neurourology Knowledge Understand normal control of micturition and sexual function. CbD (M) 1. head injury.2 mini-CEX.11 Neurorehabilitation Knowledge Understand the difference between pathology.2. MSF 1. understand the social perspective.4 Assessment Methods SCE.3. understand hypo. aneurysm.4 3.2 1. Behaviours Demonstration of relevant general and professional content competencies. impairment.

mini-CEX. CbD (R) mini-CEX.4 MSF 1.4 1.3.2.3. manage and or refer people with disordered micturition and sexual function due to neurological disorder. CbD (R) 1. Genitourinary Medicine or Uroneurologist. Behaviours Demonstration of relevant general and professional content competencies.3.2. Skills Ability to evaluate.4 Neurology August 2010 Page 32 of 47 .2.treatment strategies for disorders of micturition and sexual function. Ability to refer appropriately to Urology.

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

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

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

accessing the facilities available on the JRCPTB ePortfolio.will be achieved and. as well as duration (e. entirely laboratorybased or strong clinical commitment). Educational Supervisor and communicated to the SAC. Upon completion of the research period the competencies achieved will be agreed by the OOP Supervisor. 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. All applications for out of programme research must be prospectively approved. 3-Year PhD). 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. This would be corroborated by the subsequent ARCP. it should be returned to JRCPTB together with a job description and an up to date CV. The deanery will make an application to the GMC for approval of the out of programme research. the JRCPTB will advise the trainee and the deanery of the decision. On approval by the SAC. 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 .g.4 Academic Training For those contemplating an academic career path.g. 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. 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. 2year MD. 4. This is likely to be influenced by the nature of the research (e. 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 competencies achieved will determine the trainee’s position on return to programme. 12 month Masters. once completed.

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.academicmedicine.aspx.org. An academic trainee working in an entirely laboratory-based project would be likely to require additional clinical training. see www. If a trainee fails to achieve all the required competencies within the notional time period for the programme. Academic integrated pathways to CCT are a) considered fulltime CCTs as the default position and b) are run through in nature.uk/forms/Documents/GoldGuide2009. All applications for research must be prospectively approved by the SAC and the regulator.1 Assessment The Assessment System The purpose of the assessment system is to: • enhance learning by providing formative assessment.nhs.pdf).jrcptb. • inform the Annual Review of Competence Progression (ARCP).uk/intetacatrain and http://www.org. 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. • identify trainees who should be advised to consider changes of career direction. 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. Neurology August 2010 Page 37 of 47 .ac. • ensure trainees are acquiring competencies within the domains of Good Medical Practice.academicmedicine.1). and recommendations to allow completion of clinical training would be made (assuming other progress to be satisfactory).uk/careersacademicmedicine. 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.pdf. typically starting as a senior lecturer and aiming to progress to readership and professor. enabling trainees to receive immediate feedback. For full details see http://www. • assess trainees’ actual performance in the workplace.jrcptb.National Institute for Health Research (NIHR) and the Academy of Medical Sciences (AMS). • ensure that trainees possess the essential underlying knowledge required for their specialty. 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 http://www.ac. identifying any requirements for targeted or additional training where necessary and facilitating decisions regarding progression through the training programme. 5 5.nccrcd. A postgraduate degree will usually be essential (see “out of programme experience”) and academic mentorship is advised (see section 6. • 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. summative evidence that trainees are meeting the curriculum standards during the training programme. measure their own performance and identify areas for development.uk/uploads/A-pocket-guide.uk for details of the process. • provide robust.

5. Individual assessment methods are described in more detail below.jrcptb. including guidance for candidates.mrcpuk. Multisource Feedback (MSF) Neurology August 2010 Page 38 of 47 . 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. 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.2 Assessment Blueprint In the syllabus (3. 5. They are not individually summative but overall outcomes from a number of such assessments provide evidence for summative decision making. The SCE in neurology is a summative assessment that is a prerequisite for attainment of the CCT.3) the “Assessment Methods” shown are those that are appropriate as possible methods that could be used to assess each competency. is available on the MRCP(UK) website www. It is not expected that all competencies will be assessed and that where they are assessed not every method will be used. 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. This is explained in the guidance notes provided for the techniques. in association with the Association of British Neurologists (ABN) has developed a Specialty Certificate Examination.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.org. Information about the SCE in neurology.The integrated assessment system comprises workplace-based assessments and knowledge – based assessments. More information about these methods including guidance for trainees and assessors is available in the ePortfolio and on the JRCPTB website www.uk. Workplace-based assessments should be recorded in the trainee’s ePortfolio.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 workplace-based assessment methods include feedback opportunities as an integral part of the assessment process.

but the STC Chair/TPD may stipulate additional MSF assessments for all or some trainees within a training programme. It also serves as a method to document conversations about.This tool is a method of assessing generic skills such as communication. A typical encounter might be when presenting newly referred patients in the out-patient department. and other allied professionals. All trainees will need to complete a minimum of two MSF assessments during the 5 years training programme as a mandatory requirement. These should complement the mini-CEX assessments. The CbD should include discussion about a written record (such as written case notes. A minimum of 4 satisfactory assessments per year with the use of at least two assessors is a mandatory requirement. These assessments are not mandatory within the neurology curriculum although trainees may wish to incorporate lumbar puncture as a recommended DOPS. leadership. discharge summary). examination and clinical reasoning. derived from a number of colleagues. against a structured checklist. 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. team working. and includes doctors. and presentations of. cases by trainees. decisionmaking and application of medical knowledge in relation to patient care. 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. 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. This decision will be made in response to educational supervisor reports or the decisions from an ARCP. 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. 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. 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. 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 trainee receives immediate feedback to identify strengths and areas for development. Patient Survey (PS)* Neurology August 2010 Page 39 of 47 . administration staff.3. These are highlighted as mandatory (M) or recommended (R) in the syllabus section 3. This provides objective systematic collection and feedback of performance data on a trainee. 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. The trainee receives immediate feedback to aid learning.3. The complexity of the lumbar puncture procedure (for example therapeutic rather than diagnostic) should be greater than that achieved during CMT. out-patient letter. ‘Raters’ are individuals with whom the trainee works. reliability etc. across the domains of Good Medical Practice.

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

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 .

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

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). Outpatient and referral supervision must routinely include the opportunity to personally discuss all cases if required. Continuing concerns should be referred to the Associate Dean. As training progresses the trainee should have the opportunity for increasing autonomy. the PYA will include a face to face component. This training may be deanery. This is known as “PYA”. Royal Colleges of Physicians or hospital trust led. JRCPTB and the deanery will coordinate the appointment of this assessor. 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.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. consistent with safe and effective care for the patient. If a trainee has a complaint about the outcome from a specific assessment this is their first opportunity to raise it. 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. Appeals against decisions concerning in-year assessments will be handled at deanery level and deaneries are responsible for setting up and reviewing suitable processes. The responsibilities of supervisors have been defined by GMC in the document “Operational Guide for the PMETB Quality Framework”.5.6 Penultimate Year Assessment (PYA) The penultimate ARCP prior to the anticipated CCT date will include an external assessor from outside the training programme. 6 6. 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. These definitions have been agreed with the National Association of Clinical Tutors. and are reproduced below: Neurology August 2010 Page 43 of 47 . 5. responsible for overseeing their education. Trainees may have more than one educational supervisor dependent upon the geography of a local training programme. Depending on local arrangements these roles may be combined into a single role of educational supervisor. Whilst the ARCP will be a review of evidence. the Academy of Medical Royal Colleges and the Gold Guide team at MMC. All workplace-based assessment methods incorporate direct feedback from the assessor to the trainee and the opportunity to discuss the outcome.

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

org. 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. Royal Colleges of Physicians or hospital trust led. 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.jrcptb. 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. 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. appraisal and teaching techniques (e. This training may be deanery. and this should be recorded. Each trainee will engage with the curriculum by maintaining an ePortfolio. It is Neurology August 2010 Page 45 of 47 .educational events should also be reviewed. 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. All educational supervisors will have undergone appropriate training on how to be effective educational supervisor. 7 7. The training of STC Chairs/TPDs will be expected to be more comprehensive than educational supervisors and include sessions on trainees in difficulty (TID).uk. If there are significant concerns following the end of attachment appraisal then the programme director should be informed. Further evidence of competence in certain areas may be needed. The PDP can be amended at this review. 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. End of Attachment Appraisal Trainees should review the PDP and curriculum progress with their clinical/educational supervisor using evidence from the e-portfolio.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. Developments in the curriculum will be fed to STC Chairs/TPDs from the 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. such as planned workplace-based assessments. study days from the Physicians as Educators Course run by the Royal College of Physicians of London).g. 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. The trainee will use the curriculum to develop learning objectives and reflect on learning experiences.

religion. ethnic origin. Neurology August 2010 Page 46 of 47 . and actively seeks to recruit people to all its activities regardless of race.2 Recording Progress On enrolling with JRCPTB trainees will be given access to the ePortfolio for neurology. as advisers from the medical profession. gender or sexual orientation. 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.suggested that each STC Chair/TPD hold regular review meetings with all the supervisors to review the local training programme. prepare drafts of appraisal forms. as members of the Colleges' professional bodies or as doctors in training and examination candidates. disability. 9 Equality and Diversity The Royal Colleges of Physicians will comply. record their reflections on learning and record their progress through the curriculum. 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). reflections and personal development plans to inform appraisal meetings. write end-of-attachment appraisals and supervisor’s reports. with the requirements of equality and diversity legislation. it warmly welcomes contributors and applicants from as diverse a population as possible. either as members of staff and Officers. The supervisor’s main responsibilities are to use ePortfolio evidence such as outcomes of assessments. Accordingly. 7. They are also expected to update the trainee’s record of progress through the curriculum. Any changes made will then be sent to the JRCPTB and GMC for approval. maintain their personal development plan. Deanery quality assurance will ensure that each training programme complies with the equality and diversity standards in postgraduate medical training as set by GMC. arrange assessments and ensure they are recorded. Compliance with anti-discriminatory practice will be assured through: • monitoring of recruitment processes. Changes in neurological practice as the result of changes in NHS services and treatments will be incorporated. The trainee’s main responsibilities are to ensure the ePortfolio is kept up to date. and ensure compliance. age.

Deaf/Hearing loss. Mental Health difficulty. 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. and others as 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. 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. External advice was sought in the preparation of the updated Equality Discrimination Plan. 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. monitoring of College Examinations. Neurology August 2010 Page 47 of 47 . the MRCP(UK) Management Board is formulating an Equality Discrimination Plan to deal with issues of disability. Upper limb or back problem. ethnicity. asthma.• • • • • • ensuring all College representatives and Programme Directors have attended appropriate training sessions prior to appointment or within 12 months of taking up post. sexual orientation or disability (other than that which would make it impossible to practise safely as a physician). Chronic progressive condition. such as the Race Relations (Amendment) Act 2000. In order to meet its obligations under the relevant equal opportunities legislation. epilepsy). ensuring all assessments discriminate on objective and appropriate criteria and do not unfairly disadvantage trainees because of gender. Deaneries must also ensure contingency mechanisms are in place if trainees feel unhappy with the response or uncomfortable with the contact individual. The Academic Committee would be responsible for policy and regulations in respect of decisions on accommodations to be offered to candidates with disabilities. Autism Spectrum Disorder (including Asperger Syndrome). confidential and supportive route to report examples of inappropriate behaviour of a discriminatory nature. 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. Blind/Partially sighted. which has now been published.g. Repetitive Strain Injury (RSI). Dyslexia/Learning disability.g. the Colleges’ Examinations Departments and the panel of Examiners have adopted an Examination Race Equality Action Plan. 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. and the Disabilities Discrimination Acts of 1995 and 2005 as documented above. ensuring trainees have an appropriate. All efforts shall be made to ensure the participation of people with a disability in training. Chronic recurrent condition (e. Mobility difficulties.” In order to meet its obligations under the relevant equal opportunities legislation such as the Disability Discrimination Acts 1995 and 2005. MRCP(UK) has introduced standard operating procedures to deal with the common problems e. the MRCP(UK) Central Office. as amended by the Race Relations (Amendment) Act 2000.

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