February 2014 Dual Certification in GIM/Cardiology - guidance note for GIM PYA assessors Background On the date on which a trainee is awarded their CCT in GIM they must be competent to be a consultant on general medical take. It is therefore important that, as well as having completed all requirements of the GIM curriculum during their higher specialist training, they have had some recent experience / training in GIM. In the 'old' (2003) GIM curriculum this was recognised by a requirement that trainees should do six months of 'low intensity' GIM in their final year of training, but models of training and service delivery have changed such that this is no longer an appropriate descriptor. Guidance note In addition to completing all requirements of the GIM curriculum it is necessary that trainees receive some experience and training in GIM in the 12 calendar months before their CCT date. The minimum requirements will generally be (1) 12 shifts on-take; (2) three months of daily ward work looking after acutely unwell inpatients with a variety of medical conditions; (3) completion of 2 ACATs; (4) provision of at least two Multiple Consultant Reports (MCR's) specific to GIM. For trainees in cardiology whose specialty training arrangements are such that GIM training cannot be delivered in ST6 and ST7 because of commitment to specialty rotas, the recommendation would be either a three month placement in a combined GIM/cardiology post, or an attachment to an acute medicine service, during which time the trainee would (1) have only 30% commitment to ongoing specialty duties, (2) do the necessary 12 ontake shifts, two ACATs and obtain two MCRs, and (3) be involved in the on-going care of patients cared for by the acute medicine service. In practical terms, this can only occur at the end of ST7 when a CCT in cardiology normally would be awarded, but for those trainees who wish - or who are compelled to - dual certify, an extra 3 months of training will be required with a 70% commitment to GIM in order to satisfy the above requirements. The dual CCTs will, therefore, be delayed by 3 months on the basis of an ARCP outcome 3 for GIM. For this training, it would be advisable, if practical, for trainees to rotate back into an already existing cardiology/GIM post in order to fulfil these requirements. The period of grace would remain at 6 months starting after completion of the 3 months of GIM training (when the CCT in cardiology and GIM would be awarded), but trainees would be able to apply for consultant posts while obtaining this top-up training. Dr Brian Bourke Chair SAC in General Internal Medicine Dr John Ian Wilson Chair SAC in Cardiology
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