Professional Competence Scheme Surgery April 2011

Professional Competence Scheme Surgery

Page | 1

Table of Contents 1.0 2.0 3.0 4.0 5.0 6.0 Introduction Aims for RCSI Professional Competence Scheme Participants in the Professional Competence Scheme Governance of the Professional Competence Scheme Framework for the Professional Development Scheme Continuous Professional Development (CPD) 6.1 CPD Requirements 6.2 Recording CPD 6.3 Verification of CPD 7.0 Audit 7.1 Recording and verification 8.0 Operational aspects of the Professional Competence schemes 8.1 Registration 8.2 Fee 8.3 Annual Returns 8.4 Five Yearly returns 9.0 10.0 11.0 Confidentiality Support and Remediation Appeals Process 3 3 4 4 5 5 6 6 6 7 7 7 7 7 8 8 8 8 8

Professional Competence Scheme Surgery

Page | 2

1.0

Introduction

As of May 2011, and in accordance with Part 11 of the Medical Practitioners Act (MPA) 2007 , it will be obligatory for all registered medical practitioners (RMPs) in Ireland to enroll in one of the Medical Council approved Professional Competence Schemes relevant to their clinical practice. Enrolment is required for RMPs on both the General and Specialist division of the register. Those on the trainee specialist division are deemed to be fulfilling the requirements of Part 11 of the MPA 2007 once they remain in their training programmes. The MPA 2007, Part 11, outlines the requirements for a Professional Competence Scheme (PCS) framework which shall consist of three elements; CPD Continuing Professional Development Audit According to guidance from the Medical Council the initial requirements for the professional competence schemes will be the participation in Continuous Professional Development (CPD) and Audit. RCSI is a recognized professional training body of the Medical Council for the provision of a professional competence scheme. 2.0 Aims for RCSI Professional Competence Scheme

RCSI is committed to excellence in surgical training and standards of surgical practice. The enactment of Part 11 of the MPA 2007 is a welcome change in Irish medical practice bringing a clear focus on safeguarding the health and wellbeing of patients. RCSI see that our PCS to be integral to the overall noble purpose of our college; Building on our heritage in surgery, we will enhance human health through, endeavor, innovation and collaboration in education, research and service Our professional competence scheme in surgery shall; Support and guide surgeons to advance their professional development through maintenance of their knowledge, skills and professionalism to safeguard the safety and well being of their patients. Provide the necessary tools and structures to facilitate surgeons to independently record and verify their compliance with the requirements of scheme. Facilitate the surgeons ability to respond to changes in medical practice and technology for the benefit of patients.

Professional Competence Scheme Surgery

Page | 3

3.0

Participants in the Professional Competence Scheme (PCS)

The RCSI Professional Competence Scheme in surgery shall facilitate the enrolment of the following registered medical practitioners. 3.2.1 Surgeons on the Specialist Division of the Register of Medical Practitioners 3.2.2 Surgeons on the General Division of the Register of Medical Practitioners are not considered by RCSI to have completed their specialist training. Enrolment on the RCSI PCS for the General Division will be subject to the approval of the PDC in accordance with the following criteria; Surgery must be a predominant feature of the clinical practice of doctors on the General Division They must be employed by a Health Services Provider with structured processes for clinical governance and performance assessment Participation in the PCS of the General Division does not constitute formal specialist training. 3.2.3 For RMPs who are NOT eligible for the RCSI PCS, either on General Division or Specialist Division schemes, they will be informed in writing by the RCSI Professional Development Committee and will be referred to the Medical Council for guidance on the appropriate scheme alignment. 3.2.4 The only doctors working in Surgery not required to participate in a PCS are those on the Trainee Specialist Division of the Register i.e. doctors in training. 4.0 Governance of the Professional Competence Scheme

RCSIs Professional Development Committee (PDC), a Sub-Committee of the Surgical Affairs Committee is responsible for the development, establishment and maintenance of the RCSIs Professional Competence schemes. The surgical specialties and Emergency Medicine are represented on this Sub-Committee. The RCSIs Department of Surgical Affairs will be responsible for the provision of resources and administrative infrastructure to support the day to day operation and quality assurance of the PC schemes. The PDC has the following responsibilities relating to the PC schemes Ensuring representation from all surgical specialties and emergency medicine in the design, governance and implementation of the PC schemes Setting and approving the necessary rules and guidance for the running of the PC schemes to assure they meet the rules for PC as issued by the Medical Council.

Professional Competence Scheme Surgery

Page | 4

Publishing the list of activities at regular intervals with their credit ratings as approved for the PC schemes Having systems for the timely review of new activities to assess their relevance to the PCS and credit rating Maintaining an enrollment record of RCSI PC schemes, ensuring that there is adequate administrative and compliance assessment processes in place. The Professional Development Committee shall have oversight in terms of the following schemes being operated by RCSI A. RCSI PCS in Surgery for RMPs on the Specialist Division of the Register of Medical Practitioners B. RCSI PCS in Surgery for RMPs on the General Division of the Register of Medical Practitioners in accordance with 3.2.2 of this document C. RCSI PCS in Emergency Medicine for RMPs on the Specialist Division of the Register of Medical Practitioners in accordance with the PCS guidance published by the Advisory Committee on Emergency Medicine Training (ACEMT) D. RCSI PCS in Emergency Medicine for RMPs on the General Division of the Register of Medical Practitioners in accordance with the PCS guidance published by the ACEMT 5.0 Framework for the Professional Development Scheme

The Medical Council has confirmed that the initial role out of Professional Competence Schemes under the MPA 2007 will only involve the following 2 elements: Continuing Professional Development (CPD) Audit The third element of Multi-source Feedback will become a feature of the requirements of Part 11 of the MPA 2007 at a later unspecified date. 6.0 Continuous Professional Development (CPD)

CPD is recognized in four categories, three of which are mandatory and one recommended as outlined below: Category 1 External - Maintenance of Knowledge and Skills (Mandatory) Category 2 Internal - Practice Evaluation & Development (Mandatory) Category 3 Personal Learning (Mandatory) Category 4 Teaching and Research (Recommended) Appendix 1 outlines examples of activities in each category

Professional Competence Scheme Surgery

Page | 5

6.1 CPD Requirements To achieve compliance, a practitioner is required to earn at a minimum: 50 credits per year 250 credits per five year cycle Broken down as follows: External 20 credits per year minimum Internal 20 credits per year minimum Personal Learning five credits per year minimum Research or Teaching two credits per year desirable Accumulated credits must be balanced within the five year cycle. Practitioners are encouraged to balance credits by the 30 month mark. CPD credits will generally be calculated as one credit per one hour of activity. CPD requirements are the same for full time and part time surgeons. 6.3 Recording CPD Practitioners participating in the Surgery Professional Competence Scheme must have a suitable method of recording, storing and retrieving CPD activity. RCSI has developed an online CPD recording facility that registrants in its various PCS schemes should use to record their CPD and audit activity. Recording Personal learning CPD Much personal learning e.g. journal reading is unverifiable. Doctors claiming credit for this type of activity will be required to record and submit a reflective narrative of the activity on a word document. This document needs to be uploaded to your profile. Other facets of personal learning, e.g. e-learning, should be supported by relevant certificates. 6.4 Verification of CPD Recording of CPD activity should be supported by evidence of the activity, where possible. Such evidence should either be uploaded electronically to the PCS site or stored in a dedicated CPD folder. Such documentation must be produced in the event of an audit. Failure to produce documentary evidence will result in the relevant CPD credits being discounted. Appendix 2 outlines examples of documentary evidence of CPD

Professional Competence Scheme Surgery

Page | 6

7.

Audit

The Medical Council requirement for clinical audit is defined as the participation, at a minimum, in one audit exercise annually that directly relates to the RMPs practice. As a general guide this translates to about one hour per month on audit activity. Clinical Audit can comprise of 3 main components (1) Measurement the process of measuring specific elements of clinical practice. This can be basic activity numbers (e.g. frequency of day case, average length of stay, number of bed days used) to measuring the frequency of occurrence of adverse events or complication rates. (2) Comparison the process of comparing results with the recognized standard or literature proven outcomes. (3) Evaluation reflecting on outcome of audit and how learning is built into practice development or improvement. Clinical Audit is a cornerstone of patient safety management and good clinical governance. The RCSI is actively engaged with the main stakeholder agencies to put in place and publish an infrastructure to support surgeons participation in clinical audit that will meet the requirements of the MPA 2007, Part 11. 7.1 Recording and verification Documentary evidence of audit activity should be collated and stored. This evidence will be needed to establish compliance with the PCS. In the absence of formal documentation e.g. evidence of participation in a national audit program, practitioners can record their audit activity on a word document. 8.0 Operational aspects of the Professional Competence schemes

8.1 Registration All eligible doctors must register with the scheme by completing the on-line registration process (www.rcsi.ie/pcs) either at the instigation of the scheme or, thereafter, at the time they become eligible e.g. on completion of a training programme. 8.2 Fee The annual registration fee is 250.00, payable upon registration. This fee has been set by the Medical Council. Practicing RCSI Fellows and Members in Ireland can avail of significant discount from the PCS fee when combined with the RCSI subscription fee.

Professional Competence Scheme Surgery

Page | 7

8.3 Annual returns Participants in the scheme will be reminded electronically to submit returns outlining their CPD (internal, external, personal learning and research/education) credits and record of audit activity each year. This allows identification of doctors who may be having difficulty achieving CPD targets (less than 40 CPD credits per year). 8.4 Five-yearly returns The PCS runs over a five year cycle and, at the end of the fifth year, participants will need to submit evidence to the Medical Council that they requirements have been met. RCSI will issue annual records of CPD to those registered on its PCS. 9.0 Confidentiality

Participants individual CPD records are only accessible to that individual and to the appropriate office in RCSIs Department of Surgical Affairs. Section 95 of the 2007 Medical Practitioners Act provides for the confidentiality of information disclosed as part of a Professional Competence Scheme. The Medical Council may only disclose information in summary form which prevents the identity of individual practitioners being ascertained whether it be for the purposes of criminal proceedings or investigations or for the purposes of civil proceedings to which the Medical Council is a party. Section 95(3) specifically provides that the Freedom of Information Acts 1997 and 2003 shall not apply to a record relating to any PCS. 10. Support and Remediation

Participants in the PCS who anticipate that they may experience difficulty meeting any of the requirements of the scheme are encouraged to contact the Department of Surgical Affairs for support. RCSI will provide a comprehensive and supportive remediation process for EM practitioners who have requested remediation or in whom the PCS process has identified a need for remediation or have been referred by the Medical Council to RCSI for remediation. 11. Appeals Process

The Medical Council has an appeals process for all Professional Competence Schemes. RCSI will provide expertise when requested to support this appeals process.

Professional Competence Scheme Surgery

Page | 8

APPENDIX 1 : Category

CPD CATEGORIES Example Activities -International/National Meetings -Courses accredited by Training Body -College/Society meetings -Medically related advanced degrees -Online Courses Credits 20 credits minimum per year 100 credits minimum per cycle 20 credits minimum per year 100 credits minimum per cycle

External (Maintenance of Knowledge and Skills) Events / activities accredited by Training Bodies that meet educational standards Internal (Practice Evaluation & Development) Activities that develop and improve the quality of clinical practice

-Morbidity and Mortality Meetings -Clinical Risk Meetings -Case Presentations -Chart Reviews -Grand Rounds -Multi-disciplinary Meetings -Peer Review Groups -Activities related to analysing patient and/or department outcomes -Activities related to patient satisfaction surveys -Activities related to the organisation or review of surgical services, e.g. Head of Department and Clinical Unit meetings -Self directed education, training or assessment activities (eg Journal reading) -Participation in professional development workshops/courses -Volunteer or outreach activities -Journal clubs -E-Learning - Accredited Postgraduate Trainer -Lectures -Examiner for Postgraduate Training Body -Publishing articles -Poster Presentation -Question Setting -Participation in the mentoring and

Personal Learning

5 credits minimum 25 credits minimum per cycle

Research or Teaching

counseling of surgical trainees

A list of the events approved in the activities will soon be published in the Professional Competence section of the RCSI website

Professional Competence Scheme Surgery

Page | 9

Appendix 2 Examples of documentary evidence of CPD

Attendance certificates/registers for local/national/international educational meetings/courses E-learning self assessment certificates Attendance at examination as an examiner (e.g. exam timetable) Programmes of meetings if there are no attendance certificates Copies of proposals written for specific committees Copies of meeting agendas Protocols written Copies of papers and abstracts presented For Life Support Course instructing copies of the course programme Research grants List of papers refereed Programmes of courses on which you have lectured Medically Related Advanced Degrees copy of diploma or final transcript Research - Copy of published articles first page Poster Presentation - Copy of page from conference proceedings that lists the poster abstract and identifies the presenter Postgraduate Trainer/Examiner/Question Setting - Confirmed by relevant training body

Professional Competence Scheme Surgery

Page | 10