Portfolio
Fourteen Fish
FourteenFish is the online appraisal system used to demonstrate your competencies in workplace based assessments (WPBA). You are required to purchase this for the full three years of training and complete the mandatory requirements each year to progress.
Members of the RCGP (also required whilst in training) get a 30% discount on the annual price.
Purchase here: https://www.fourteenfish.com/
Mandatory Requirements
A helpful chart of the mandatory requirements required for each year can be found below. Further descriptors of what each component is can be found below.
Portfolio Components (click title for RCGP Website)
Personal Development Plans (PDPs) are learning goals that you believe you can meet during your current placement, based on your learning needs. You must discuss the learning need, how you plan to achieve it (actions) and how you will demonstrate success in achieving this. Consider the fact you should reflect on what you have and haven't achieved at the end of the placement - hence think SMART! (Specific, Measurable, Achievable, Realistic and Time-bound). Discuss your proposed PDPs with your supervisor and set these early on in your placement so you can review them in your iESR/ESR. 3 goals per review period is an ideal minimum.
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Click here for the FourteenFish guide on how to add PDPs to your portfolio.
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Action plans
These are plans which you will undertake to achieve your PDPs, that are specific to the 13 core capabilities. Examples include e-learning modules, attending clinics, attending courses, writing new practice protocols or writing patient information leaflets.
Click here for the FourteenFish guide on how to add Action Plans to your portfolio
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ESR stands for Educational Supervisor's Review. It's an opportunity for you and your Educational Supervisor to evaluate your progress and make sure there are no problems.
An ESR happens at the end of each Review Period (6 months) and both you and your Supervisor need to sign it off.
For the interim, or mid-year ESR, aim to have at least 50% of your sign offs done to ensure you're on track.
Click here for the FourteenFish guide on how to add an iESR to your portfolio
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Click here for the FourteenFish guide on how to an ESR to your portfolio
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Learning logs
Clinical Case Reviews
You require 36 each the year, 18 by mid-year ESR
For a full time GP trainee there is a requirement for a minimum of 3 in each calendar month.
Before starting this I highly recommend reading Ram notes to understand what each of the capabilities mean.
Have a look at the indicators and use it to reflect on your daily clinical practice. It is acceptable to be in the needs further development section as you are in training, you will only need to be signed off as competent in your ST3 year for CCT. Look at what it means to be competent or excellent in each of the domains as these will help you come up with action plans to improve your clinical practice. These are the same domains outlined in the RCGP curriculum and highlights the path to becoming a GP.
The sooner you understand the capabilities, the less daunting all of this will be.
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Extra resources and example logs
Ram notes (Bradford VTS) with detailed descriptors
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This is where you can add the following: reading, eLearning, lecture/seminar, course/certificate, OOH attendance sheets.
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Learning Event Analysis/Significant Event
One entry is required each year.
This can be a case you have been directly involved in or a case that has been discussed in a practice meeting, SI or M&M meeting.
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A new reflective log entry enables you to reflect on the following feedback: Colleagues (MSF), Patients (PSQ) and Leadership (Leadership MSF), in addition to reflections on the ESR, CSR, Educator notes, CSA and AKT results.
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Leadership, Management and Professionalism
Click on the title for detailed information from the RCGP website.
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Click on the title for detailed information from the RCGP website.
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You are required to complete this in ST3.
It follows a formal process where you will review your prescribing of 50 consecutive prescriptions in relation to safety and appropriateness. This assessment has been created because of the importance attached to prescribing by the GMC.
There is more information about the prescribing assessment and the documents required on the RCGP website.
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Work Place Based Assessments
The Case-based Discussion (CbD) is a structured interview designed to assess your professional judgement in clinical cases.
You should provide the option of at least two cases that you are able to discuss in detail, including your assessment, diagnosis, management and learning from each.
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Consultant Observation Tool (COT)
Trainers use the Consultation Observation Tool (COT) to support holistic judgements about your practice on primary care placements.
Your assessor reviews a number of your patient consultations - either video recordings or by direct observation. You’ll use the resulting discussion and feedback as evidence for your Trainee ePortfolio. For information about who can complete COT
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As above, but for audio recordings of telephone consultations. It is encouraged to do these as well as standard COTs due to the high prevalence of telephone consulting in general practice.
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Clinical Examination and Procedural Skills
There are 5 mandatory skills that the trainee is required to be signed off as 'fully independent' in, by the end of ST3.
These include breast, rectal, prostate, male genital examinations and female genital examination, to include speculum examination and bimanual pelvic examination. You need to be observed performing these examinations by a suitably trained professional.
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Recently added, are seven 'other skills' (Respiratory, ENT, Abdominal, Cardiovascular, MSK, Neurological and Child 1-5 years exams). These are not mandatory but should be conducted and completed as above, if identified as a learning need in any of your reviews.
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The Multi-Source Feedback (MSF) tool is used to collect colleagues’ opinions on your clinical performance and professional behaviour. You must complete one MSF per year.
Respondents:
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In secondary care, five clinicians who know your work well; they should come from a range of roles and include people with a range of seniority.
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In primary care, five clinicians (mainly established GPs) and five non-clinicians
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Patient Satisfaction Questionnaire
ST3 ONLY - WHILST IN PRIMARY CARE
The Patient Satisfaction Questionnaire (PSQ) provides patient feedback on your empathy and relationship-building skills during consultations.
34 responses are required in total.
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The Compliance Passport is an area within your Portfolio, where you can add and keep track of mandatory training.
Must have the submit the following for end-of year ESR..
One each year
- Form R
Submitted on HEE TIS Self-Service website
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- Basic Life Support
Certificate of completion must include Paediatric BLS and use of AED.
Can be booked with your practice or at annual VTS session.
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- Safeguarding Children: Level 3
Certificate of training completion + a separate reflection in clinical case review titled ''Safeguarding Children''
Training can be completed online (eLFH, a trust, at practice) or at annual VTS session.
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- Safeguarding Adults: Level 3
Certificate of training completion + a separate reflection in clinical case review titled ''Safeguarding Adult''
Training can be completed online (eLFH, a trust, at practice) or at annual VTS session.
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- National GMC Training Survey
Although this is not related to the portfolio, you will receive a survey from the GMC to provide feedback for your rotations.
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Applied Knowledge Test (AKT)
The Applied Knowledge Test (AKT) is a computer-based assessment that forms part of the MRCGP.
The AKT takes place three times a year at Pearson VUE test centres across the UK.
Trainees have 3 hours and 10 minutes to answer 200 questions. The questions are approximately:
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80% on clinical knowledge
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10% on evidence-based practice (including evidence interpretation and the critical appraisal skills needed to interpret research data)
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10% on primary care organisation and management issues (including administrative, ethical, regulatory and statutory frameworks)
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Simulated Consultation Assessment
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An assessment of twelve simulated consultations, each lasting twelve minutes
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Conducted remotely in a local GP surgery
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Sat only during ST3 training year
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Delivered across 9 months of the year
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The exam fee will be £1,180