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GUIDANCE DOCUMENT FOR APPLICANTS APPLYING FOR ENTRY TO THE SPECIALIST DIVISION OF THE REGISTER IN GENERAL INTERNAL MEDICINE

SUMMARY DESCRIPTION OF REQUIREMENTS AND EVIDENCE ACCEPTED TO

SUPPORT APPLICATION FOR GENERAL INTERNAL MEDICINE – MONO AND DUAL SPECIALTY

PART A – OVERVIEW OF STRUCTURE AND CONTENT OF TRAINING PROGRAMME

DOCUMENT PURPOSE: To enable applicants to assess their training and experience against the requirements of Specialist Training in Ireland and to clarify evidence required to be submitted with application. The evidence requested is not exhaustive and the onus is on the applicant to provide sufficient and appropriate evidence to support their application. In support of your application you will be required to submit a structured CV, profile of posts held and references using the proforma templates provided, together with certified copies of your qualifications, logbooks and assessments.

FRAMEWORK OF PROGRAMME FOR HIGHER SPECIALIST TRAINING IN GENERAL INTERNAL MEDICINE IN IRELAND

Programme Duration: The programme duration is four years full-time, one year of which may be gained from a period of full-time research. To ‘dual train’ in G(I)M plus another specialty will require a minimum of five years. Applicants seeking assessment in two specialties will be measured against standards required for both specialties. Programme Location: The programme is delivered by the Irish Committee on Higher Medical Training, RCPI, the Postgraduate Training Body approved by the Medical Council for the delivery of specialist training in General Internal Medicine. Programme Accrediting Authority: This programme is developed by the Irish Committee on Higher Medical Training, RCPI. It is approved by the Medical Council of Ireland. It meets with the minimum standards set down in Article 25 and Annex V 5.1.3 of EU Directive 2005/36/EC Programme Training Structures: Trainees train at the Non-Consultant Hospital Grade of SpR in designated teaching hospitals. The posts are inspected and approved by the Irish Committee on Higher Medical Training, RCPI. The optimum duration of training is four years in four supervised posts undertaking high intensity General Internal Medicine. Under circumstances where a single post is occupied for more than two years, or less than three months, credit will not be given for training purposes. Specialist Registrars may not remain in the same hospital for longer than two years of clinical training; or with the same trainer for more than one year. A high intensity GIM year should have the following components: A minimum commitment of four days per month (resident on-call) of acute unselected emergency admissions.


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PROGRAMME ENTRY REQUIREMENTS

A minimum of two years Basic Specialist Training (BST) in approved posts and obtained the MRCPI or MRCP(UK) or equivalent

Evidence Required for Assessment:

A certified copy of BST/GPT Certificate BST is generally undertaken immediately post internship and consists of a minimum of 24 months in medicine posts with direct patient care. In your application you should provide evidence of RCPI Certificate of BST or its equivalent. The RCPI recognise Certificates of BST from the following zones as equivalent:

o EU – Posts approved by the recognised training body in that country;

o UK – Posts approved by the Royal College of Physicians; o Australia & New Zealand – Posts approved by the Royal

Australasian College of Physicians; o US – ACGME Approved Residency Programmes; o Canada – Posts approved by the Royal College of

Physicians and Surgeons of Canada; o Oman – Fellowship programme of the OMAN Medical

Specialist Board OMSB. Applicants who do not hold a Certificate of BST as outlined above must complete a ‘BST Post Summary Form’ as evidence of BST. The number of forms to be supplied will depend on the number of BST posts held. Applicants should have each BST Form submitted signed by a Fellow of the Irish College or Sister Colleges

A certified copy of MRCPI/MRCP (UK) certificate or equivalent. Those who do not hold MRCPI /MRCP (UK) must provide evidence of equivalence. The RCPI recognise the following qualifications as equivalent for the purposes of SDR Assessment:

o FRCPI o MRCP (London, Glasgow, Edinburgh) o MRACP (Australia)


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o FRCP (C) (Canada) o FCP (SA) (South Africa) o American Board in General Internal Medicine

SUMMARY OF PROGRAMME REQUIREMENTS

In your application you must demonstrate training and experience in the following clinical activities:

Emergency Medicine: Acute Emergency “Take” Responsibilities: There must be evidence of direct supervision of the activity of the more junior members of the “on-take” team and a minimum of 10 (480 per year) emergency admissions during the 24-hour period are expected. In addition, you will be expected to have had ongoing care/responsibility for a proportion of the patients admitted, “on-take” and a post take ward round with his/her trainer. CCU, ITU, ICU or equivalent Experience: The minimum requirement is that you must have had front line responsibility for acute emergency patients admitted to the above units. If this is not possible in a particular hospital/training institution then a period of secondment to the appropriate unit will be required.

Inpatient Responsibilities: The applicant will have had front line supervisory responsibilities for general medical inpatients. This will require supervising the activities (e.g. being available for advice) of the more junior members (SHO/Intern) of the clinical team at all times. In addition to personal ward rounds, a minimum of two ward rounds with the consultant each week is expected for educational experience. Ongoing responsibility for shared care of the team’s inpatients whilst in the ITU/HDU/CCU is also essential. Outpatient Responsibilities: The applicant is expected to have personal responsibilities for the assessment and review of general medicine outpatients with a minimum of at


A copy, translated into English where applicable, of the training programme that you undertook

Logbooks

Details of high and low intensity GIM experience should be set out in your application.

You should set out in both your CV and the attached forms details of your posts, supervision etc.

Details of Emergency Medicine responsibilities should be set out in your application

CCU, ITU , ICU or equivalent experience should be set out in your application

Inpatient and outpatient responsibilities should be set out in your application

Details of Management, and Communication Skills should be set out in the application

Provision of a copy of a current ACLS certificate

Evidence of clinical and management skills in emergency scenarios

Evidence of teaching, research and audit

Evidence of attendance at mandatory courses


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least one consultant led GIM clinic per week. The applicant must demonstrate training and experience in the assessment of new patients; access to consultant opinion/supervision during the clinic is an essential requirement. A minimum of 20 clinics is required over a six month period.

High intensity training in an AMAU and Emergency Medicine is acceptable. General Education in Training: The applicant is expected to spend four hours per week, in formal general professional education for certification of training.

The applicant will be expected to have undergone training in management. This will take the form of day-to-day involvement in the administration of the team/firm and must include attendance at a management course.

Applicants will be expected to have been actively involved in audit. They should also have regularly attended other activities, study days, journal clubs, x-ray conferences, pathology meetings etc.

They will be expected to show evidence of the development of effective communication skills. This can be assessed by providing evidence of participation in formal case presentations or in giving lectures/seminars to other staff or research/audit presentations at unit meetings.

All applicants must have a current ACLS certificate throughout their HST.

Procedures: Applicants must demonstrate that they have acquired those practical skills that are needed in the management of medical emergencies, particularly those occurring out of normal working hours. Essential & Additional Experience: Applicants will be expected to have had experience of/be familiar with the management of a wide range of cases presenting to hospitals as part of an unselected acute medical emergency “take”. Whilst applicants will not need to be expert in all of these areas they will be expected to be able to plan and


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interpret the results of immediate investigations, initiate emergency therapy and triage cases to the appropriate specialist care. Registration on the SDR in GIM implies knowledge and competencies across the wide spectrum of medical disorders. Where an essential element of the specialist knowledge is missing, access to it should be arranged, by day release for example, or if necessary by secondment.

Teaching, Research and Audit All applicants are required to demonstrate participation in teaching. They should also have received basic training in research methods, including statistics, so as to be capable of critically evaluating published work. For applicants in GIM alone a period of at least one year of supervised research relevant to GIM and/or a period of up to one year could be gained through periods spent in specialties relevant to General Internal Medicine. A period spent in supervised research and/or in GIM subspecialties is considered highly desirable and will contribute towards registration on the SDR in GIM. Some applicants may have spent two or three years in research leading to an MSc, MD, or PhD. Additional educational credit may be granted for clinical work relevant to the curriculum undertaken during the second and subsequent years of this research. Trainees are required to engage in audit during training and to provide evidence of having completed the process. Mandatory Training Courses – Applicants must provide evidence of training in the following:

Communication Course

Audit Course

Ethics Course including: Ethics & Law, Ethics in Research, Professionalism and ‘End of Life’

Leadership in Clinical Practice


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ACLS Course

NIHSS stroke Scale

Ultrasound Course (desirable)

Up-to-date training records and a portfolio of achievements will be maintained by trainees throughout their structured training. These training records/ePortfolio will be countersigned as appropriate by the trainers to confirm the satisfactory fulfilment of the required training experience and the acquisition of the competencies set out in the GIM Curriculum must be produced at the annual assessment review.

PROGRAMME EXAMS / TESTS OF KNOWLEDGE

Applicants must hold the MRCPI/MRCP (UK) or equivalent


A certified copy of MRCPI/MRCP (UK) certificate or equivalent. Those who do not hold MRCPI/MRCP (UK) must provide evidence of equivalence. The RCPI recognise the following qualifications as equivalent for the purposes of SDR Assessment:

o FRCPI o MRCP (London, Glasgow, Edinburgh) o MRACP (Australia) o FRCP (C ) (Canada) o FCP (SA) (South Africa) o American Board in General Internal Medicine


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ASSESSMENT OF TRAINING

Annual Reviews – The PeTRA Process

Each year trainees undergo a formal review by a panel including the Dean, or the Dean’s representative, the National Specialty Director, and whenever possible, a representative member from another specialty. The panel reviews in detail the training record, will explore with the trainee the range of experience and depth of understanding which has been achieved and consider individual trainer’s reports. The award of a CSCST will be determined by a satisfactory outcome after completion of the entire series of PeTRA assessments. Workplace Based Assessments Where you have undertaken workplace based assessment, the same should be provided to support your Specialist Division of the Register application. DOPS

Definition: Directly Observed Procedural Skills (DOPS) is a method, similar to the mini-CEX that has been designed specifically for the assessment of practical skills. DOPS assess the capabilities of a trainee while they perform a procedure.

Mini-CEX Definition: Designed to provide feedback on skills essential to the provision of good clinical care by observing an actual clinical encounter. A “snapshot” of a doctor/patient interaction based on 15 minute observation.

Case Based Discussion Definition: Case-based discussion (CBD) is used to enable the documenting of conversations about, and presentations of cases. CBD is used to evaluate core skills that can be demonstrated during an interactive discussion based on a single case in which the trainee has been actively involved.


Evidence of similar in training assessments


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QUALITY OF EVIDENCE REQUIRED

Applicants are required to have all proforma templates signed and stamped as requested on each form. Applicants are requested to provide certified copies of the documents submitted as part of your application To have a copy certified, you must present the original document and the photocopy to one of the following: A Fellow of the Royal College of Physicians of Ireland (please note that Fellows may not certify their own documents) A member of the Garda Síochána at a police station A Commissioner for Oaths A Notary Public The copy must be certified with the following words or an appropriate equivalent (BLOCK CAPITALS, please) I (NAME) certify that this is a true and faithful copy of an original document which I have seen. It must then be signed, officially stamped and dated. In the case of a document being certified by a Fellow of the College, the stamp of the hospital must accompany the signature


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PART B – OVERVIEW OF MINIMUM REQUIREMENTS FOR ASSESSEMENT OF SPECIALIST

TRAINING IN GENERAL INTERNAL MEDICINE AND EVIDENCE REQUIRED

Your application will be assessed against the minimum requirements of training in General Internal Medicine as set out below. Please map these requirements to your CV and information provided in the SDR Post Summary form(s) and Reference form(s) and provide supporting documentary evidence as required.

Curriculum Requirement Required/Desirable Evidence Required

Programme Entry Requirements

Minimum of two years Basic Specialist Training (BST) in approved posts Required

Certified copy of Certificate of BST

or equivalent; or Completed and

approved evidence of BST Post

Summary Form(s)

MRCPI/MRCP (UK) or equivalent Required Certified Copy of Qualification

Section 1 - Time Table –please submit details as follows

Weekly Timetable (Sample Weekly Timetable for Post/Clinical Attachment) Required Post Summary Form(s)

On Call Rota (2 nights on call every month Low Intensity, 4 nights on call every month

High Intensity) Post Summary Form(s)

Section 2 – Evidence of the following Clinical Activities

Inpatient:

Participation/lead in Ward Rounds/Consultations (Minimum of 2 ward rounds with the

consultant and at least one personal ward round per week)

Reference Form(s); Post Summary

Form(s), Certified Copy of Logbook/

Assessments (if available)

Consultant Led Required

SpR Led Required


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Consultations Required

ICU/CCU Experience or equivalent

ICU Required

CCU Required

Outpatient Clinics –participation in the following specialty outpatient clinics (High

Intensity 1 clinic per week, Low Intensity 1 clinic per week) Required

General Internal Medicine Required

Cardiology Required

Geriatric Required

Rheumatology Required

Infectious Diseases Required

GUM Required

Gastroenterology Required

Endocrinology Required

Nephrology Required

Respiratory Required

Emergencies/Complicated Cases (Minimum of 1 per week) This requires at a minimum

a personal 'post take' ward round and ongoing responsibility for a proportion of the

patients seen on emergency take Desirable

Procedures/Practical Skills/Surgical Skills


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* Where workplace based assessments were undertaken please provide evidence

of same

ECG interpretation * Required

Central venous line placement - under ultrasound * Required

DC cardioversion * Required

Pleural aspiration - under ultrasound * Required

Abdominal paracentesis - under ultrasound * Required

Intercostal drain Insertion - under ultrasound * Desirable

Lumbar puncture * Required

Joint aspiration * Required

BIPAP/CPAP * Required

Echocardiography Desirable

Relatively Unusual Cases Desirable

Chronic Cases/Long term care Desirable

Outline your Management and Administrative Experience Required

Section 3 – Evidence of Participation in the following Educational Activities

Mandatory Courses

Audit Required Copy of Attendance Certificate(s)

(Copy of course programme also Communications Required


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Leadership in Clinical Practice Required required for non-RCPI courses)

Ethics I Professionalism Required

Ethics II Ethics & Law Required

Ethics III Research Required

Ethics IV End of Life Required

NIHSS Stroke Scale Required

ACLS Certified Required

Ultrasound Course Desirable

Non – Mandatory Courses Desirable Copy of Attendance Certificate(s)

Study days (Minimum of 6 study days per year of High Intensity Training; 3 per year Low

intensity) Examples : Safe Prescribing, Oncology, Infection control, Evidence based

medicine Required Copy of Attendance Certificate(s)

In-house Activities Minimum of 1 per month from the categories below:

Grand Rounds Required

CV Template; Reference Form(s);

Post Summary Form(s)

Journal Club Required

Radiology Conference Required

Pathology conference Required

Multi Disciplinary Team Meetings Required

Seminar Required

Lecture Required


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Formal Teaching Activity (at least one formal teaching session per month)

This should include the following categories:

CV Template; Post Summary

Form(s)

Lecture Required

Tutorial Required

Bed side teaching Required

Research – Outline Research opportunities Desirable

CV Template; Post Summary Form;

Brief Summary of Research

Audit activities (1 audit a year either new or complete) Required

CV Template; Completed Audit

Report Template Form(s) (two most

recent audits); Post Summary

Form(s)

Publications Desirable CV Template; Copy of first page of

publication

Presentations Required

CV Template Listing of

presentations referenced with date

and meeting

Attendance at National/International meetings (Minimum 1 per year) Required Attendance Certificate

Committee Attendance (Serve on at least one committee) Required

CV Template; Letter from Chair of

Committee confirming attendance

and participation


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PART C – DESCRIPTION OF EVIDENCE OF EXPERIENCE

General Evidence of Experience. In order to compensate for a shorter duration and / or content of training, experience should be comparable to the structures for training. All experience will be assessed, but not all will necessarily be accepted. Applicants should have regard to the following guidelines when submitting experience for assessment:

The experience should be at an appropriate grade, befitting that of a trainee specialist. In Ireland, this constitutes Registrar grade or a substantive consultant post. Locum posts and posts of shorter duration that three months will not give the assurances that the applicant has built a required competency or set of competencies and, as a rule, will not be accredited

The experience should be documented and benchmarked as closely as possible to the above evidence required for training

Experience will only attract credit when the opportunity to gain curriculum requirements occurs

Experience will be considered on a case by case basis with due weight given to content and quality of evidence submitted. Experience will typically be given less or no credit under the following circumstances:

Experience obtained prior to formal training

Experience obtained in a different specialty or non-medical role

Experience in the absence of formal training

Experience obtained in a private, unsupervised capacity

Experience obtained in posts of junior responsibility

Experience obtained of greater duration than one year in the same post

Experience obtained in less than three-six months full-time duration

Unsupervised experience

Experience that does not involve clinical skills i.e. academic/research, unless it is for the purpose of demonstrating research skills

Experience not adequately documented or testified. For example, attestations by colleagues who have not directly observed the medical practitioner in practise


Of comparable standard to the evidence required for proof of training.


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EXPERIENCE ASSESSMENT METHODS

Assessment methods to demonstrate experience should include, where possible, the assessments methods outlined for training (above). However, the College



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accepts that the assessment methods may differ. Under such circumstances, evidence of experience via clinical audit, structured 360 degree feedback, ongoing professional competence, structured references, and structured post references is highly desirable.

Similar to the training assessments, where possible

Clinical Audit

360 degree feedback

Logbooks

Structured references

Structured post forms

Ongoing professional competence

EXPERIENCE TEST OF KNOWLEDGE

Applicants must hold the MRCPI/MRCP (UK) or equivalent Evidence Required for Assessment:

A certified copy of MRCPI/MRCP (UK) certificate or equivalent. Those who do not hold MRCPI/MRCP (UK) must provide evidence of equivalence. The RCPI recognise the following qualifications as equivalent for the purposes of SDR Assessment:

o FRCPI o MRCP (London, Glasgow, Edinburgh) o MRACP (Australia) o FRCP (C) (Canada) o FCP (SA) (South Africa) o American Board in General Internal Medicine

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APPLICATION CHECKLIST – To be submitted with completed application

Minimum Curriculum Requirements for Assessment ofSpecialist Training in General Internal Medicine

Your application will be assessed against the minimum requirements of training in General Internal Medicine as set out below.Please map these requirements to your CV and information provided in the SDR Post Summary form(s) and Reference form(s)and provide supporting documentary evidence as required.

Curriculum RequirementRequired/

DesirableEvidence Required

Please state where

demonstrated within

application (i.e. CV,

Reference, Post Summary

Form)

Programme Entry Requirements

Minimum of two years Basic Specialist Training (BST) in approved posts Required

Certified copy of

Certificate of BST or

equivalent; or

Completed and

approved evidence of

BST Post Summary

Form(s)

MRCPI/MRCP (UK) or equivalent Required

Certified Copy of

Qualification

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Section 1 - Time Table –please submit details as follows

Weekly Timetable (Sample Weekly Timetable for Post/Clinical

Attachment) Required


(BST)

On Call Rota (2 nights on call every month Low Intensity, 4 nights on call

every month High Intensity)


(HST)

Duration of Training: Evidence of four years full time, one of which may

be gained from a period of full time research.Required

CV Template, Post

Summary Form(s)

(HST), Reference

Form(s)

Section 2 – Evidence of the following Clinical Activities

Inpatient:

Participation/lead in Ward Rounds/Consultations (Minimum of 2 ward

rounds with the consultant and at least one personal ward round per week)

Reference Form(s);


(HST); Certified Copy

of Logbook/

Assessments (if

available)

Consultant Led Required

SpR Led Required

Consultations Required

ICU/CCU Experience or equivalent

ICU Required

CCU Required

Outpatient Clinics –participation in the following specialty outpatient

clinics (High Intensity 1 clinic per week, Low Intensity 1 clinic per week) Required

General Internal Medicine Required

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Cardiology Required

Geriatric Required

Rheumatology Required

Infectious Diseases Required

GUM Required

Gastroenterology Required

Endocrinology Required

Nephrology Required

Respiratory Required

Emergencies/Complicated Cases (Minimum of 1 per week) This requires

at a minimum a personal 'post take' ward round and ongoing responsibility

for a proportion of the patients seen on emergency take Desirable

Procedures/Practical Skills/Surgical Skills

* Where workplace based assessments were undertaken please

provide evidence of same

ECG interpretation * Required

Central venous line placement - under ultrasound * Required

DC cardioversion * Required

Pleural aspiration - under ultrasound * Required

Abdominal paracentesis - under ultrasound * Required

Intercostal drain Insertion - under ultrasound * Desirable

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Lumbar puncture * Required

Joint aspiration * Required

BIPAP/CPAP * Required

Echocardiography Desirable

Relatively Unusual Cases Desirable

Chronic Cases/Long term care Desirable

Outline your Management and Administrative Experience Required

Section 3 – Evidence of Participation in the following Educational

Activities

Mandatory Courses

Copy of Attendance

Certificate (copy of

course programme also

required for non-RCPI

courses)

Audit Required

Communications Required

Leadership in Clinical Practice Required

Ethics I Professionalism Required

Ethics II Ethics & Law Required

Ethics III Research Required

Ethics IV End of Life Required

NIHSS Stroke Scale Required

ACLS Certified Required

Ultrasound Course Desirable

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Non – Mandatory Courses Desirable

Copy of Attendance

Certificate(s)

Study days (Minimum of 6 study days per year of High Intensity Training;

3 per year Low intensity) See examples below : Safe Prescribing,

Oncology, Infection control, Evidence based medicine Required

Copy of Attendance

Certificate(s)

In-house Activities Minimum of 1 per month from the categories below:

Grand Rounds Required

CV Template

Reference Form(s);


(HST)

Journal Club Required

Radiology Conference Required

Pathology conference Required

Multi Disciplinary Team Meetings Required

Seminar Required

Lecture Required

Formal Teaching Activity (At least one formal teaching session per

month)

This should include the following categories:

CV Template; Post

Summary Form(s)

(HST)

Lecture Required

Tutorial Required

Bed side teaching Required

Research – Outline Research opportunities DesirableCV Template; Post

Summary Form(s)

(HST); Brief Summary

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of Research

Audit activities (1 audit a year either new or complete) RequiredCV Template;

Completed Audit

Report Template Form

Publications Desirable

CV Template; Copy of

first page of publication

Presentations Required

CV Template Listing of

presentations

referenced with date

and meeting

Attendance at National/International meetings (Minimum 1 per year) Required Attendance Cert

Committee Attendance (Serve on at least one committee) Required

CV Template; Letter

from Chair of

Committee confirming

attendance and

participation

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CURRICULUM VITAE – GENERAL INTERNAL MEDICINEPlease complete and attach documentary evidence as required

PERSONAL DETAILS

Mandatory Details:

Name:

Address:

Telephone Number:

Mobile Number:

Email Address:

Optional:

Date of Birth:

Nationality:

Languages:

ACADEMIC QUALIFICATIONS (A full list of all academic qualifications obtained, bothundergraduate and postgraduate must be given in date order)

Qualification Awarding Body Date/s Completed Evidence Required(Certified copy ofQualification)

MEDICAL REGISTRATIONS (Please list all Medical Registration held with regulating bodies,including dates if applicable e.g. Full Registration with Irish Medical Council, General Division,Reg No: 123456)

Registration Regulating Body Date Evidence Required (Certified copy ofQualification)

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PERSONAL STATEMENT: (Desirable) - Should you choose to give a personal statement it ishere that you outline your thoughts on your career path to date as well as your career intentionsfor the future (Max number of words 300)

POSITIONS HELD: A full list of all posts held must be included from Internship to the current positionheld, starting with current position and working backwards. The posts should be in sections describingyour status at the time e.g. intern, BST trainee, HST trainee, consultant. The nature of each post shouldalso be specified i.e. academic, honorary or clinical post. Full dates of employment as well as the name ofthe Supervisor/Trainer for each post must be provided. An outline of each post must be provided. Pleaseprovide Post Summary Forms for each post you wish to be considered.

Position Institution Date Supervisor/Trainer

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EDUCATIONAL ACTIVITIES

Mandatory Courses Attendedas Per ICHMT GeneralInternal Medicine Curriculumof Training

Date/s Completed Evidence RequiredCopy of Attendance Certificate (copyof course programme for non-RCPIcourses)

Audit

CommunicationsLeadership in ClinicalPractice

Ethics I Professionalism

Ethics II Ethics & Law

Ethics III Research

Ethics IV End of Life

NIHSS Stroke Scale

ACLS CertifiedUltrasound Course(desirable)

Study Days or equivalent(please list)

Other (please list) e.g.International Conferences,Masterclasses, Clinicalupdates

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PUBLICATIONS /RESEARCH/BIBLIOGRAPHY – A full listing of Publications should be providedusing the following referencing: Name of Authors. Title of Article/Paper, Journal/PlaceArticle/Paper was Published, Date of Publication.Only publications subjected to a peer review process should be listed.

List Publications /Research and referenceJournals – Example: Smith J., Murphy P.,Delaney A., Pituitary tumours:Developments aid diagnosis andtreatment. Lancet. 12 (7): 5, 2001.

Date/s Evidence Required(Copy of first page of publication)

ABSTRACTS – A listing of your ten most recent abstracts should be listed using the followingreferencing: Name of author/s, Title of abstract, Place Abstract was Published, Date ofPublication.

List Abstracts and reference Journals -Example: Kennedy A., Smith J.,Keogh D., Pituitary tumours:developments aid diagnosis andtreatment. Lancet. 12 (7): 5, 2001.

Date/s Evidence Required(Copy of abstract)

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FORMAL TEACHING ACTIVITY/PRESENTATIONSPlease give a description of teaching activity to date (including Lecture, Tutorial and Bed side teaching)

Description Date/s Evidence Required(Post Summary Form(s)(HST))

MANAGEMENT/ADMINISTRATIVE/COMMITTEE EXPERIENCEPlease give a description of Management/administrative/Committee experience to date referencing postsand committees

Description Post Date/s EvidenceRequired(Post SummaryForm(s) (HST),letter fromappointing body)

AUDIT

List of Audits Performed/Completed Date/s Evidence Required(Copy ofAudit/Completed AuditTemplate ReportForm)

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PCS/CPD Information

Are you currently enrolled in a Professional Competence Scheme (PCS)/Continuing Professional

Development (CPD)Programme: Yes No

If yes please give detail of programme/scheme: ________________________________

Referees: A list of referees with full contact details (address/phone/email) should be provided.References should be provided from supervising trainers and are to be provided from all major trainingand specialist posts held. Should these prove difficult to obtain references will be accepted fromcolleagues or other appropriate persons who can attest to the applicant’s current level of practice.

Name:

Address:

Telephone Number:

Mobile Number:

Email Address

Name:

Address:

Telephone Number:

Mobile Number:

Email Address

Name:

Address:

Telephone Number:

Mobile Number:

Email Address

Page 7 of 8

Name:

Address:

Telephone Number:

Mobile Number:

Email Address

Name:

Address:

Telephone Number:

Mobile Number:

Email Address

I certify that the above information is a true record of my Qualifications, Positions Held, EducationalActivities, Publications/Research, Audit, Formal Teaching Activity Presentations andManagement/Administrative Experience to date.

Signed by Applicant

SIGNATURE:

TITLE:

DATE:

Page 8 of 8

CHECKLIST OF ADDITIONAL DOCUMENTS TO BE

ATTACHED WITH CURRICULUM VITAE:

Please tick Yes/No as

appropriate:

YES NO

Certified Copies of Qualifications Undergraduate and

Postgraduate

Posts Summary Forms for each post you wish to be

considered as against Training/Experience

Educational Activities Certificates of Attendance

Publications/Research – Copy of First page of

Publication

Audit - Copy of audit/Completed Audit Template

Report Form

Page 1 of 4

BASIC SPECIALIST TRAINING (BST)

POST SUMMARY FORM – GENERAL INTERNAL MEDICINE

In the absence of a Certificate of BST or equivalent please complete a form for each post/appointment you aresubmitting as evidence of basic specialist training in support of your application for entry to the Specialist

Division of the Register and ensure it is certified by the Medical Manpower/Administration within each institutionlisted.

One form to be completed for each post/appointment held at BST Level.

Definition of Training/Supervised Post: Post that is recognised for training in specialty and occupied by atrainee prospectively approved by relevant authority/training body and applicant is supervised for duration ofpost by recognised trainer.

Definition of Service Post: Post that is not recognised for training in specialty by relevant authority/trainingbody and applicant is not supervised for duration of post by recognised trainer. (note where forms are beingsubmitted for Service posts the applicant should indicate if post was held in a hospital/institution that isrecognised for training within specialty applied for.)

Applicant Name: ____________________________________________________________________

Details of Post

Hospital:Duration of post & Dates inpost:Specialty:Position/Post Title:Was this post a Training Postor Service Post (give detail):SupervisingConsultant/RecognisedTrainer:(If applicable)

Clinical Responsibilities

Approx number of rosteredhours per week.

Outline your frequency of:On Call commitmentAverage number of Admissionson call

Outpatient Responsibilitiesper week:Number of Outpatient ClinicsAverage number of New CasesAverage number of ReturnCases

Inpatient Responsibilities perweek:

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Average number of admissions:Average number of inpatientconsultations:Level of experience in:

ICUCCU

Participation in ProfessionalCompetence Activities

Are there consultant-led wardrounds?What is their frequency?

Do/Did you attend grandrounds?What is their frequency?

How many hours per week ofscheduledlectures/conferences take/took place in your workingweek?List your Researchopportunities/activitiesduring your time in this post:List your Auditopportunities/activitiesduring your time in this post:

The above post provides satisfactory training/experience in the following areas (tick Yes/No asappropriate):

Emergencies/Complicated Cases (average 40 acuteassessments and/or admissions) to include 6 of thefollowing category of patient over training

Yes No

CollapsePsychiatric crisesPoisoning and self harmChest painAcute abdominal emergenciesTraumatic brain injuryAcute ear, nose and throat problemsAcute rheumatological conditionsDVTPEAcute respiratory emergencies/Non invasive ventilationAcute GI BleedDiabetic emergenciesAcute stroke/TIAsProcedures/Practical Skills/Surgical Skills

Lumbar puncturePleural aspiration

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Performance & Interpretation of ECG’s (restingand exercise)Outpatient Clinics (1 per week)

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I certify that the above information is a true record of the training/experience gained in post

Signed by Applicant

SIGNATURE:

TITLE:

DATE:

Certified by Clinical Director/Supervisor

SIGNATURE:

TITLE:

DATE:

This form will not be acceptedwithout a Hospital Stamp

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HIGHER SPECIALIST TRAINING (HST)

POST SUMMARY FORM – GENERAL INTERNAL MEDICINE

Please complete a form for each post/appointment you are submitting as evidence in support of your applicationfor entry to the Specialist Division of the Register and ensure it is certified by the Medical

Manpower/Administration within each institution listed.

One form to be completed for each post/appointment held including your present appointment.

Definition of Training/Supervised Post: Post that is recognised for training in specialty and occupied by atrainee prospectively approved by relevant authority/training body and applicant is supervised for duration of postby recognised trainer.

Definition of Service Post: Post that is not recognised for training in specialty by relevant authority/training bodyand applicant is not supervised for duration of post by recognised trainer. (note where forms are being submittedfor Service posts the applicant should indicate if post was held in a hospital/institution that is recognised fortraining within specialty applied for.)

Applicant Name: ___________________________________________________________________

Details of Post

Hospital:Duration of Post & Dates inPost:Specialty:Position/Post Title:Was this post a Training Postor Service Post? (give detail):SupervisingConsultant/RecognisedTrainer:(If applicable)Was this hospital accreditedfor Higher Specialist Trainingin General Internal Medicine?

Clinical Responsibilities

Approximate Number ofrostered hours per week.

Outline your frequency of:On Call commitmentAverage number of Admissionson call

Outpatient Responsibilitiesper week:Number of Outpatient ClinicsAverage number of New CasesAverage number of ReturnCases

Inpatient Responsibilities perweek:Average number of admissions:Average number of inpatientconsultations:

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Level of experience in:ICUCCU

Professional CompetenceActivities

Are there consultant-led wardrounds?What is their frequency?

Do/Did you attend grandrounds?What is their frequency?How many hours per week ofscheduledlectures/conferences take/took place in your workingweek?List your Researchopportunities/activitiesduring your time in this post:List your Auditopportunities/activitiesduring your time in this post:List your Teachingopportunities/activitiesduring your time in this post:

The above post provides satisfactory training/experience in the following areas:(Please tick Yes/No as appropriate)

Procedures/Practical Skills/Surgical Skills Yes NoECG interpretationCentral venous line placement – underultrasoundDC cardioversionPleural aspiration – under ultrasoundAbdominal paracentesis – under ultrasoundIntercostal drain Insertion – under ultrasound(desirable)Lumbar punctureJoint aspirationBIPAP/CPAPEchocardiography (desirable)ICUCCUOutpatient Clinics in the following specialties:General Internal MedicineCardiologyGeriatricRheumatologyInfectious DiseasesGUMGastroenterology

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EndocrinologyNephrologyRespiratory

Relatively Unusual CasesChronic Cases/Long term care (minimum 2

cases over training)ICU/CCUManagement Experience

I certify that the above information is a true record of the training/experience gained in post

Signed by Applicant

SIGNATURE:

TITLE:

DATE:

Certified by Clinical Director/Supervisor

SIGNATURE:

TITLE:

DATE:

This form will not be acceptedwithout a Hospital Stamp

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Audit Report Form*Title

Background

Aim(s) of the audit

Standards

Methodology

Results

Conclusions

Recommendations& Action Plan

Re-audit

*Note: Audit report templates should be completed and supplied for two most recentlyperformed audits and should be no more than One page in length.

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How to Complete This Audit Report FormTitle This should be the same as the title on the proforma. It should also include the

auditor’s name and title, the date of the report, and the name of the individualhospital.

Background Clarify why the audit was done. For example, was the project prompted by anidentified local problem or concern? The background should explain the rationale fordoing the audit. Summarise the evidence base for the audit topic, giving fullreferences at the end. If a team was convened to undertake this audit, describe howthis was organised and who was involved.

Aim(s) of the audit Explain the aims of the project. Use BSMART guidelines (benefits, specific,measurable, aligned/agreed, realistic, time bound).

Standards Outline standards, guidelines or benchmarks, and their source and strength ofevidence. If not measured against existing standards then stated intention to setstandards at the end of the project should be included and if so, which aspects ofcare those standards pertain to.

Methodology State chosen population to be audited and how the sample was selected, specifyingwhether a retrospective or prospective approach was used. Identify the size of thesample, the time period, and how this was calculated or agreed upon. The method ofdata collection, a list of who was responsible for data collection, when this was done,and the method of data input and analysis should be included.

Results The number and percentage of cases meeting each criteria of the standard shouldbe included in the data analysis. Use graphs and charts to enhance and simplifypresentation. Both raw figures & percentages are required. Confidentiality guidelinesshould be strictly followed, omitting any identifiable information of staff and/orpatients.

Conclusions Present key points that flow from results - use bullet points and avoid longparagraphs. Conclusions need to be supported by the data, regardless whether thedata points to firm conclusions or not. The conclusion should be objective withfactual statements.

Recommendations& Action Plan

Recommendations for change should be made. Recommendations must be realisticand achievable. An action plan should be agreed stating what changes will beimplemented, who will be responsible for carrying them out and when this will bedone. If appropriate a date for a re-audit, if not already included in the report, shouldbe stated for the completion of the audit cycle.

Re-audit Present the re-audit finding in exactly the same format as the initial audit report. Anexplanation of the aims of the re-audit is included. Based on findings a new set ofrecommendations is set (i.e. develop new standards, perform additional audits etc).Re-audit is an essential and integrated part of the audit and without it the audit isincomplete.

*Note: Audit report templates should be completed and supplied for two most recentlyperformed audits and should be no more than One page in length.

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APPLICATION BUILDER PACK

The application builder pack is to assist applicants in preparing their

application in a structured manner. While the application is submitted in a

standardised format, it is up to each applicant to determine precisely what

they are required to submit by consulting the training programme and

associated guidance document for each specialty. This is what you will be

measured against.

APPLICATION BUILDER PACK I have Completed the below Personal Statement Regarding Training and Experience

Y/N

I have consulted the approved training programme in Ireland and relevant guidance document in assembling my application pack

Y/N

I have inserted in the separators provided, the documentation concerning my training

Y/N

I have inserted in the separators provided, the documentation concerning my experience

Y/N

I understand that for the definition of specialist training, Articles 25 and 28 of EU Directive 2005.36.EC will apply

Y/N

I have submitted my application in the format required using the application Builder Pack and acknowledge that if the application has not been submitted in the format required, following the instructions in the pack, the application will be returned immediately

Y/N

I acknowledge that submission of further material will not be possible until receipt of an initial assessment and an invitation to submit a written request for Review. Any additional material submitted will result in the application being returned.

Y/N

I have previously been assessed by the Medical Council for registration in this specialty

Y/N

Signed by the Applicant:_______________ _____ Date______________

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Personal Statement Concerning Training and Experience Please briefly summarise your specialist training with reference to the programme for your specialty

Please briefly summarise your specialist experience with reference to your specialty

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FOR OFFICE USE ONLY –

A COPY OF THE GUIDANCE DOCUMENT (CRITERIA) USED BY THE APPLICANT TO ASSEMBLE THIS APPLICATION TO BE ENCLOSED

HERE

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FOR OFFICE USE ONLY –

A COPY OF THE STRUCTURED REFERENCES SUBMITTED BY THE APPLICANT’S REFEREES ARE TO BE ENCLOSED HERE

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THE FOLLOWING SECTIONS SHOULD BE COMPLETED BY THE APPLICANT

WHEN COMPLETING THE FOLLOWING SECTIONS, YOU SHOULD USE THE CURRICULUM OF TRAINING (WHERE APPLICABLE) AND

THE SPECIALTY GUIDANCE DOCUMENT, WHICH LISTS THE EVIDENCE THAT YOU SHOULD SUBMIT TO THE BEST OF YOUR

ABILITY IN SUPPORT OF YOUR APPLICATION.

IF THERE IS ANYTHING RECOMMENDED IN THE GUIDANCE DOCUMENTATION THAT YOU WISH TO INCLUDE BUT CANNOT IDENTIFY A SUITABLE SEPARATOR FOR, PLEASE ENCLOSE IT AT

THE “MISCELLANEOUS” SEPARATOR AT THE END

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SEPARATOR ONE: CHECKLIST

Please insert here the checklist sent to you in the application pack (NB – not every specialty is accompanied by a checklist and if you did not receive a checklist you can skip this part).

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SEPARATOR TWO: STRUCTURED CV

Please insert here the structured CV, a template of which was sent to you in your application pack. The structured CV should be typed, not handwritten.

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SEPARATOR THREE: EVIDENCE OF FORMAL QUALIFICATIONS

Please insert here the following documents, which must be accompanied by English translations where applicable and notarised or attested by a notary public, solicitor, or commissioner of oaths:

1. Basic Medical Qualification 2. Higher Specialist Qualification 3. Membership Exam or Equivalent 4. Fellowship Exam or Equivalent

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SEPARATOR FOUR: PROGRAMME/TRAINING ENTRY REQUIREMENTS

With reference to the relevant specialty guidance document, please insert here evidence of your basic training (if applicable) prior to

embarking on a programme of specialist training. (NB - Not all medical practitioners complete basic postgraduate training prior to

embarking on specialist training programmes). All logbooks must have patient names removed. All documents must be translated into English. All documents must be loose-leaf in A4 format and single sided. All logbooks, audit documents etc, must be authenticated on each page by the hospital or institutions where you trained and/or practised

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SEPARATOR FIVE: PROGRAMME/TRAINING CONTENT With reference to the relevant specialty guidance document, please insert here evidence of having completed a programme of specialist training, or the equivalent, which clearly shows the knowledge and

skills attained during training

Article 25 of EU Directive 2005.36.EC applies for specialists and Article 28 applies for General Practice training.

All logbooks must have patient names removed. All documents must be translated into English. All documents must be loose-leaf in A4 format and single sided. All logbooks, audit documents etc, must be authenticated on each page by the hospital or institutions where you trained and/or practised

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SEPARATOR SIX: PROGRAMME/TRAINING ASSESSMENT METHODS

With reference to the relevant specialty guidance document, please

insert here evidence of your performance during the programme with reference to the types of assessment methods employed


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SEPARATOR SEVEN: PROGRAMME/TRAINING CORPORATE

GOVERNANCE STANDARDS

Please insert here brief evidence of the external corporate governance of the institutions where you trained (for example evidence of recognition by the Medical Council/Department of

Health of your jurisdiction)

NB – Examples of suitable evidence may include extracts from official websites.

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SEPARATOR EIGHT: EXPERIENCE CONTENT

With reference to the relevant specialty guidance document, please insert here evidence of the content of your experience in specialised

medicine


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SEPARATOR NINE: EXPERIENCE ASSESSMENT METHODS


insert here evidence of the assessment methods used by the institutions where you have worked to monitor your performance

and measure your experience


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SEPARATOR TEN: CPD, RESEARCH AND MANAGEMENT


insert here evidence of CPD activity, research activity and management training and experience

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SEPARATOR ELEVEN: POST HELD FORMS


insert here the completed Higher Specialist Training (and Basic Specialist Training if applicable) post held forms that were sent to you

in the application pack.

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SEPARATOR TWELVE: AUDIT REPORT FORM

Please insert here the completed audit report form (this is the template form that was included in the application pack sent to you)

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SEPARATOR THIRTEEN: MISCELLANEOUS

If there is anything listed in the guidance document that you feel is not covered by a separator above, please include it here.

APPLICATION INSTRUCTIONS

1. Read the criteria document and make sure to consult the training

programme upon which the criteria document is based.

2. Assemble the documents to support your application. At all times

make sure that the documentation is prepared correctly. It should

always be on A4 paper, single sided and ready for scanning and

authenticated where required. If any other type of format is submitted

the application will be returned to you.

3. Complete the structured CV. This should be typed.

4. For each hospital (or other medical) post you have occupied, ensure

that suitable (BST or HST or both) post held forms are completed and

stamped. Again, these should be typed.

5. Where applicable, similarly organise for the completion of the audit

report form.

6. Complete the checklist (where applicable) and enclose with your

application.

7. Place your application in the application dividers and complete the

personal statement at the front of the dividers.

8. Submit with the application form. First time applicants for registration

in Ireland will also be required to submit the documents listed at

Checklist One on the application form for new entrants to the Register.

9. Check that you have completed your application according to the

training body requirements and submit by post only, to Registration

Section, the Medical Council, Kingram House, Kingram Place, Dublin 2.

FREQUENTLY ASKED QUESTIONS

Q. When examining the criteria, I noticed that I do not meet the requirements set out

in some areas. Will I still be successful in being granted specialist registration?

A. If you do not meet the requirements set out, these will be identified during the

course of the assessment. The assessment report will detail these and a

recommendation will be made that these deficits in the requirements are addressed

prior. The Medical Council will then make a decision on the recommendation.

Q. There are a lot of forms to fill in and paperwork to complete. Is it necessary to

complete it all?

A. Yes. The purpose of the assessment is to allow a Postgraduate Training Body (PGTB)

determine whether your training (and experience where applicable) is comparable to

that of a graduate of the training programme set down in Ireland for the specialty

concerned. The forms are an important component of the assessment.

Q. What if I can’t provide all the evidence required?

A. The PGTB can only make an assessment based on the information before it. It cannot

make assumptions about training or experience, if there is a lack of detailed supporting

evidence.

Q. I can’t provide information concerning the content of training programmes. I can

only provide a certificate demonstrating completion of training. Is this information

enough?

A. This information will not be enough as the PGTB will need to see the content of the

training programme in order to compare it to the content of the training programme in

Ireland.

Q. I can’t provide the requested information concerning details of my performance in

the training programme. I can only provide a certificate demonstrating completion of

training. Is this information enough?

A. This information will not be enough as the PGTB will need to see evidence of your

performance in the training programme, as you progressed through the programme.

Q. I can only provide three referees. Is this enough?

A. You will need to list 5 referees in order for your application to be supported by a

suitably broad base of independent opinion on your performance.

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