1. A Credit Based Scoring System for trainee progression Mr. Mark J McCarthy TPD for Core Surgical Training- East Midlands (South)

2. Background Credit Based Scoring system began in August 2007 with the introduction of run- through trainees Concerns that trainees may become complacent Concerns over work based assessments Concerns over which trainees would enter which specialty at ST3

3. Principles involved Trainees gain credits for academic and clinical accomplishments over a 12 month period Prior to ARCP the credits are totalled and the trainees ranked against each other Trainees told of rank during ARCP interview The highest ranking trainees then select post/specialty of choice

4. What did it involve? All trainees were told in August 07 of the credit based scoring system during their induction and also given a written protocol All had to be registered with ISCP MCQ for ST1 and OSCE ST2 CV completion by May 2007

5. REQUIREMENTSCREDIT/SCORETOTAL Minimum Required to progress to ST2 Definitions MANDATORY Mini-CEX (at least 6) 212 2 points for a competent ST1 performance Mini-PAT (at least 6) 212 2 points for a competent ST1 performance Surgical- DOPS (at least 6) 212 2 points for a competent ST1 performance Internal MCQ (May 2008) 10060 DISCRETIONARY Attend ST1 Educational days2 per day ( -2 if no written excuse of absence) 30 Attend Basic Surgical Skills 15 Logbook review 20 20 points for achieving to ST1 level as set out by ISCP curriculum OPTIONAL Completed an audit 5

6. Take part in research (Publication in peer reviewed journal) 20 10 points for a case report 15 points for a review 20 points for a meta-analysis 20 points for a other publications Presentation of work (local) 10 Presentation of work (national) 15 DESIRABLE Passed MRCS MCQ 50 Extra activities e.g. ASIT council, Prizes etc 5 for each Award of MD/PhD 50 NEGATIVE ATTRIBUTES Attitude -10 Complaints -10 EDUCATIONAL /CLINICAL SUPERVISORS REPORT Satisfactory = 100 Borderline = 50 Should not proceed= 0 283- minimum score

7. ST1 Trainees 1-10 Courses45 30 45 30 Papers4015201525300000 Presentations304580559015 01015 Logbook20 Assessments1066250563662 5862 Supervisors report100 Teaching30 Audit605002030 02010 Additional activities350050001050 Local exam40 5044363949312630 MRCS exam100 50 Total606507495475447406371368354347 Rank12345678910

8. ST2 Trainees 1-9 Courses45 3045 Papers32540552025301000 Presentations370506085600000 Logbook20 Assessments628450805468865472 Supervisors report100 Teaching30 Audit205020103040305020 Additional activities0010 000 Local exam825981667175555665 MRCS exam100 Total1154578571566545503476465452 Rank123456789

10. Outcome after 1 st year-Trainers view Useful to praise those that are doing well at ARCP interview and useful evidence to encourage others and give goal directed feedback Help make decisions with regards to trainee placements and specialty of choice

11. Outcome after 1 st year-Trainers view Higher attendances for educational days Promotion by merit and clinical aptitude Results correlated well with interview scores with an r value of 0.83

12. Outcome after 1 st year-Trainees view Gave them clear objectives and goals Felt it made them more competitive and enhanced their Curriculum Vitae Those at the bottom of the ranking wish they had taken it more seriously but are doing so now Exams were good preparation for the MRCS

13. August 2008 and beyond Now all CT1 and CT2 trainees are part of this system Has been adapted for T+O and General Surgery for ST3 and above