Trainee FAQ

As the number of cases of COVID-19 grows daily it is clear that the NHS is going to be under pressure over the next few weeks and months. We know that Trainees will want to do everything they can to care for patients, but we also know that Trainees will have concerns and questions.

Whilst it’s too early to accurately predict the course of the next few months or the duration of significantly increased demands upon NHS services and staff, trainees are understandably anxious about the affect this may have on them.

As things develop and new advice and guidance is published, we will update these FAQs. If you have a question that we haven’t answered please send it through to policy@rcplondon.ac.uk and we will seek to answer questions where we can.

Given the rapidly evolving situation both with regards to the national situation with the viral outbreak, how patients are managed and how organisations are responding is constantly changing. Where another organisation has published guidance, we have linked to that guidance below. Whilst many situations below are outside of the direct control of the RCP we’ve tried to make it clear what we’re asking organisations to do and where appropriate have contacted these organisations to help answer our questions.

NHS England and Health Education England have created dedicated resources which are being constantly updated.

Looking after yourself/your family/your patients

I have symptoms of COVID-19 infection/flu/a cold what should I do?

Doctors should both look after themselves and protect their patients from risk. Medical inpatients generally fall into high risk groups if they acquire the infection. If you have any symptoms of COVID-19/flu/a cold follow the NHS Guidance or contact your local occupational health department.

I think I’ve been exposed to COVID-19/someone in my household has COVID-19 what should I do?

If you’ve potentially been exposed follow the NHS Guidance or contact your local occupational health department.

What is the risk of catching COVID-19 at work?

Public Health England and NHS England have published advice for clinicians on infection and prevention control.

What if I have to take time off work for caring responsibilities, for instance for childcare if schools are closed? 

If you need to take time off either for self-isolation or illness you should report this following normal procedures unless you are told otherwise by your employer. JRCPTB’s guidance on trainee progression in 2020 explains how this is unlikely to significantly affect progression.

I am worried about my mental health if there is a UK COVID-19 epidemic. What additional provisions might there be in place to support doctors during additional pressures?

The RCPs online wellbeing resource includes signposting to a range of helplines and support groups that are there to help and offer expert advice.

I am pregnant. How will this affect me?

Together the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Royal College of Paediatrics and Child Health, Public Health England and Health Protection Scotland have published guidance for healthcare professionals on COVID-19 infections in pregnancy.

I am a parent with a baby/child at home. Will I be able to work in a low risk area to minimise the risk of transmission to them?

PHE advise “current evidence on COVID-19 suggests that children do not experience severe illness. We are still learning about how children get infected and how likely they are to transmit it to older people or people with underlying health conditions.”

Local information and policies can be obtained from your local occupational health department.

Examinations/Progression/Recruitment

Will RCP examinations be cancelled?

The Federation of the Royal Colleges of Physicians of the UK has taken the extremely difficult but necessary decision to cancel all MRCP(UK) examinations in the UK and internationally.

I have an exam coming up that is required for training progression (such as PACES/SCE). If the exam is cancelled, or I cannot attend due to self-isolation, illness, or caring responsibilities, will my training progression be affected?

The Joint Royal College of Physicians Training Board as published detailed information about trainee progression and COVID-19.

Will my training time need to be extended if I have to self-isolate, or am ill with COVID19?

The Joint Royal College of Physicians Training Board as published detailed information about trainee progression and COVID-19.

What if I miss training opportunities that are required for progression of training?

Many training opportunities, including our own Medicine 2020, have been or may be postponed or cancelled.

In a recent letter to NHS trusts HEE stated ‘HEE is reviewing the situation daily and will provide further updates if required as the situation changes on aspects of training such as study leave and course and conference attendance, recruitment and selection processes, rotation dates, ARCPs and the impact of any illness or changes in training to progression through training’

The Joint Royal College of Physicians Training Board as published detailed information about trainee progression and COVID-19.

Once the pressures from COVID-19 have reduced we will engage with organisations asking them to consider how they are able to provide training opportunities which may have been affected by COVID-19.

I am applying to a training programme via JRCPTB this year. How will the application and interview process be affected by an epidemic?

HEE have published an update on the application and interview process. We will update this FAQ are more information becomes available.

I am applying for a non-training job abroad this year. Are there any implications for my application?

This may depend upon specific requirements of the job you are applying for and we’re unable to advise here.

Will ARCPs happen this summer if there is an epidemic?

The Joint Royal College of Physicians Training Board as published detailed information about trainee progression and COVID-19.

Working Practices

Will I be expected to work outside of my specialty?

I am not training in GIM. Will I be expected to work in GIM?

I am a non-GIM medical registrar. If I am asked to work within GIM will I be expected to work at registrar level?

Will I be asked to move to work at a different site?

The four UK education organisations have set out ‘guidance principles for all trainees’:

  • Trainees must not be asked to undertake any activity beyond their level of competence and must be advised they should seek senior workplace guidance if that arises.
  • Trainees deployed to a different clinical area must have appropriate induction and be informed of who they are reporting to, and who is providing supervision details with details of how to contact them
  • Arrangement for redeployed trainees should be reviewed weekly and updates provided to the relevant Postgraduate Dean on a weekly basis to ensure that trainees are adequately supervised in the host environment/specialty, and that they continue to work within the limits of their competence appropriate to their stage of training.

In addition to this guidance recent letter to trusts provides further detail on the movement and redistribution of trainees. HEE’s ‘Policy and Procedure for Management of Pandemic and Major Infectious Disease Outbreaks’ provides additional information.

If I work outside my specialty, how will I be supervised?

The four UK education bodies have provided guidance which states:

"Trainees deployed to a different clinical area must have appropriate induction and be informed of who they are reporting to, and who is providing supervision with details of how to contact them” (From Supporting the COVID-19 Response, no link yet)

Additionally HEE has issued additional guidance which states: “Supervision should be from a senior doctor in the covering specialty e.g. ST3 or above in general internal medicine, able to make decisions and discharge patients.”

I am a CMT/IMT trainee. Will I be expected to act up in a Med Reg role if there is an epidemic?

It is too early to know exactly what will happen at the moment but trainees should review JRPCTB’s existing guidance. Additionally, the four UK education bodies guidance states: “Trainees must not be asked to undertake any activity beyond their level of competence and must be advised they should seek senior workplace guidance if that arises”.

Will medical trainees deliver more direct patient care than they do currently?

Models of working may well change throughout the next few months. In joint guidance to the profession the four UK chief medical officers and the GMC have said ‘We need to stick to the basic principles of being a good doctor. All doctors are expected to follow GMC guidance and use their judgement in applying the principles to the situations they face, but these rightly take account of the realities of a very abnormal emergency situation. We want doctors, in partnership with patients, always to use their professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles set out in their professional standards. A rational approach to varying practice in an emergency is part of that professional response.

It is the responsibility of GP practices, hospitals, trusts and health boards to ensure that clinicians working in their organisations are supported to do this. They must bear in mind that clinicians may need to depart, possibly significantly, from established procedures in order to care for patients in the highly challenging but time-bound circumstances of the peak of an epidemic.'