The syllabus for the Rehabilitation Medicine curriculum is being developed by a working party under the aegis of the Specialist Advisory Committee, which is responsible for the training programmes. A first draft has been completed, and we are putting it out for review by anyone interested. This post gives a little background information, explains the process, links to the 2021 curriculum, which can be downloaded, and gives information on making your comments.
The Rehabilitation Medicine curriculum was last revised in 2010. In October 2016 work started on a new curriculum, which took a radically different form. This change was initiated by the General Medical Council (GMC). The GMC wanted all sub-specialist trying removed from all curricula, and want a limited number of high-level outcomes to determine completion of training which was to be based on capability, not time and experience alone.
Two specific major changes have occurred from the 2010 Rehabilitation medicine curriculum. There is no longer any sub specialisation in the training programme, whereas in the 2010 up to two years of sub-speciality training could occur. The scope of the curriculum has broadened to include everything, For example both paediatric and geriatric rehabilitation are now included; the range of disorders covered has extend to cover almost all illness (psychiatric rehabilitation is only partly covered); and the range of setting extends from hyper acute inpatient units through all hospital settings, care homes into people’s own homes.
The new-style GMC curricula contain no specific syllabus of expected competencies or standards at the level of competency. The standards defined relate to the high-level outcomes.
This lack of more detailed guidance caused some disquiet among both trainees and trainers. A Curriculum Training Advisory Group comprising 15 interested and concerned people – trainers and trainees – was convened and first met on November 18th 2020 (met metaphorically, using Zoom). The first completed draft was agreed on March 17th 2021.
The syllabus is intended to be guidance. Nothing in it is mandatory. The standards suggested will be used inform decisions on successful completion of training but they do not determinate decisions. Only the curriculum can specify what is mandatory, and what standards can be used to assess a trainee’s completion of training. Nonetheless, someone who does not acquire most of the competencies suggested is less likely to be considered safe to practice as a consultant. On the other hand, Acquisition of all competencies at the required standard will by no means guarantee that a trainee is safe to be a consultant.
The document has an introductory 12 pages, setting the syllabus in context, explaining what the syllabus does and does not do, and explaining its structure and how knowledge and skills are graded. There is then a table showing an overview of the 39 competencies. Then there is a long section with each competency defined.
To ease reading, each competency starts on a new page. Many are restricted to one page but some extend to two pages. Each competency is set out in the same format. Some have a few additional documents listed at the end.
We are putting the draft syllabus in the public domain, and anyone may download it, read it, and give feedback. Instructions on feedback are given with the downloaded document. Readers may give any feedback they wish, though we hope that it will be constructive and help improve the syllabus. Some of the questions a reader can consider are:
- scope and extent. Is the syllabus too broad, or not broad enough? Have we covered most of the important areas of clinical practice? The syllabus cannot cover every possible area, and trainees will be exposed to areas of practice that fall outside the listed competencies. The hope is that at least 80% of the work faced in the year after completing training will have been covered by the syllabus.
- detail. Is sufficient detail about what is expected given for each competency? The syllabus is not a text book. It is supposed to guide the trainee, and offer the trainee and trainer a framework for discussion about learning, and experience. However the descriptors should cover most of the important areas of knowledge or skill.
- standard. A trainee’s standard is judged by the trainer, and quantified as shown in a table on page XX. It is used in relation to their observed or recorded performance, using the behaviours indicated for the competency. Does this seem practical and reasonable? It is based on methods used in other syllabi. Any suggestions for improvement need to be applicable across all competencies.
- additional information. A debate we have had concerns the value of adding a few references or documents at the end of each competency, to help the trainee in acquiring knowledge. We also debated the risks, such as the trainee thinking that is all that is needed, or having complaints that other documents were not mentioned. Do you have any views?
- The text. Is the material given in the part before the competencies useful? Are there issues that should be covered that are not mentioned? Is it clear? There needs to be some introductory matter, but any suggestions on improvement will be welcome.
If you want to read the syllabus, then click here to download it. There is a front page giving the contents, with brief instructions on feedback. Further information, including the questions above, is at the end. For people who like forms, there is a form to complete but it is not compulsory.
We do ask that anyone giving feedback gives their name, their email address, and an indication of their status or role in relation to the syllabus such as trainee, consultant in rehabilitation medicine, doctor or medical student but not in rehabilitation practice, other healthcare professional, patient, interested person etc. The data will be used only to acknowledge your contribution and, if requested, to inform you when the next draft is written. You could also be informed when the final syllabus is published.
Thank you for reading this, and thank you for any feedback you may give.