Combined Training

The Combined Training pathways provide the opportunity for you to combine previous relevant experience with your GP training programme.

Your previous experience may be from another UK specialty training programme, a substantive paid or SAS role, or relevant overseas experience above Foundation level or equivalent. The amount of time contributing can vary from 3 to 12 months depending on the breadth of your experience, the quality of evidence you can provide and your progress in the first six months of the GP training programme.

There are two combined training pathways:

  • Accreditation of Transferable Capabilities (ATC) for applicants who are transferring to general practice training from another GMC approved specialty training programme
  • Certificate of Completion of Training: Combined Programme (CCT CP) for applicants who have relevant experience from outside a GMC approved specialty training programme. This might include substantive clinical roles or overseas training and experience.

From 1 January 2021, all GP trainees who are training on the CEGPR (CP) pathway will be eligible to apply for CCT after successfully completing the training programme.

Who can apply for Combined Training?

If you have relevant clinical experience above Foundation level, you may be eligible for a combined training pathway. Eligibility for a combined training programme will depend on the type of experience you are bringing with you. If you are applying with more than one type of experience, please consider the eligibility and evidential requirements for each type of experience included in your application.

Experience within a GMC approved specialty training programme (ATC)

If you are transferring to GP training from another GMC approved specialty training programme in the UK, you may be able to apply for combined training if you meet the following criteria:

  • Have completed a minimum of 12 months (full time equivalent) in any other relevant GMC approved specialty training programme
  • Have been in a GMC approved specialty programme training post within the five years preceding your planned start date for GP specialty training
  • Can provide ARCP outcome forms covering at least 12 months (full time equivalent) of your previous training programme.

Experience from outside an approved specialty training programme (CCT CP)

If you have been working in the UK in posts that were not part of a GMC approved specialty training programme or have relevant training or experience from overseas, you may be able to apply for combined training if you meet the following criteria:

  • Have at least 12 months (full time equivalent) of relevant experience above Foundation level (or equivalent) within the five years preceding your planned start date for GP specialty training
  • Can provide evidence to support this experience.

Please see Supporting evidence for more information.

How to apply

To apply for combined training, you must first apply to join a three year GP training programme through the GP National Recruitment Office (GPNRO) and indicate as part of your application that you would like to be considered for the ATC or CCT (CP) pathway.

If you did not indicate a combined training pathway on your application to GP training, it will not be possible to apply once you have commenced the training programme.

Steps to applying for combined training

  1. Apply to GP training and select the “ATCF” or “CCT (CP)” option on the application
  2. Register with the RCGP at least one month before your training programme commences. This will give you access to the Trainee Portfolio
  3. Your HEE office or deanery will invite you to upload a CV to the Trainee Portfolio for review. You should discuss your previous experience with them at the earliest opportunity so they can confirm if you are eligible to apply, plan your GP training programme and confirm what evidence you will need to provide to support your application
  4. If you are eligible to apply for combined training, you will be invited to complete the online application in the Trainee Portfolio.

More information can be found in the Applicant guide to applying for combined training and the Detailed process guidance.

Supporting evidence

As part of an application for combined training, you will be asked to upload evidence to support your experience and reflect on how it has helped towards achieving the curriculum and capabilities required for general practice

You should begin to collect your evidence before your training begins and upload it to your Trainee Portfolio within the first month of your GP training programme.

Guidance for supporting evidence

UK specialty training experience

This guidance outlines the evidence requirements to support any UK specialty training included in an application for combined training.

If you would like experience or training from outside a UK specialty training programme to be considered as part of an application, please see the guidance for UK experience and overseas experience.

Curriculum Vitae (CV)

You should provide an up to date CV that includes details of all training, posts and experience within the last five years.

Annual Reviews of Competence Progression (ARCPs)

You must provide the most recent ARCP outcome forms from your previous specialty training programme which document at least 12 months full-time equivalent (FTE) of training.

Acceptable format for ARCP evidence

  • A PDF version of the original ARCP/s (downloaded directly from a training portfolio)
  • A scanned image of a paper ARCP
  • Screenshots from an online training portfolio can only be accepted if it is clear from the image/s that you are signed into your own portfolio and the whole form is captured.

We are unable to accept photos of ARCPs, or ARCPs copied into a word processing programme, e.g. Word.

If your ARCP covers less than 12 months of clinical training time or you have been working less than full time or as an academic trainee, you should provide additional ARCP/s to ensure the evidence covers a minimum 12 months FTE in approved clinical training posts.

There must be no more than five years between the end of the last post assessed by the ARCP panel and the start date of your GP training programme.

If your ARCP/s from your previous training programme carry a non-standard outcome (2, 3 or 4), it is essential that you provide an explanatory statement in the field provided.

If your exiting ARCP carried a non-standard outcome, you must also upload a supporting letter from the Postgraduate Dean outlining any corrective strategy in place.

Qualifications, Exams and Previous Posts

Details of the posts you would like considered towards your application for combined training must be added to the posts section of the application form.

 

  • You should include at least 12 months of GMC approved specialty training experience (full time equivalent)
  • Please note any gaps or breaks in training e.g. career breaks or statutory leave
  • Posts completed within five years of your planned start date of GP training are considered most relevant
  • You must be able to provide evidence to support each post listed
  • Foundation level posts or their equivalent should not be included.

You should also provide details of any qualifications and exams completed within your previous training that you consider relevant to the general practice programme.

UK non-training experience

This guidance outlines the evidence requirements to support non-training UK experience included in an application for combined training.

If you would like experience or training from overseas to be considered as part of an application, please see our guidance for including evidence of overseas experience.

Curriculum Vitae (CV)

You should provide an up to date CV which includes details of all training, posts and experience within the last five years.

Statements of employment

A letter from your employer should be provided for each post included in your application. The letter should confirm the grade of the post and precise dates of employment.

Job or post descriptions

A job description should be provided for each post you would like considered towards your application.

If a job description is not available, you may write an account of your duties which should be signed by your clinical supervisor.

Appraisal documentation

You should include any recent appraisal documentation and evidence collected to support your appraisal that may be relevant to your application.

End of post or end of term reports

This may include references written by your supervisor. If your application includes training in another UK specialty training programme, you should include your ARCP (Annual Review of Competence Progression) outcome forms.

If you have other evidence of review of your performance and progress in post, this may also be useful to include.

Qualifications, Exams and Previous Posts

Details of the posts you would like considered towards your application for combined training should be added to the posts section of the application form.

  • You should include at least 12 months of experience (full time equivalent). This may include relevant overseas experience or UK training experience if you have any
  • Please note any gaps or breaks in employment e.g. career breaks or statutory leave
  • Posts completed in the five years before your planned start date of GP training are considered most relevant
  • You must be able to provide evidence to support each post listed
  • Foundation level posts or their equivalent should not be included in an application for combined training.

Overseas and Non-UK experience

This guidance outlines the evidence requirements to support any overseas experience included in an application for combined training. All evidence must be presented in English.

If you are applying for experience or training from within the UK to be evaluated as part of an application, please see our evidence guidance for UK experience.

Curriculum Vitae (CV)

You should provide an up to date CV which includes details of all training, posts and experience within the last five years.

Summary of the posts and evidence you are submitting

Please provide a list of the posts you are putting forward and state clearly the documents you have submitted for each one.

Job or post descriptions

A job description should be provided for each post you would like considered towards your application for combined training.

If a job description is not available, you may write an account of your duties which should be signed by your clinical supervisor.

If your post was part of a formal training programme, you should provide a letter from your programme director or training provider describing:

  • the programme structure
  • the programme content
  • any assessments you completed as part of the programme.

If your post was in general practice, you should provide information about your role and the healthcare context in a statement describing:

  • the setting
  • your role and responsibilities
  • how your work was supervised
  • the primary care team
  • your work with other teams and services
  • your daily case load
  • your case mix or patient population

To help with this, you may wish to include your reflections on cases you managed while working in general practice outside the UK. Visit our website to read exemplars of reflective case studies.

A statement signed by your clinical supervisor for each post to be considered

The statement must include:

  • your full name
  • your grade
  • the specialty
  • the precise dates of your employment, whole or part time
  • details of your performance and progress in the role
  • your clinical supervisor's signature

Evaluations or reviews of performance

These might include reports and evaluations completed by your supervisor or visiting assessor and workplace based assessments.

Testimonials and reference letters

These should include details of your role and level of responsibility in the post(s) you are presenting. A maximum of three letters is recommended.

Qualifications, Exams and Previous Posts

You should include the details of at least 12 months of experience (full time equivalent). This may include relevant UK based experience if you have any.

  • Posts completed in the five years before your planned start date of GP training are considered most relevant
  • Please note any gaps or breaks in employment e.g. career breaks or statutory leave
  • You must be able to provide evidence to support each post listed
  • Foundation level posts or their equivalent should not be included in an application for combined training.
You should also provide details and evidence of any qualifications and exams completed that you consider to be relevant to the general practice programme.

Capability mapping

To complete the capability mapping section of the combined training application, you should conduct a self-assessment of your experience against each of the 13 capabilities in the GP training curriculum.

You should include reflections on how your experience has helped you develop some of the 13 capabilities for general practice. You should try to reflect personally on the experience and avoid statements that are simply descriptive in nature.

Using the capability descriptors and curriculum as a guide, you should consider and evaluate how the evidence you are providing demonstrates your skills and performance linked to each capability.

Your reflection on each capability should include:

  • How your previous experience has helped you develop skills within the capability and how your chosen evidence demonstrates this
  • Reflection on how this experience is transferable to general practice
  • Identification of any gaps in your skills or knowledge and how you will address them during your general practice training.

Your evidence and reflections will be reviewed against what would usually be expected of an ST1 or ST2 general practice trainee who is progressing satisfactorily. At ST1 or ST2, a GP trainee should be meeting the capability descriptors listed under "Needs Further Development (NFD)" or above.

Supporting evidence

  • All evidence should be provided in PDF format and uploaded to the Trainee Portfolio.
  • Evidence of assessments should be downloaded directly from your previous training portfolio and referenced against the appropriate capability.
  • Quality of evidence is more important than quantity. We recommend that no more than three pieces of evidence are provided for each capability.
  • Avoid attaching a large training portfolio as evidence against a capability. If you are unable to extract specific pieces of evidence to upload, you must reference specific assessments or pages within the portfolio that demonstrate your performance within the capability.
  • Try to avoid writing long or detailed descriptions of cases as part of your reflection, especially if they are also attached as evidence to the capability. Instead, you should summarise the learning points in the case and how it may be relevant to general practice.
  • Some pieces of evidence may be relevant to more than one capability so you can link evidence to more than one section if appropriate. However, we strongly encourage a range of evidence to support an application. This might include assessments, multi-source feedback (MSF), CSRs or other evidence from your previous roles.
  • Some capabilities may be more difficult to develop in non-primary care placements so you may not be able to provide evidence for all 13 capabilities. Where you cannot provide evidence to support a capability, reflection is still required to support the development of a learning plan once you begin your training.
  • You should only include evidence from and reflect on the posts being reviewed as part of your combined training application. Please do not include evidence from other roles or posts, or from your GP training programme.

Next steps

Your HEE or deanery assessment team will review your evidence and consult the RCGP to determine how much of your previous experience may be able to contribute towards the GP training programme.

The final decision on the remaining length of your programme will be made six months (full time equivalent) into your ST1 phase by an ARCP panel. At this panel, your progress in GP training will be reviewed alongside the evidence you have provided to support your combined training application to confirm your training pathway.  

Any time agreed to contribute to the training programme will be counted towards the remainder of your ST1 phase and, if more than six months is approved, the beginning of your ST2 phase of training.

Once your training pathway and programme length is approved by your ARCP Panel, it will not be possible to revert to the standard three year programme.

If your application for combined training is not successful, you can remain in training and complete a standard three year CCT programme.

To qualify for a CCT at the end of a combined training programme, you must complete all curriculum and examination requirements of the CCT programme within training. This includes the Applied Knowledge Test (AKT), Recorded Consultation Assessment (RCA) and Workplace Based Assessment (WPBA).

Further Information

For more information about the combined training pathways, please contact us.

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