Did I Really Fail My First ARCP? Understanding UK Annual Training Performance Review


I had my first ARCP (Annual Review of Competency Progression) for my ST3 vascular training post in June 2024. This review came 10 months into my training and two months before my next placement. Naturally, I was anxious and eager to receive an outcome 1, which signifies satisfactory progress. Unfortunately, I wasn’t so lucky; instead, I received an outcome 5, meaning incomplete evidence was presented, which could imply that additional training time may be required.

This outcome was particularly stressful and frustrating, given my dedication throughout the year. I had invested time in teaching, participated in over five research and audit projects, was the first author of a publication, and even won an award at an international conference (ASGBI). Despite what I thought were exemplary efforts, I didn’t achieve an outcome 1. However, this experience taught me much about the ARCP process and how to secure a satisfactory outcome, especially for your first time.

Understanding the ARCP Process

ARCP is an annual review for doctors in training in the UK, assessing their progress and competency development. These reviews are conducted annually for all doctors in UK training programs, from foundation to Higher Specialty Training. The aim is to ensure that trainees are making satisfactory progress in acquiring the skills and competencies required for their training level. The General Medical Council (GMC) mandates annual appraisals for all doctors to demonstrate learning and growth as well as guide their personal development plans. For doctors in training, the ARCP serves as this yearly appraisal.

According to Health Education England (HEE), ARCP outcomes include:

  1. Outcome 1: Satisfactory progress – achieving progress and the development of competencies at the expected rate.
  2. Outcome 2: Development of specific competencies required – additional training time not required.
  3. Outcome 3: Inadequate progress – additional training time required.
  4. Outcome 4: Released from the training program – with or without specified competencies.
  5. Outcome 5: Incomplete evidence presented – additional training time may be required.
  6. Outcome 6: Gained all required competencies – recommended as having completed the training program.
  7. Outcome 7: For Doctor on Locum Appointment for Training (LAT).
  8. Outcome 8: Out of program for clinical experience, research, or a career break (OOPE/OOPR/OOPC).

My ARCP Experience

My ARCP was conducted virtually by a panel of six members, including my Training Program Director and five other consultants I hadn’t met before. I received an email a month prior informing me of the planned assessment. Our TPD also sent a reminder with advice on preparing for a good outcome. I followed their advice, did all the required preparations, and additionally met with my educational supervisor to review my portfolio. I received my outcome on my online portfolio a day after the ARCP meeting was held. I had a disappointing outcome 5 with the following main reasons given:

  1. I didn’t have a multi-consultant review (MCR) done for my current placement.
  2. My portfolio didn’t have an Assessment of Audit (AOA).

I was given a month to address these issues and scheduled for a subsequent ARCP, which I passed.

Lessons Learned and Tips for a Successful ARCP

Here’s what I learned from this process and how to prepare for ARCPs to ensure a satisfactory outcome:

  1. Get the Most Relevant Checklist: Ensure you have the most up-to-date checklist for your training program level. Even if the checklist is outdated, it provides a good baseline to set your target goals. I used the 2017 Vascular ST4 checklist.
  2. Early Notice for MCRs: Inform and remind your supervisor early about multi-consultant reviews. These reviews are logistically challenging and may sometimes only happen monthly, depending on how your department works. Missing the window could delay your MCR and, therefore, lead to a poor ARCP outcome.
  3. Correct Assessment Documentation: Ensure you complete the correct assessments for your activities. I had done audits but hadn’t documented an AOA, which the reviewers needed. It’s crucial to submit evidence in the format the ARCP panel requires. This may, at times, feel like a tick-box exercise; just play the game according to the rules given.
  4. Maximise Work-Based Assessments: You can use the same case/evidence for multiple assessments in the Intercollegiate Surgical Curriculum Programme (ISCP) portfolio. For example, a single case can be used for CBD, PBA, and DOPS. An audit can cover AOA, research, teaching, and management experience.

In the end, despite initially receiving an outcome 5, I achieved a satisfactory outcome. This experience was a valuable learning opportunity, helping me understand the ARCP process and how to prepare better for future assessments to secure outcome 1 on the first attempt.

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