Acting Up Consultant (AUC) Guidance
The Royal College of Psychiatrists, in line with the Gold Guide for Training (2016)and GMC guidance on out of programme, recognises that acting up experience in a properly supervised training environment can provide advanced trainees an opportunity to consolidate the skills in the final year of training.
Although present in all of the specialty curricula, acting up is not to be considered as an essential or mandatory part of training but should be seen as a potentially useful tool to support the consolidation of targeted competencies. This is particularly true when it takes place "within programme" where there are the necessary checks and balances as well as important access to the educational supervisor/TPD to provide guidance and support to remedy any issues that may arise.
AUC posts must not be used to remedy any gap identified in a trainee's competence as these should already have been covered by a properly constituted training programme. They can only be offered to individuals who have had successful ARCP outcomes.
It is important to emphasise that trainees acting up as consultants must have appropriate support and clinical supervision within the employing trust to a level approved by the TPD as well as ongoing access to weekly educational supervision.
It is not possible to undertake a period of acting up in the post-CCT period of grace. Trainees in their period of grace wishing to undertake a time-limited period of working into a vacant consultant post will need to resign from the rotation and be appointed by the employing trust as de-facto locum consultant.
A maximum of three months (for LTFT trainees the timescale is also three months as per Gold guide 2016) spent in an AUC post may count towards a trainees CCT or CESR(CP) as part of the GMC approved specialty programme provided it meets the following criteria
- The trainee follows local procedures by making contact with the Postgraduate Dean and their team who will advise trainees about obtaining prospective approval.
- The trainee is in their final year of training (or possibly penultimate year if in dual training)
- The post is undertaken in the appropriate CCT specialty
- The approval of the Training Programme Director (TPD), Head of School and Postgraduate Dean is given
- There is agreement from the employing trust to provide support and clinical supervision to a level approved by the trainee's TPD.
- The trainee still receives one hour per week education supervision either face to face or over the phone by a trainer who is recognised by the GMC system.
- Doctors in training will retain their National Training Number during the period of acting up
- All clinical sessions are devoted to the AUC post (i.e., there must be no split between training and AUC work). Full-time trainees cannot 'Act up' in a part-time consultant post and LTFT trainees cannot spend their non-Acting up time in clinical work.
- The post has been approved by the Regional Advisor in its current form. A new post must have this approval.
- If the trainee is on call there must be consultant supervision.
- A trainee who is acting up should be referred to a 'Dr XXX, ST6, Acting Consultant'
- If the period is at the end of the final year of the training programme, a recommendation for the award of a CCT will not be made until the report from the educational supervisor has been received and there is a satisfactory ARCP outcome.
Trainees wishing to undertake AUC posts within a different training programme.
The GMC states if an AUC post is in a different training programme, the usual Out of Programme (OOP) approval process applies and the GMC will need to see an application form and a college letter endorsing the AUC post. Approval cannot be retrospective and it is recommended that applications are submitted to the College at least 3 months prior to the AUC post start date.
The College has concerns that the out of programme AUC, especially in the last three months essentially cuts the trainee off from the educational process. The College will only consider supporting AUC posts outside of programme where an important educational need by the TPD has been identified and the TPD has identified in writing to the College that the AUC post provides an important part of a trainee's progress. The hosting TPD should also confirm in writing that they will act as a guarantor of quality.
For further information see Gold Guide for Training and GMC OOP guidance.
*A programme is a formal alignment or rotation of posts which together comprise a programme of training in a given specialty or subspecialty as approved by the GMC, which are based on a particular geographical area.