Educational Governance

Introduction 

This page sets out the educational governance structure for Severn postgraduate medical education to ensure that we meet our responsibilities to deliver postgraduate education to the standard required by the General Medical Council.

This page summarises:

  • Roles and responsibilities of those working in Postgraduate Medical Education
  • Key committee and meeting structures to support the delivery of these roles
  • Appointment, accountability and reporting framework

Roles and Responsibilities of those Working in Postgraduate Medical Education 

It is essential that there is a clear understanding of respective roles, responsibilities and accountabilities of all those working in postgraduate medical education. These are described in the Educational Roles and Responsibilities for Clinical Supervisors, Educational Supervisors, Training Programme Directors, Director of Medical Education, Heads of Postgraduate Schools and others involved in postgraduate medical education.

Governance Structure 

The overarching governance structure within Severn PGME consists of the following formal and business meetings.

Formal Advisory Meetings 

  • Foundation School Board
  • School Boards
  • Speciality Training Committees
  • Trainees Forums

Business Meetings 

  • Governing Body meeting
  • Severn PGME Executive Team Meeting
  • Severn PGME Staff Meeting
  • Director of Medical Education / Heads of School Meetings
  • Training Programme Directors Meeting

Accountability and Reporting Framework 

A summary of the accountability and reporting framework for key individuals involved in Post Graduate Medical Education is shown below.

Trainee 

The role of the trainee is defined in the Gold Guide.

In particular it should be noted that trainees must maintain a learning portfolio that must be shared with their Educational Supervisors.

Clinical Supervisor 

The role of the Clinical Supervisor was defined by the General Medical Council

A named clinical supervisor is a trainer who is responsible for overseeing a specified trainee’s clinical work throughout a placement in a clinical or medical environment and is appropriately trained to do so. He or she will provide constructive feedback during that placement. He or she will lead on providing a review of the trainee’s clinical or medical practice throughout the placement that will contribute to the educational supervisor’s report on whether the trainee should progress to the next stage of their training.

- GMC Recognising and Approving supervisors: The Implementation Plan

Educational Supervisor 

The role of the Educational Supervisor was defined by the General Medical Council.

A named educational supervisor is a trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a trainee’s trajectory of learning and educational progress during a placement or series of placements. Every trainee must have a named educational supervisor. The educational supervisor helps the trainee to plan their training and achieve agreed learning outcomes. He or she is responsible for the educational agreement and for bringing together all relevant evidence to form a summative judgement at the end of the placement or series of placements.

- GMC Recognising and Approving supervisors: The Implementation Plan

It is set out in the Gold Guide and is summarised below:

Educational supervisors are responsible for overseeing training to ensure that trainees are making the necessary clinical and educational progress.

Educational supervisors should:

  • be adequately prepared for the role and have an understanding of educational theory and practical educational techniques e.g. have undertaken formal facilitated training or an on-line training programme or participate in relevant Training the Trainers programmes
  • be trained to offer educational supervision and undertake appraisal and feedback
  • undertake training in competence assessment for specialty training
  • be trained in equality and diversity
  • provide regular appraisal opportunities which should take place at the beginning, middle and end of a placement
  • develop a learning agreement and educational objectives with the trainee which is mutually agreed and is the point of reference for future appraisal
  • be responsible for ensuring that trainees whom they supervise maintain and develop their specialty learning portfolio and participate in the specialty assessment process
  • provide regular feedback to the trainee on their progress
  • ensure that the structured report which is a detailed review and synopsis of the trainee’s learning portfolio is returned within the necessary timescales
  • contact the employer (usually the Medical Director), the Training Programme Director and the Postgraduate Dean should the level of performance of a trainee gives rise for concern
  • be able to advise the trainee about access to career management
  • be responsible for their educational role to the Training Programme Director and locally to the employer’s lead for postgraduate medical education, usually the Director of Medical Education
  • have responsibilities through their supervision of trainees to support the delivery of the educational contract which exists between employers which provide postgraduate training and Postgraduate Deaneries.
  • are responsible both for the educational appraisal of trainees, and also for review of their performance based on Good Medical Practice.

These important educational and review roles make it essential that there are unambiguous lines of accountability for educational supervisors into both educational programme arrangements through the Training Programme Director and also into the management structure of the trainee’s employer (e.g. through clinical directors or the designated lead for medical education such as the Director of Medical Education or Specialty Tutor) so that there is clarity about:

  • who is providing educational supervision
  • the clear link between the appraisal, assessment and planning of a trainee’s educational programme and their performance as a doctor
  • the transparency of the process ensuring that the trainee is aware of the information being shared with the employer
  • the arrangements for raising matters of clinical concern and professional performance about a trainee within the employing authority and with postgraduate medical education in line with wider regulatory requirements

Employers of educational supervisors must have this role recognised within job planning arrangements.

Within Severn PGME, the Postgraduate Medical Dean will expect Directors of Medical Education to ensure that suitable arrangements are in place within the Trust to ensure clarity as above. This will include Foundation Doctors, Fixed Term Specialty Training Appointments, Specialist Registrars and General Practice Vocational Training Scheme doctors who are within the Trusts. The Director of GP Education will undertake this role for General Practice Educators, and the Head of the School of Public Health will ensure that Directors of Public Health undertake this function for educational supervisors in diverse locations such as the government office and Primary Care Trusts.

Training Programme Director 

The role of the Training Programme Directors is set out in the Gold Guide and is summarised below.

Training Programme Directors have responsibility for managing specialty training programmes including Fixed Term Specialty Training Appointments (FTSTAs).

They should:

  • participate in the local arrangements developed by the Postgraduate Dean to support the management of the specialty training programme(s) within or across Severn PGME boundaries
  • Work with delegated College/Faculty representatives (e.g. college tutors, regional advisors) and national College/Faculty training or Specialty Advisory Committees (SACs) to ensure that programmes deliver the specialty curriculum and enable trainees to gain the relevant competences, knowledge, skills, attitudes and experience.
  • In General Practice a GP Director or Associate Patch Dean would take on these roles.
  • take into account the collective needs of the trainees in the programme when planning individual programmes
  • provide support for clinical and educational supervisors within the programme
  • contribute to the annual assessment outcome process in the specialty
  • help the Postgraduate Dean manage trainees who are running into difficulties by supporting educational supervisors in their assessments and in identifying remedial placements where required
  • ensure, with the help of postgraduate medical education administrative support, that employers are normally notified at least three months in advance of the name and relevant details of the trainees who will be placed with them. From time to time, however, it might be necessary for Training Programme Directors to recommend that trainees be moved at shorter notice.
  • be responsible for organising and chairing the Speciality Training Committee. (This can be delegated if so wished to another member of the Specialty Advisory Committees, example, regional adviser, senior experienced member).

Training Programme Directors also have a career management role.

They will need to:

  • ensure that there is a policy for careers management which covers the needs of all trainees in their specialty programmes and posts
  • have career management skills (or be able to provide access to them)
  • play a part in marketing the specialty, where there is a need to do so, to attract appropriate candidates e.g. coordinating taster sessions during Foundation training, career fair representation, maintaining the Programme web site, and liaison with Specialty Tutors and with Royal Colleges/Faculties.

Training Programme Directors are appointed by Severn PGME on behalf of Health Education England. They will be accountable for their work to the Postgraduate Dean. Where Training Programme Directors are part of a School lead by an Associate Dean such as Medicine, Surgery and Psychiatry, responsibility for appraisal will be delegated to the Head of School.

A budget is allocated to Training Programme Directors to support their work on a capitation fee per trainee; this is allocated to the employing Trust. The Training Programme Director will be expected to monitor and provide reports to Health Education South West on the use of this budget.

Director of Medical Education 

The role and responsibilities of the Director of Medical education are set out in the Learning Development Agreement (LDA) between the Health Education South West and the Trust.

The Director of Medical Education is responsible for maintaining and developing the profile of medical education in the Trust, and for ensuring the delivery of the Learning Development Agreement (Educational Contract) with Health Education South West with respect to medical education.

Funding for 1-2 sessions depending on the size of the Trust is included within the Learning Development Agreement.

In addition the Director of Medical Education is accountable to the Trust for the delivery of medical education (this role may vary according to Trust Policy). Directors of Medical Education will therefore be jointly appointed by the Dean and the Trust (normally via the Medical Director), and will have a joint appraisal with the Trust.

The Director of Medical Education will normally line manage the Foundation Programme Directors and the Medical Education Manager(s).

The Director of Medical Education is responsible to the Chief Executive for the business of Medical Education and Training within the organization and for ensuring the delivery of the medical aspects of the Learning Development Agreement. They will have a close professional relationship with the postgraduate Dean to ensure quality control of Programmes, develop and deliver the wider educational agenda and for supporting and developing supervisors and tutors as educators.

General Responsibilities 

Take responsibility for the organisation achieving defined standards of postgraduate (and in some places undergraduate) medical education.

  • Provide professional leadership and vision for the organisation on medical education issues
  • Produce, implement and monitor a strategy for the provision of medical education and training
  • Align medical training and education with the service objectives as defined by the Trust Board or equivalent
  • Represent the organization on medical education issues, both externally and internally.

In order to deliver these, the Director of Medical Education will:

  • Identify a structure for the local delivery of medical education, ensuring that all those involved have clear roles and responsibilities and are accountable for these educational roles
  • Lead, direct and develop all involved in medical education and be involved in their appointment
  • Manage resources and budgets devolved by the organisation to medical education and training
  • Manage data collection and reporting processes necessary both for internal quality control and training service development
  • Liaise with other educational leaders towards the development of multi-professional learning as appropriate

Key Result Areas 

  • Provide evidence of robust systems for educational governance required by statute for the General Medical Council Quality Assurance processes, and other external bodies as required
  • Ensure that trainers and trainees are fit for purpose within the organization
  • Report to Trust Board, or equivalent, as appropriate to ensure awareness of the impact of changes in medical education on the organization
  • Implement, monitor and improve medical training programmes
  • Provide an annual financial report and business plan