CPD Guidance For Surgeons
CPD Guidance For Surgeons
CPD Guidance For Surgeons
Colleges
Continuing Professional Development
Scheme for Surgery
September 2011
Definition of “Continuing Professional Development” (CPD)
A continuing process, outside formal undergraduate and postgraduate training, that enables
individual doctors to maintain and improve standards of medical practice through the
development of knowledge, skills, attitudes and behaviour. CPD should also support specific
changes in practice.
Statement of Principle
The Royal College of Physicians and Surgeons of Glasgow, the Royal College of Surgeons of
Edinburgh and the Royal College of Surgeons of England the support the Ten Principles for
College/Faculty CPD schemes as revised in October 2007 [1]
COLLEGE/FACULTY DETAILS
Description of the College or Faculty
The Royal College of Physicians and Surgeons of Glasgow, the Royal College of Surgeons of
Edinburgh and the Royal College of Surgeons of England represent surgery in general in the
UK. Agreement has been reached between the surgical Royal Colleges and the nine SAC-
defined specialty associations to manage CPD in a way that minimises confusion and facilitates
a surgeon from any college to collect, collate and validate their CPD activities.
Royal College of Physicians and Surgeons of Glasgow
Our growing collegiate body is unique to the UK. It includes professionals in surgery, medicine,
dentistry, and travel medicine. We are a multidisciplinary body with 8,500 members across all
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five continents. There are 2387 Surgeons. We provide many courses which are CPD approved
and these are advertised on our website.
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INTRODUCTION
The rationale behind participation in CPD and the relevance of CPD to revalidation
Revalidation is the process that will ensure that licensed doctors remain up to date and fit to
practise.
The contribution of CPD to Revalidation is set out in the Chief Medical Officer’s Report, ‘Medical
Revalidation – Principles and Next Steps’ [2]. The Report states that:
The Ten Principles support this approach, and in particular, Principles 1, 2 and 10 set out the
relationship between CPD, Appraisal and Revalidation.
*
‘Monitored systems’ is taken to mean arrangements in place to quality assure Colleges’ and Faculties’ CPD
programmes.
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THE PRINCIPLES OF THE CPD PROGRAMME
Normally, credits given by Colleges/Faculties for CPD should be based on one credit† equating
to one hour of educational activity (or an equivalent measure of educational activity). The
minimum required should be an average of 50 hours per year. Credits for un-timed activities
such as writing, reading and e-learning should be justified by the participant or should comply
with the principles outlined in the list of Education Activities that qualify for (Principle 4).
If reliable methods can be developed and validated that relate credits to the learning achieved
during an activity, then this would also be acceptable.
It will be the responsibility of individual doctors to ensure that they undertake a range of CPD
activities that reflect the local and national needs of their practice and their own learning needs.
It is expected that most surgeons in full time active clinical practice would easily exceed the 50
hour minimum.
All doctors who have a licence to practise will be required to provide documentation that they are
participating in CPD in order to keep up to date and fit to practise. Documentation of
participation in, and learning from, CPD to the standards set by the College or Faculty will be a
requirement for revalidation.
Individuals have the responsibility to record CPD that has educational value. Where an activity
has not been formally approved for CPD, it is the responsibility of the individual to record the
activity and document the learning achieved. Learning may reinforce existing good practice as
well as provide new knowledge.
†
A CPD Credit represents learning that is equivalent to one hour of educational time spent in good quality educational
activity. The actual learning will vary between individuals. Other methods of estimating the educational value of CPD
activities are being developed and piloted.
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activities should be provided, as determined by each individual College or Faculty (Adapted from
Principle 6).
Surgeons will need to record data about their CPD activities; it is recommended this is done
online using the Surgeons’ Portfolio or a similar tool. Supporting information such as certificates
should be uploaded or retained by the surgeon in hard copy as proof.
Surgeons should undertake recorded reflection of all activities. The Surgeons’ Portfolio provides
guided space for reflection based on standard questions developed by the Academy of Medical
Royal Colleges to be applied across medicine.
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THE PROGRAMME
CPD should include activities both within and outside the employing institution, where there is
one. In order to support doctors in obtaining a proportion of their CPD outside their workplace, it
is desirable to include a category of ‘external’ CPD wherever possible. There should also be a
balance of learning methods that includes a component of active learning (Principle 2). CPD
activities should include professional development outside narrower specialty interests (Adapted
from Principle 1).
Categories assist people to classify CPD and to ensure that a balance of activities is
undertaken.
Revalidation requires doctors to define their practice. A surgeon’s CPD should be planned to
reflect their practice in the balance of their activities.
Surgeons should aim to achieve a balance of activities across three categories of activities:
Clinical; Academic; and Professional (including Managerial); and three environments: Internal;
External; and Personal. These can be represented in a simple matrix:
There are no minima or maxima in any category but surgeons should aim for a balanced
programme that reflects their practice and development needs. It would normally be expected
that a surgeon’s five-year CPD programme would include CPD activity within each category and
environment (i.e. some entries in each box) but, depending on the surgeon’s role, it is
recognised that this may not always be possible. Planned programmes should be agreed
between a surgeon and their appraiser when setting a Personal Development Plan (PDP).
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Total 100 90 60 250
Surgeons will be free to participate in the CPD systems of any of the three UK surgical colleges.
For non-members a charge will be levied.
There are no requirements for any activity to be recognised/ approved/ accredited by a college
or specialty association. The formal recording and submission of CPD activity records is new to
surgery and such recognition/ approval/ accreditation systems are in relative infancy. Until such
systems are well established it would be an unreasonable burden to expect a proportion of CPD
to be from recognised/ approved/ accredited sources.
The Surgeons’ Portfolio, provided by the Colleges, will provide a report on participation that can
be accessed by the surgeon at any time.
CPD is measured in hours. Appropriate developmental activity is measured hour for hour.
Surgeons should accrue at least 50 hours per year and at least 250 hours every five years of
their revalidation cycle. There will be some flexibility from year to year at the discretion of the
surgeon’s appraiser.
Surgeons are responsible for recording the CPD activity and the hours that are attributed to it
although some suggestions are provided for activities that are difficult to measure. Activity
should be developmental and surgeons should be able to justify to their appraisers that the
activity contributed to their personal development.
There are no limits on the number of hours that can be claimed for the same type of activity.
However, to encourage a balanced programme, normally no more than 20 of the minimum
50 hours per year should come from a single type of activity, representing a suitable
maximum. E.g. the publication of an article/chapter in books – a surgeon might publish three
articles (30 hours) but an appraiser should be looking for a further 30 (rather than 20) to come
from different sources.
‡
Verifiable CPD activities must have:
1. concise educational aims and objectives;
2. clear anticipated outcomes; and
3. quality controls (ie you should be given the opportunity to give feedback)
Additionally, you must obtain documentary evidence. (Derived from GDC CPD requirements)
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Educational activities that qualify for CPD
This list is a guide and is not intended to be exhaustive. Surgeons should discuss planned
activities with their appraisers and agree anything that is not on this list.
Clinical
Self directed learning e.g. journal reading and information through the internet
Completing multiple choice questions on journal article or similar
Meetings
Courses (including e-learning)
Interactive surgical and clinical workshops
Clinical and procedural learning from peer visits or attendance at academic institutions.
Seminars, small group learning
Programme of training in a new technique or service
Academic
Basic science research
Translational research
Clinical research and trials
Participation in local audit activities
Participation in national clinical audits
Technical and Clinical Innovation
Creation of a local or national audit programme
Writing a report of a local audit
The publication of a surgical / medical book
The publication of an articles/chapter in books
Peer reviewing papers for journals
Presentation to surgical peers at a scientific meeting (first presentation only)
Presentation to other health professionals or community groups
Professional
Teaching on College/ specialty associations courses
Training in supervision and assessment of surgical trainees
Participation in a mentoring scheme as a mentor
Development of educational material
General teaching e.g. undergraduate/ post-graduate
Acting as an examiner for undergraduate exams§
Acting as an examiner for exams e.g. MRCS**/FRCS
§
It is expected that only in exceptional circumstances undergraduate examining will provide professional
development for the examiner.
**
Repeated examining, eg Objective Structured Clinical Examinations (OSCE) style examining, is unlikely
to provide significant professional development for the examiner and it is recommended that claimed
hours are kept to a minimum.
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Standard setting for exams
Writing and developing exam papers
Attendance at morbidity and mortality meetings where there was an explicit learning element
(learning must be demonstrated via reflection)
Self directed learning e.g. journal reading and information through the internet
Completing multiple choice questions on journal article or similar
Courses (including e-learning) such as:
o Leadership
o Management
o Teaching/ training
o Interviewer training
o Supervisor training
o Risk Management
o Expert Witness/ Medical legal work
o Writing reports
o Statistics
o Patient safety
o Research methods
Seminars, small group learning (see suggested topics above)
Advisory Appointments Committee participants
Invited Review Mechanism reviewer (Individual or Service Review)
Invited Review Mechanism reviewer (Case Note Review)
Development activity relating to role as a College representative or officer (e.g. induction
training)
Development activity relating to role as a Specialty Association or specialty representative or
officer (e.g. induction training)
A number of activities are separately included in the revalidation requirements as other types of
supporting information; these should be a normal part of practice and would not qualify for CPD.
These include:
Participation in appraisal
Routine attendance at morbidity and mortality meetings (unless there was a specific
learning element)
Routine attendance at multi-disciplinary team meetings
Participation in multi-source feedback exercises (either as the subject or a reviewer)
Participation in patient feedback exercises
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PLANNING AND REVIEW OF INDIVIDUAL CPD ACTIVITY
CPD and Annual Appraisal
Participants will need to collect evidence to record their CPD activity, normally using a structured
portfolio. This portfolio will be reviewed as part of the process of appraisal and revalidation
(Adapted from Principle 2).
Annual appraisal will lead to a personal development plan which will include future CPD activity
The CPD undertaken should reflect and be relevant to a doctor’s current and future profile of
professional practice and performance (Adapted from Principle 1).
A number of methods may be used by different Colleges and Faculties to achieve these
objectives.
Surgeons are not required to submit information to their College on the CPD activities they have
undertaken but the Colleges have provided a recording facility as part of the Surgeons’ Portfolio.
Surgeons must present information on their CPD for discussion and assessment at appraisal.
The appraiser should discuss with the surgeon the CPD activities undertaken throughout the
previous year. Discussions should include the learning and changes in practice that have arisen
from the activities. The appraiser should challenge the relevance of chosen CPD activities if
relevant.
The appraisal should also include discussion of future CPD including the setting of a Personal
Development Plan that sets that balance of categories and environments for the year ahead
(see matrix example above).
Surgeons should produce a summary of the CPD undertaken for their appraiser. This will be
available from online portfolios including the Surgeons’ Portfolio. Appraisers will have the right to
request detailed supporting information from the surgeon based on this summary.
Any of the following would be acceptable with the agreement of the surgeon’s appraiser.
Event programmes
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Letters from organisers
Reflection records
Copies of titles and details (e.g. abstracts) of articles/ chapters/ books (full copies should
be available on request)
Titles and details of presentations or books (full copies should be available on request)
Surgeons should reflect on the activity and note any learning points. The following should be
addressed:
Brief description of activity including why you selected this activity for CPD.
Outline any further learning or development needs highlighted by the activity. How do
you intend to address these?
The means whereby individual CPD activity and the Personal Development Plan
(PDP) relate to each other
The appraisal should include discussion of future CPD including the setting of a Personal
Development Plan that sets that balance of categories and environments for the year ahead
(see matrix example above).
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APPROVAL AND QUALITY CONTROL OF CPD ACTIVITIES
Responsibilities of the providers of CPD activities
Where a formal approval or accreditation process exists for CPD activities, there should be clear
guidance to providers about the criteria against which activities will be evaluated.
Formal recognition, approval or accreditation processes are in their infancy in surgery. Until they
are established there will not be a formal requirement for a proportion of CPD activities to be
from recognised/approved/ accredited sources.
Common standards across medicine for the accreditation/ approval of CPD activities are being
developed by the Academy of Medical Royal Colleges.
Where formal recognition/ approval/ accreditation has not been sought by the provider the
surgeon and their appraiser should look for the following characteristics††:
The activity contributes to continuous learning and addresses a clear learning need.
The teaching methods used are relevant to the defined learning outcomes.
Formal recognition/ approval/ accreditation of the quality of educational activities for CPD by
Colleges/ Faculties should be achieved with minimum bureaucracy and with complete reciprocity
between Colleges/Faculties for all approved activities. The recognition/ approval/ accreditation
process and criteria should be such as to ensure the quality and likely effectiveness of the
activity (Principle 5b).
††
These standards form a basis for standards for formal accreditation processes.
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The surgical Colleges and specialty associations have different procedures for
recognising/approving/ accrediting activities. These will meet the standards being developed by
the Academy of Medical Royal Colleges once they are available.
Currently the College only recognises in-house programmes and exceptionally other events and
encourages the specialty associations to consider accreditation of activities, although this
situation is under review. It is likely that the procedures available will mirror the other Colleges.
The Royal College of Surgeons of England accepts applications for the recognition of meetings
and events. Course accreditation is also offered and CPD hours awarded but this is undertaken
as a separate process and the standards and requirements exceed those for CPD recognition
for meetings and events.
Application for CPD recognition is through an online portal and depending on the type of
organisation running the activity a fee may be levied.
Feedback on the quality of CPD activities should be given to the activity provider and acted
upon. Where the activity has been formally approved the feedback should be available to the
approving body and used in quality control of the approval process.
Feedback should be sought by activity providers through evaluation forms or equivalent. This
would be a requirement for recognition/ approval/ accreditation. We encourage CPD Activity
providers to provide tools to direct reflection including Multiple Choice Questions.
The surgical Colleges and specialty associations have different procedures for
recognising/approving/ accrediting activities. These will meet the standards being developed by
the Academy of Medical Royal Colleges once they are available.
All in house and accredited events have a quality assurance assessment and one component of
this is participant and contributor feedback.Royal College Surgeons of Edinburgh
Feedback is all important and the College audits the educational activity which it has supported.
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Royal College Surgeons of England
CPD activity providers are required to submit to the College a report on the evaluation received
from participants. Until this point recognition is provisional and future recognition is dependent
on the results of this evaluation.
The surgical Colleges and specialty associations have different procedures for
recognising/approving/ accrediting activities.
All events are approved by the Education Training and Professional Development Board or the
Director for Surgical CPD and Professional Development.Royal College Surgeons of
Edinburgh
Applications are reviewed in the first instance by staff in the Professional Standards and
Regulation Quality Assurance department. A recommendation is made to the responsible trustee
for CPD. If specialty advice is required this is obtained.
The surgical Colleges and specialty associations have different procedures for
recognising/approving/ accrediting activities.
There is no formal training and monitoring but the Education, Training and Professional
Development Board along with the secretariat report regularly to College Council.Royal College
Surgeons of Edinburgh
Formal training is not provided but staff in the Professional Standards and Regulation Quality
Assurance department provide guidance and oversee the process.
The surgical Colleges and specialty associations have different procedures for
recognising/approving/ accrediting activities.
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Royal College of Physicians and Surgeons of Glasgow
The Department of E-Learning is involved in the monitoring process, within Professional Affairs.
The system has been running for a limited time and so is still in development and subject to
constant review.
Audit of Compliance
In order to quality assure their CPD system and to verify that claimed activities have been
undertaken and are appropriate, Colleges/Faculties should audit participants’ activities on a
random basis (Adapted from Principle 8).
Until alternative quality assurance processes are established, the proportion of participants
involved in random audit each year should be of a size to give confidence that it is
representative and effective. This proportion will vary according to the number of participants in
a given scheme (Principle 9).
Surgeons are not required to submit information to their College on the CPD activities they have
undertaken but the Colleges have provided a recording facility as part of the Surgeons’ Portfolio.
However, surgeons must present information on their CPD for discussion and assessment at
appraisal. Forward planning of CPD should be undertaken at the appraisal meeting and the
surgeon and their appraiser should agree a Personal Development Plan that includes plans for
CPD.
CPD is a compulsory element of revalidation and appraisal is the means by which CPD, and
other types of supporting information, will be reviewed. The quality assurance systems being
developed for revalidation will provide assurance of compliance.
Failure to produce sufficient evidence to support claimed credits will result in an individual’s
annual statement being annotated accordingly for the year involved and the individual
subsequently being subject to audit annually for a defined period. Further failure or suspected
falsification of evidence for claimed CPD activities may call into question the individual’s fitness
for revalidation, and may result in referral to the GMC/GDC (Adapted from Principle 10).
CPD is a compulsory element of revalidation and appraisal is the means by which CPD, and
other types of supporting information, will be reviewed. If a surgeon failed to provide evidence
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or provided insufficient evidence for CPD they would be unable to revalidate and the
consequences of this would be directed through the revalidation process.
We would expect appraisers to be sufficiently trained so that they can exercise common sense
discretion.
ADMINISTRATION
Administering CPD
Vice-President
Convener of CPD
Registration of Participants
College/Faculty CPD schemes should be available to all Members and Fellows and, at
reasonable cost, to non-Members and Fellows who practise in a relevant specialty (Principle 3).
Participation can be accessed through enrolment and signing into the Surgeons’ Portfolio.
Access to the Surgeons’ Portfolio will be free to members of any of the three UK surgical Royal
Colleges and the Royal College of Surgeons in Ireland. A fee will be levied for non members.
Responsibilities of Employers
Employers and organisations that doctors work in should recognise the benefits of
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allowing enough resources for doctors to carry out CPD activities.
Resources, such as time to think and access to on-site educational facilities, should be
available to all doctors to allow them to develop professionally.
The responsibility for fulfilling CPD requirements and achieving learning needs rests with the
individual doctor. However, the employing organisation (including locum agencies, where
applicable) should provide support for professional development in partnership with other
relevant bodies.
SPECIAL CIRCUMSTANCES
All doctors (including those in independent private practice) who hold a licence to practise
should remain up to date with the CPD requirements set out by their Medical Royal College or
Faculty. Doctors working less than full time have an equal obligation to provide high quality
patient care as do those working full time, and thus should maintain the same commitment to
their CPD. Colleges and Faculties, as well as employers, should be as flexible as possible in
enabling this commitment to be met for all doctors.
In addition, the local arrangements to facilitate CPD should reflect current NHS guidance on
equality and diversity in the workplace [4].
In some circumstances participation in CPD may be difficult or impossible for periods of time.
The following are some of the circumstances to be considered, and some of the ways in which
these may be addressed:
A shortfall in CPD activity at the end of a fixed five-year cycle is difficult to make up. However,
the use of a rolling cycle allows the average amount of activity to be maintained over five years if
a shortfall occurs
This is likely to be rare, and the period of suspension before return to work, or a decision on re-
training or remediation should be short. Where necessary it should be possible to make up any
lost CPD hours over a five-year cycle.
Any deficit in CPD activity should be made up over the remainder of the five-year cycle. This
may be achieved either prospectively (where possible) retrospectively after return to clinical
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work, or a combination. Where the absence is for more than a year, advice from the College or
Faculty should be sought.
If a retired doctor wishes to retain a licence to practise, then the CPD requirements of the
College or Faculty should be met. As much flexibility as possible should be provided, and a
doctor experiencing difficulty should contact the relevant College or Faculty.
This group of doctors should meet the same CPD requirements as other career grade doctors in
their specialty.
In some circumstances the type of CPD activity available may not conform to the quality
standards set by the College or Faculty. The doctor should self-accredit as much CPD as
appears justifiable in terms of the learning achieved. Any shortfall should be made up on return
to the UK. Periods of absence of more than one year may require specific CPD as agreed with
the doctor’s appraiser, College or Faculty.
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REFERENCES
1. Academy of Medical Royal Colleges 10 Principles of CPD. AoMRC, London 2007. At:
http://www.aomrc.org.uk/committees/directors-of-continuing-professional-
development/item/cpd-documents.html
2. Medical Revalidation – Principles and Next Steps. Department of Health, 27th July 2008. At:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_086430
5. Current Senate of Surgery (now named Forum of Surgery) guidance on CPD is available
online http://www.rcseng.ac.uk/publications/docs/maintaining_performance.html
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Appendix 1: Academy of Medical Royal Colleges10 Principles of CPD
2. CPD should include activities both within and outside the employing institution, where there
is one, and a balance of learning methods which include a component of active learning.
Participants will need to collect evidence to record this process, normally using a structured
portfolio cataloguing the different activities. This portfolio will be reviewed as part of appraisal
and revalidation.
3. College/Faculty CPD schemes should be available to all members and fellows and, at
reasonable cost, to non-members and fellows who practise in a relevant specialty.
4. Normally, credits given by Colleges/Faculties for CPD should be based on one credit
equating to one hour of educational activity. The minimum required should be an average of
50 per year. Credits for un-timed activities such as writing, reading and e-learning should be
justified by the participant or should be agreed between the provider(s) and College/Faculty
directors of CPD.
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7. Participation in College/Faculty based CPD schemes should normally be confirmed by a
regular statement issued to participants which should be based on annually submitted
returns, and should be signed off at appraisal.
8. In order to quality assure their CPD system, Colleges/Faculties should fully audit participants’
activities on a random basis. Such peer-based audit should verify that claimed activities have
been undertaken and are appropriate. Participants will need to collect evidence to enable
this process.
9. Until alternative quality assurance processes are established, the proportion of participants
involved in random audit each year should be of a size to give confidence that it is
representative and effective. This proportion will vary according to the number of participants
in a given scheme.
10. Failure to produce sufficient evidence to support claimed credits will result in an individual’s
annual statement being endorsed accordingly for the year involved and the individual
subsequently being subject to audit annually for a defined period. Suspected falsification of
evidence for claimed CPD activities will call into question the individual’s fitness for
revalidation, and may result in referral to the GMC/GDC.
October 2007
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