Annual Review Part 1 – ARCPs – Two sides.

As trainees, we had the joy of the ARCP: the Annual Review of Competency Progression. Each year a panel sits that includes Training Programme Directors, Advisory Committee Liaison members, consultants and others, with additional members drawn from HEE, the military and academia as needed.

The objective is to review all the evidence for the year and determine how the trainee is progressing. In an ideal world, the ARCP also gives trainees the opportunity to raise concerns and discuss issues, with a view to planning for the future.

I have some fond memories of the ARCP. I was lucky to have a solid Training Programme Director who was a terrific person all round, but that didn’t make sitting in front of a group of people and feeling judged any easier.

The build-up was fairly straightforward. We had the JCST documents and checkpoint requirements, so we knew what was expected. The bigger issue at times was achieving everything, particularly logbook experience. Once, I was sent on rotation with a specific target for knee replacement numbers, but due to winter bed pressures and consultant absence I only managed 5 TKRs in six months. Understandably, this raised eyebrows at the ARCP, though the question was really whether the issue lay with me or with the placement. Thankfully, the eyebrows settled when I provided evidence that I’d completed all my hand and wrist competencies.

Most panel members were fair and constructive, though not every interaction was. At times, comments were made that I accepted as normal then but that wouldn’t be considered acceptable today, including a suggestion that I sell my car to fund a course when I asked about study budgets. Looking back, it’s a reminder of how much training culture has changed, and how much it still needs to.

Ultimately, I received Outcome 1 (achieving at the expected rate, no added time) on six occasions, Outcome 2 (focused training, no added time) once, and Outcome 6 (completion of training) at the end.

In hindsight, my colleagues and I always went to the ARCP not expecting praise but hoping to avoid criticism. In the formality of that setting, I don’t think I ever expected anything more than “satisfactory”. However, given everything I’d put in, I do sometimes wish the panel had recognised more of it.

As a TPD for Core Surgery, I later sat on ARCP panels myself. The first round I was involved in introduced two new COVID-related outcomes. Assessing trainees and their portfolios was very difficult when COVID had disrupted almost every element of training. Despite this, we recognised the resilience of so many of our trainees, and I made sure that every trainee I engaged with through the panel, including those I called with results, heard recognition of the good work they had done.

I saw some phenomenal trainees, and I’m not just referring to their achievements: the character of many of them was inspirational. I don’t do many ARCPs now because my role has changed, and the process has evolved since I was last involved. How much of an improvement it is remains open to debate. But my advice is the same on both sides of the table. As a trainee, engage and complete the paperwork, however tedious it feels. As a panel member, take a moment to recognise good work when you see it. It costs nothing and is remembered for years.