RCPCH START - guidance for trainees

RCPCH START - guidance for trainees
Training Services team
​START means Specialty Trainee Assessment of Readiness for Tenure. It guides
trainees as they prepare for completion of training and practice as a new
consultant paediatrician. Find out how to check your eligibility, apply and pay, and
how it fits in with your educational supervision.
Status
RCPCH

Last modified
22 October 2021

Post date
30 April 2018

Table of contents

     What is RCPCH START?
     Who needs to, or should, take START?
     When and where does START take place?
     When do I take START?
     What happens if I am in sub-specialty training (GRID)?
     How much does START cost, and how do I pay?
     How do I apply?
     How does RCPCH prioritise applications?
     Withdrawing and refunds
     How do I prepare?
     What do I need to know on the day?
     How do assessors judge my performance?
     How do I get feedback?
     What do I do with the feedback?
     What happens if there are concerns?

How does this relate to ARCPs (Annual Review of Competence Progression)?
     Contact
     Downloads

What is RCPCH START?

Ordinarily, START is a three-hour assessment with consultant paediatricians which
assesses your abilities relating to clinical decision-making as a new consultant. It
helps you address any gaps that you may have in your training.

START has a circuit of stations, which test different skills. The stations include
scenario based discussions on acute disease, chronic problems, behaviour
difficulties and neonatal care. Other scenarios include safeguarding, ward
handover and ethics. There are also scenarios on critical appraisal and teaching.
You can read more about the circuit, watch our videos and download example
scenarios on our how it works page.

Who needs to, or should, take START?

You must take START if you are paediatric trainee expecting to attain a CCT
(certificate of completion of training) or CESR Combined Programme, ie, will
complete a UK Paediatric Training programme leading to entry on the Specialist
Register.

You can also take part if you are a doctor in a non-approved training post, such as
a Specialty Doctor, Trust Doctor, Associate Specialist, Staff Grade or Locum
Approved for Service post. This is subject to availability and capacity, with trainees
taking preference.

If you are not sure whether to take it, email us on training.services@rcpch.ac.uk.

When and where does START take place?

We normally host START twice a year, in the spring and autumn.

The spring 2021 session took place over three days: 25 March, 16 April and 22
April. The autumn 2021 session was also on three days: 5, 8 and 20 October. Both
sessions were delivered online.

The application windows for START are currently fixed depending on the time of
assessment. Spring assessment (usually March/ April) application window is the
first Monday October to the last Friday November preceding; Autumn assessment
(usually September/ October) application window is first Monday April to last
Friday May. In 2022, we are running three diets, Spring, Summer and Autumn and
the application period will run from October to December (inclusive) 2021 to apply
for a 2022 sitting. See more detail in How do I apply.

When do I take START?

We determine places for START based on your CCT date as detailed in either your
latest ARCP outcome on your ePortfolio or in the Trainee-led Record for
Completion of Training Date form on your ePortfolio.

Do not expect to be guaranteed a place even if you have applied previously. If you
are expecting to change your CCT date, you need to complete the form on your
ePortfolio.

What happens if I am in sub-specialty training
(GRID)?

If you plan to complete training in an approved sub-specialty training
programme, you must have START in that sub-specialty.

We advise that you apply after you have been accepted for a sub-specialty post
and are working in that post. You should be confident that you are ready to be
assessed in your sub-specialty before you apply.

You will need to include your sub-specialty on your application so we can place
you on the relevant circuit.

If you are in a SPIN module, you will sit General Paediatrics START so do not
select the subspecialty if doing a SPIN module.

How much does START cost, and how do I pay?

The fees (came into effect as of October 2020 START):

     Run-through trainees who enrolled with RCPCH for training before 1 August
     2019 pay between £268 and £559
     Run-through trainees who enrolled with the RCPCH for training on or after 1
     August 2019 (indicatively taking the START assessment in 2024) pay £850
     Non run-through trainees - £850
     For a fuller explanation on how the fees are determined, see our training
     guide

You'll pay after you are granted a place, and can pay online by card.

We are happy to issue receipts for the assessment fee - please email your request
to us at training.services@rcpch.ac.uk

We do not pay for travel or accommodation costs.

How do I apply?

Note on CCT date Before you apply, check your latest ARCP has the correct CCT
date, as we use this to prioritise placements for START. If the CCT date is not
correct, you will need to get confirmation of your correct CCT date from your
Training Programme Director or Head of School, and ask them to complete the
Record of Completion of Training Date on your ePortfolio.

To apply during an application window, log in to our online booking system with
your RCPCH number and password (as used for your ePortfolio), and follow the on-
screen instructions.

The application form will ask you for:

     Your CCT date - this is so we can prioritise according to training time
     Your whole time equivalent training time - this is so we can prioritise
     according to training time
     Your current grade - this is so we can prioritise according to training time
     Whether you are subspecialty or general paediatrics (NB SPIN trainees are
     considered general paediatrics)

This table shows the recent and upcoming START dates and application
information.

START dates                 Application open and close dates                Status

Spring, Summer and
Autumn 2022
23, 25, 29 March
                            From first Monday October to last Friday of
6, 8, 12 July                                                               Open
                            December 2021
5, 7, 11 October
All online assessments
for trainees

How does RCPCH prioritise applications?

We recommend you apply for START early in the application period. We prioritise
as follows:

   1. Applicants in run-through training, particularly those in ST8 posts
  2. Applicants with CCT dates closest to the assessment determined by training
     time left rather than chronologically - see 'Note on CCT date' above
  3. Date application received

The number of times of you have applied will not be relevant if your CCT date
does not warrant a place on the assessment. An expectation to complete your
CCT early is insufficient evidence of a change and we will require confirmation
from your Training Programme Director and CSAC, if GRID training, before we
accept an earlier date. You are now able to submit a Record of Completion of
Training Date on your ePortfolio to show us the most accurate CCT date possible.

If you think you may gain your CCT early, or you have any other information that
you think would be useful for us to know, you must include this in your
application. Make sure you use the comments box on the application form and
send support for an earlier CCT date from Programme Director/Head of School or
CSAC to training.services@rcpch.ac.uk.

If we don't receive the necessary information and email support before the
application window closes, we may not be able to consider you for shortlisting or

offer you a place. Please note, there is no guarantee of a place in the assessment
even if you do have supporting emails as others may take priority.

The final decision on place allocation rests with the RCPCH office so we need all
relevant information to make an informed decision.

Withdrawing and refunds

You can withdraw up to one week before the assessment date. You must inform
us in writing to training.services@rcpch.ac.uk and we may ask you to provide
supporting documentation.

If you are unable to attend the assessment due to unforeseen circumstances,
please inform us in writing no later than the day of the assessment.

Refund policy

       Time of cancellation before START date                Refund of START fee

                                                       Full refund if place can be
                                                       filled by another trainee
Up to 14 working days
                                                       If place cannot be filled, full
                                                       refund minus £85 admin fee

                                                       Full refund minus £85 admin
Within 14 working days before
                                                       fee

No refund will be given for non-attendance on the day or cancellation within 24
hours before the assessment, regardless of reason.

How do I prepare?

You aren’t required to do any ‘revision’ – the scenarios should be examples of your
‘day-to-day’ work but you will approach them as if you're a day one consultant.

You will probably find it helpful to familiarise yourself and keep up to date with

NICE guidance and GMC guidance on confidentiality, consent, capacity, duty of
candour, colleague in difficulty, answering complaints and safeguarding. You may
consider going through your drug charts with a pharmacist.

What do I need to know on the day?

At the moment, the assessment is virtual and all trainees are offered a briefing via
webinar to explain how the assessment works, including the system used for the
assessment.

There is no dress code. Do dress as you would when going to work. There's no
need for a suit and tie, or dress - but if that’s more comfortable for you, then that’s
fine, too!

How do assessors judge my performance?

START has anchor statements which allow assessors to make judgments on
trainees at each station.

This covers six domains and all stations cover all domains. These are: decision
making and prioritising, knowledge, management of complexity, professional
approach, safety and risk management, and communication.

A global rating is also made as an assessment of performance overall in the
scenario.

Within each domain, the trainee is assessed at three levels - well above expected
standard, performed at expected standard and further development required.

Well above equates to performing as if you've been a consultant for a few
weeks. Performing at expected standard means day one consultant. Further
development means you've performed at trainee standard and there are some
areas to work on - this is fine and to be expected as part of the formative nature of
the assessment.

You can download the benchmarking standards below.

The assessors complete an assessor feedback form at each station, also available
to download below.

How do I get feedback?

We will send your feedback report about six weeks after the assessment. It will
appear in your RCPCH ePortfolio, and you can search for it in your timeline.

Your report will include your global rating, your overall score, your performance
against the competency domains and the written feedback for each station. It is
similar to the MSF report.

There is no pass/ fail mark. However, trainees can under-perform and the
feedback will include recommendations to address any development areas.

What do I do with the feedback?

You should discuss your feedback with your educational supervisor within four
weeks of getting it. Your supervisor can help you interpret the feedback into a
development plan.

You and your supervisor can use the Guide for START assessment feedback and
targeted development for educational supervisors, available to download below.

If you are not in training, you will be asked to nominate a supervisor who can
assist in the feedback process.

What happens if there are concerns?

The responsibility to remediate concerns will lie with your local education
provider. The College works closely with all paediatric schools, College Tutors and
educational supervisors to ensure a robust system is implemented in assisting
those in training to address issues.

Trainees will not be expected to undertake the assessment again.

How does this relate to ARCPs (Annual Review of
Competence Progression)?

START is not designed to gate‐keep progression through training and should not
be the sole determinant of ARCP outcome. Rather it is another formative piece of

evidence a trainee has in their portfolio on capabilities acquired through training
that are relevant to completing training. There is a START feedback PDP form that
we would strongly encourage you to use with your supervisor, when you have
received your feedback.

We will not allow trainees to re-take START.

You can find out more in the START and ARCPs statement, as well as the
Guide for educational supervisors, available to download below.

Contact

If you have any queries, please contact training.services@rcpch.ac.uk

Downloads
Benchmarking standards, or anchor statements (2015).pdf275.32 KB
Assessor feedback form.pdf136.81 KB
Guide for START feedback and targeted development for educational supervisors
342.59 KB
START and ARCPs - statement from Board109.3 KB