Every assessment, explained the same way

What it is

A structured conversation about a case you chose, where your supervisor probes the reasoning behind what you did. It is an assessment of thinking, not of knowledge.

When, and how many

Four in ST1 and four in ST2, spread through the year rather than clustered.

Choosing a case that will go well

• Pick a case where you actually had to decide something. A textbook presentation managed textbook-ly gives your supervisor nothing to explore.
• Cases with uncertainty, competing priorities or a decision you are not sure about produce the best discussions and the most useful feedback.
• Bring the record. Discussing a case from memory drifts towards how you wish it had gone.

What good looks like

• You can explain not just what you did but what else you considered and why you rejected it.
• You are honest about the parts you found difficult.
• The feedback names something specific you will do differently.

What commonly trips people up

• Choosing only cases that went well, which produces bland feedback and a thin evidence trail.
• Treating it as a viva. It is a discussion, and saying “I did not know, so I looked it up and here is what I found” is a strong answer.
• Leaving all four to the final six weeks of the year.

What it is

The ST3 successor to the CbD. Broader in scope — it looks at how you handle the whole span of general practice, including complexity, continuity and the parts of a case that are not strictly clinical.

When, and how many

Five across ST3.

Choosing a case that will go well

• Complexity is the point. Choose the multi-morbid patient, the family situation, the case that crossed several appointments.
• Cases where you coordinated with other services evidence several capabilities at once.
• Do not save these for the end. The CAT rewards cases you have followed over time, which needs time.

What good looks like

• You show reasoning under genuine uncertainty rather than recall of a pathway.
• You can talk about the patient as a person in a context, not a presentation.
• You identify what you would do differently without being prompted.

What commonly trips people up

• Treating it as a longer CbD. The breadth is deliberate — bring the messiness.
• Choosing five cases from the same clinical area.
• Not leaving enough time between them for the feedback to change anything.

What it is

An observed consultation with a real patient in a primary care setting, assessed against the components of an effective consultation.

When, and how many

Counts towards your combined COT and mini-CEX total, and the mix matters as much as the number.

Choosing a case that will go well

• You need a spread — face to face, telephone and remote — with at least one audio COT and at least one in person.
• Ten to fifteen minute consultations with something to work with. A repeat prescription request is not assessable.
• New problems generally show more than follow-ups.

What good looks like

• Clear structure with a genuine ending — a plan the patient understood and safety-netting they could act on.
• Space for the patient to say what they were actually worried about.
• You respond to the feedback rather than defending the consultation.

What commonly trips people up

• Seven face-to-face COTs and none by phone. The composition rule catches people out late in the year.
• Choosing the patient you find easiest.
• Recording without proper consent — sort the consent process out with the practice at the start of the post.

What it is

A COT applied to a telephone consultation. It assesses the skills that are specific to consulting without seeing the patient.

When, and how many

At least one is required within your COT mix.

Choosing a case that will go well

• A call with real diagnostic uncertainty, where you had to decide whether the patient needed to be seen.
• Avoid administrative calls — results, sick notes, medication queries.
• Calls where you brought the patient in are often the strongest, because the reasoning is visible.

What good looks like

• You compensate deliberately for the missing examination — more history, clearer safety-netting, explicit follow-up.
• You check understanding out loud, because you cannot read the room.
• You are clear with the patient about what happens next and when to call back.

What commonly trips people up

• Consent and recording logistics left until the day.
• Choosing a call that was simply a conversation with no decision in it.
• Safety-netting that is generic rather than specific to this patient and this problem.

What it is

The hospital-post equivalent of the COT — an observed interaction with a real patient, assessed on the spot.

When, and how many

Counts towards your combined COT and mini-CEX total for the year.

Choosing a case that will go well

• Any clinical encounter with a beginning, a middle and a decision. Clerking, a ward review, a difficult discussion with a relative.
• Ask early in the post. Consultants are generally willing; finding them in the final fortnight is harder.
• Choose encounters that connect to general practice — the ones you will see again in a GP surgery.

What good looks like

• You ask for the assessment before the encounter rather than reconstructing it afterwards.
• The feedback is written on the day, while the detail is fresh.
• You draw out the general practice relevance in your own reflection.

What commonly trips people up

• Leaving them all to the end of the placement.
• Choosing only encounters within your specialty comfort zone.
• Accepting “fine, no concerns” as feedback. Ask for one specific thing to work on.

What it is

Evidence that you examine patients and perform procedures competently, safely and with appropriate consent and chaperoning.

When, and how many

Ongoing and post-appropriate through ST1 and ST2. By the end of ST3 you need all the intimate examinations plus a range of others relevant to general practice.

Choosing a case that will go well

• Take intimate examination opportunities when they arise. They do not appear on demand, and trainees who wait until ST3 run into real difficulty.
• Sexual health, gynaecology and urology placements or clinics are worth seeking out deliberately.
• Musculoskeletal, ENT, ophthalmoscopy and dermatological examination are all worth capturing.

What good looks like

• Consent and chaperone arrangements are explicit in what you record.
• You describe the examination technique, not just that you did it.
• The range is genuinely broad by the end.

What commonly trips people up

• This is the single most common cause of a last-minute panic in ST3.
• Assuming a GP post will provide the intimate examinations. It may not, in the numbers you need.
• Recording the procedure without recording the consent conversation.

What it is

Structured, anonymous feedback from the people you work with, on your clinical performance and your professional behaviour.

When, and how many

Once in ST1, once in ST2, and twice in ST3 — one of which is a Leadership MSF.

Choosing a case that will go well

• You need a minimum of five clinical and five non-clinical responders. Reception and administrative staff are not padding — they see things clinicians do not.
• Choose people who will be honest rather than kind. Uniformly glowing feedback tells a panel nothing and helps you less.
• Send it early in the cycle. Chasing responses in the final week is a familiar misery.

What good looks like

• The reflection engages with the least comfortable comment rather than the average score.
• You name something specific you changed as a result.
• You revisit it later in the year and say whether the change held.

What commonly trips people up

• Uploading the report with a two-line reflection. The report is not the evidence; your response to it is.
• Only asking colleagues who like you.
• Being defensive in writing about a single negative comment. Panels notice.

What it is

A multi-source feedback exercise focused specifically on how you lead — in a team, in a project, in a crisis.

When, and how many

Once in ST3, alongside your standard MSF.

Choosing a case that will go well

• Ask people who saw you lead something, not simply people who worked near you.
• It pairs naturally with your leadership activity — the same people can often comment on both.

What good looks like

• You have a piece of leadership to point at, however modest.
• The reflection is honest about what you found hard about leading.

What commonly trips people up

• Leaving it until you have done no leadership, which makes the feedback meaningless.
• Assuming leadership means a formal role. Organising a rota change or leading a significant event review counts.

What it is

Patients rate your empathy and relationship-building across a consecutive run of consultations.

When, and how many

Once in ST3, and it needs a GP post.

Choosing a case that will go well

• Consecutive patients, not selected ones. Selecting patients defeats the exercise and is easy to spot.
• Plan it early in the ST3 GP post. Practices need warning and the collection takes time.

What good looks like

• You reflect on the spread of responses rather than the average.
• You look at what the least positive responses have in common.

What commonly trips people up

• Leaving it until the final months of ST3, when there may not be a GP post left to do it in.
• A reflection that reports the numbers back without interpreting them.

What it is

A structured attempt to improve something, measured. A QIP in a GP post; a Quality Improvement Activity in other placements.

When, and how many

Required once during ST1 or ST2 — get it done early rather than carrying it into ST3.

Choosing a case that will go well

• Small and finished beats ambitious and abandoned. One measurable change, measured twice, is a complete project.
• Choose something the practice actually wants improved — you will get support and the change will stick.
• Ask what data already exists before designing anything.

What good looks like

• There is a second measurement. A project without a re-measure is an audit of a good intention.
• You are honest when the change did not work, and say what you learned.
• You name who else was involved and what they contributed.

What commonly trips people up

• Choosing a topic that needs data nobody can extract.
• Running out of placement before the second cycle.
• Counting it for one capability when it usually evidences three or four.

What it is

A structured look at an event that could have gone better — or that went well because a system worked.

When, and how many

One per training year.

Choosing a case that will go well

• It does not have to be a disaster. A near miss, a delayed result, a communication breakdown all work well.
• System problems make stronger entries than individual errors, because the learning generalises.
• Something you were genuinely involved in. Analysing someone else’s event at a distance reads thinly.

What good looks like

• You separate what happened from why it happened.
• The changes you identify are specific and within somebody’s power to make.
• You say what happened to the change afterwards.

What commonly trips people up

• Writing it as a confession. The point is the system and the learning, not blame.
• Choosing an event so trivial there is nothing to analyse.
• No follow-through — an action agreed and never revisited.

What it is

A formative review of your own prescribing — a look at what you actually prescribe and whether it stands up.

When, and how many

Once in ST3.

Choosing a case that will go well

• A run of your own recent prescriptions rather than a curated selection.
• Areas where you are least confident are the most useful to examine.

What good looks like

• You identify a pattern in your own prescribing rather than commenting case by case.
• You look at monitoring and review, not just the initial decision.

What commonly trips people up

• Treating it as a knowledge test rather than a review of your habits.
• Selecting only the prescriptions you feel good about.

What it is

Something you led, written up with what you did, what happened, and what you learned about leading.

When, and how many

Once in ST3.

Choosing a case that will go well

• Modest is fine. Reorganising a clinic template, leading a significant event meeting, setting up a teaching series.
• Something with a visible outcome, so you have something to reflect on.
• It works best when it overlaps with your QIP or your Leadership MSF.

What good looks like

• You are specific about what you did rather than what the group did.
• You are honest about the parts of leading you found uncomfortable.

What commonly trips people up

• Describing membership of a project rather than leadership of one.
• Leaving it so late that there is no time for anything to happen.

What it is

The conversation at the start of a placement that establishes what is available in this post and what you are going to get out of it.

When, and how many

Once per post, in the first few weeks.

Choosing a case that will go well

• Come with a draft. A supervisor faced with a blank meeting will fill it with generic objectives.
• Look at what is outstanding in your Evidence Tracker and plan the post around the gaps.

What good looks like

• Objectives that are specific to this placement and achievable within it.
• An explicit conversation about which assessments will happen and roughly when.

What commonly trips people up

• Skipping it, or doing it in month four. It is one of the easiest requirements to meet and one of the most commonly missing.
• Objectives so generic they could apply to any post in any year.

What it is

A short structured report from the supervisor of that placement, on how you performed in it.

When, and how many

Once per post, at the end.

Choosing a case that will go well

• Ask two or three weeks before the post ends, not on the last day.
• If you have worked with several consultants, ask the one who saw you most.

What good looks like

• It refers to specific things you did rather than general impressions.
• It is written while you are still in the post and the detail is fresh.

What commonly trips people up

• Chasing a supervisor who has moved on. This is a common cause of missing evidence at ARCP.
• Not reading it. If it says something surprising, that is worth a conversation and a reflection.

What it is

Your educational supervisor’s overall judgement of your progress, built from everything else in the portfolio.

When, and how many

For each review, with an interim review part-way through.

Choosing a case that will go well

• Book it early. Supervisors have a queue at the same time every year.
• Go in having read your own portfolio. Knowing your own gaps changes the tone of the meeting entirely.

What good looks like

• You bring a view of your own progress rather than waiting to be told.
• Areas for development are agreed rather than announced.
• Anything the panel might query is addressed in the report rather than left visible and unexplained.

What commonly trips people up

• Arriving without having looked at your own evidence.
• A report written from memory because the logs were not up to date.
• Booking it after the deadline that matters.

What it is

Your own declaration to the deanery, covering your training history and any matters you need to declare.

When, and how many

Once per ARCP, at minimum annually.

What good looks like

• Submitted on time, complete, with declarations made honestly.

What commonly trips people up

• Forgetting it entirely. It is administrative, but a missing Form R can hold up an otherwise flawless portfolio.
• Leaving a declaration blank rather than declaring and explaining.

What it is

Goals you set for yourself, work on, and then review honestly.

When, and how many

A minimum of two per training year, with demonstrable progress.

Choosing a case that will go well

• Goals that are specific enough to know whether you achieved them.
• Something you actually intend to do, rather than something that reads well.

What good looks like

• There is visible movement between setting the goal and reviewing it.
• At least one goal comes from feedback somebody else gave you.

What commonly trips people up

• Both entries written on the same afternoon shortly before a review.
• Goals so vague that the review cannot say anything.