Application for appointment as an examiner for the MRCP(UK) Part 2 Clinical Examination (PACES)

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Application for appointment as an examiner for the MRCP(UK) Part 2 Clinical Examination (PACES) ear Colleague, Nomination and Appointment of Examiners Thank you for your interest in applying to become a PACES examiner. The PACES exam is an integral part of the United Kingdom s medical training system and helps to ensure that trainees meet the highest standards of patient care. Examining offers physicians the opportunity to earn external CP points, develop their skills as an assessor, and share best practice with other physicians from around the country. Applicants should review the attached criteria and complete the application form. Completed forms must be submitted to the Examination epartment of your College (or your chosen College if you are a Fellow of more than one). Please pay particular attention to the declarations section of the form as we will require your signature before the application will be considered. Supporting statements and signatures are required from two referees, both of whom should be Fellows, or Members, of one of the Royal Colleges of Physicians of the UK. One of the referees must be a current PACES examiner. Information on the appointment criteria can be found overleaf. Any applicants who are unsure of their eligibility should contact their College s Examination epartment for guidance. Once appointed, examiners must satisfactorily complete examiner training before they will be permitted to examine. Once trained, examiners are invited to examine at venues organised by any of the three Royal Colleges of Physicians. In order to retain examiner status, examiners will be required to abide by the PACES examiner code of conduct, and maintain adherence to the criteria, and will be asked to confirm this on an annual basis. Thank you, once again, for your interest. r Kenneth agg Associate Medical irector for Clinical Examinations, MRCP(UK) kenneth.dagg@mrcpuk.org Last updated Nov 2016

MRCP(UK) PACES Examiner Selection Criteria Hold MRCP(UK) (desirable). Collegiate Member or Fellow in good standing of one of the Royal College of Physicians of the UK. GMC registered with a licence to practise and in good standing (or regulatory equivalent in country of practice). Have been involved with physicians in training within the last two years. (UK only) Participate in revalidation, including annual appraisal in current post, and adhere to CP requirements. (UK only) Have undergone equality and diversity training within the past three years. Physicians interested in, but not necessarily expert in, medical assessment. Collegiate Members must have achieved the Certificate of Completion of Training (CCT), or be on the specialist register, and be in a substantive consultant post. Examiners who are resident outside the UK and who wish to examine must hold Fellowship of one of the UK colleges of physicians and be in good standing. Examine at least six cycles (30 candidates) per annum averaged over two years.

MRCP(UK) Part 2 Clinical Examination (PACES) Examiner Application Form Section 1 Important Information College Membership/Fellowship Number GMC Number Application to: (Please tick your single preference) Edinburgh Glasgow London (Paper applications are no longer accepted. Please apply via the online form.) Section 2 Personal etails Family/Last name Forename(s) Which College(s) do you hold Membership/Fellowship with (tick accordingly)? Member Fellow College Year elected Work/preferred correspondence address Edinburgh Glasgow London City Postcode _ Country Work telephone no. Mobile no. E-mail

Section 3 Qualifications and posts Please list your qualifications and details of current position and previous positions if you have been in your current post for less than five years. Qualifications ate (from to) University/ Awarding body Current appointment ate (from to) Position and specialty Previous appointments (if in current position less than five years) escribe your on call duties, average in patient numbers supervised and clinics performed per week

Section 4 Examining and Teaching Experience Why would you like to be an MRCP(UK) Examiner? escribe other examining experience that you have, e.g. undergraduate or other College examinations escribe your teaching experience and current commitment to training

List the teaching/examinations courses to which you have contributed Section 5 Criteria (Please tick the appropriate box and provide information where necessary) o you hold MRCP(UK)? Yes No Comment Are you: a Fellow in good standing of one of the UK Colleges of Physicians, OR a Collegiate Member who holds a UK Certificate of Completion of Training, and in a substantive consultant post? Are you GMC registered with a licence to practise and in good standing (or regulatory equivalent in country of practise)? Have you been involved with physicians in training within the last two years? (UK only) In your current post do you adhere to CP requirements and participate in revalidation, including annual appraisal. Have you undertaken equality and diversity training within the last three years?

Section 6 References Give the names, postal addresses and email addresses of two referees who know your professional and educational work and are Fellows or Collegiate Members (who have held a substantive consultant positions for 2 years or more)of one of the Royal Colleges of Physicians of the UK. At least one referee must be a PACES Examiner (please indicate and quote examiner number). (Please note that referees may be contacted with regard to your application). 1. Name Correspondence address City Postcode _ Country Email Supporting statement Signature Examiner number: _ 2. Name _ Correspondence address City Postcode _ Country Email Supporting statement Signature Examiner number: _

Section 7 eclarations(please tick the appropriate box) Yes No (UK based examiners) I confirm that I am working towards revalidation (including being up to date with appraisal and CP). Please enter date of next revalidation: (non UK based examiners) I confirm that I am on the medical register of the country in which I practice. I confirm that I will commit to examining a minimum of 6 cycles (30 candidates) per annum in PACES to maintain my skills as an examiner. Membership/Fellowship I understand that, if for any reason my Membership/Fellowship of my College of entry is withdrawn, or if I fail to meet the terms and conditions of maintaining standing as a Member/Fellow, my appointment as an MRCP(UK) Examiner will be rescinded automatically. Avoidance of discriminatory behaviour All examiners are reminded that avoidance of discriminatory behaviour will include attitudes, activities, assumptions, and beliefs, whether conscious or unconscious. MRCP(UK) Examination procedures, Examination papers, Examination results and individual Examiner performance will be analysed routinely by the MRCP(UK) Management Board, the MRCP(UK) Examining Boards and the MRCP(UK) Standard Setting Advisory Groups to confirm that fair treatment is being provided to all candidates. Confidentiality All examiners are reminded that it is of the utmost importance that the security of the Clinical Examination is not breached. The identity of the patients and scenarios to be used in the Examination should be known only to a limited number of individuals, all of whom will have signed a confidentiality clause before being involved in the Examination. In addition, confidentiality of the provisional results of the MRCP(UK) Clinical Examination is of paramount importance. As a Clinical Examiner I will maintain strict confidentiality and will not divulge to any third party who does not have a right to such information the identity of patients and scenarios to be used in the Examination and will not communicate any provisional results, Station scores or any other aspect of candidate performance. Participation in commercial activities It is not acceptable for MRCP(UK) Examiners to take part in commercially run courses. If a non-examiner takes part in such courses and is invited subsequently to become an Examiner, it is on the understanding that such activity will cease. It is not acceptable for Examiners to write or contribute to non-college books or other materials such as C-Roms or to re-edit or revise existing texts or other publications whose specific purpose is to help candidates prepare for any or all parts of the MRCP(UK) Examination. Assignment of copyright I assign to the Federation of Royal Colleges of Physicians of the UK the copyright of the material which I have prepared or will in future prepare, for any part of the MRCP(UK) Examination. This includes questions for the MRCP(UK) Part 1 and Part 2 Written Papers and scenarios for the MRCP(UK) Part 2 Clinical Examination (PACES). I accept that the Federation may not only use this material in the MRCP(UK) Examination, but also may publish it, as it sees fit, without any payment to me. To the best of my knowledge, the material I have prepared for use in the MRCP(UK) Examination has not been published previously, and is not the intellectual property of anyone else. The same conditions will apply to any material I submit in the future. I will not publish, independently of the Federation, any material which I have prepared for the MRCP(UK) Examination, or which I have reviewed through my work for the MRCP(UK) Examination. I have read and accept the assignation of copyright and the details with regard to commercial activities, avoidance of discriminatory behaviour, and confidentiality. Signature Name (please print) _ate M M Y Y