Each domain requires specific evidence.

If your evidence is in a foreign language, you must include a certified version translated into English. If you changed your name since the date of any of your evidence, you must include formal evidence of your name change (for example, marriage certificate, deed poll certificate).

Domain 1 - Postgraduate Medical Qualifications

Masters qualification in a relevant field, such as quality improvement, patient safety, leadership, management, ultrasound
Score 5
Comments None at present
Evidence required Degree certificate.
Maximum number of pieces of evidence required To be confirmed
Postgraduate diploma in a relevant field, such as quality improvement, patient safety, leadership, management, ultrasound
Score 4
Comments None at present
Evidence required Degree certificate.
Maximum number of pieces of evidence required To be confirmed
UK primary postgraduate qualification, such as Membership of the Royal Colleges of Physicians (MRCP) Part 1, Member of College of Emergency Medicine (MCEM) A (excluding Membership of Royal College of Obstetrics and Gynaecology (MRCOG)), ultrasound
Score 3
Comments None at present
Evidence required Degree certificate.
Maximum number of pieces of evidence required To be confirmed
Postgraduate certificate in relevant field in a relevant field, such as quality improvement, patient safety, leadership, management, ultrasound
Score 3
Comments None at present
Evidence required Degree certificate.
Maximum number of pieces of evidence required To be confirmed
Diplomate of National Board or equivalent and/or none of the above
Score 0

Domain 2 - Quality improvement projects (QIP)

2 quality improvement projects, with at least one presented nationally/internationally
Score 6
Comments None at present.
Evidence required For each QIP please provide a summary including QIP details, action plan, evaluations/re-audit/assessment to quantify impact of intervention, dates QIP undertaken, and clear evidence of where and when it was presented and the intended audience.

You must also provide evidence of your involvement in each QIP, such as email acknowledgement of registration of QIP with Clinical Governance team or response from QIP lead and/or written signed confirmation on letter headed paper from Educational Supervisor or QiP Lead for local, regional, national or international change.

Also ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
2 quality improvement projects, with at least one presented regionally
Score 5
Comments None at present.
Evidence required For each QIP please provide a summary including QIP details, action plan, evaluations/re-audit/assessment to quantify impact of intervention, dates QIP undertaken, and clear evidence of where and when it was presented and the intended audience.

You must also provide evidence of your involvement in each QIP, such as email acknowledgement of registration of QIP with Clinical Governance team or response from QIP lead and/or written signed confirmation on letter headed paper from Educational Supervisor or QiP Lead for local, regional, national or international change.

Also ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
2 quality improvement projects, both presented locally
Score 4
Comments None at present.
Evidence required For each QIP please provide a summary including QIP details, action plan, evaluations/re-audit/assessment to quantify impact of intervention, dates QIP undertaken, and clear evidence of where and when it was presented and the intended audience.

You must also provide evidence of your involvement in each QIP, such as email acknowledgement of registration of QIP with Clinical Governance team or response from QIP lead and/or written signed confirmation on letter headed paper from Educational Supervisor or QiP Lead for local, regional, national or international change.

Also ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
1 quality improvement project presented nationally/internationally
Score 3
Comments None at present.
Evidence required For each QIP please provide a summary including QIP details, action plan, evaluations/re-audit/assessment to quantify impact of intervention, dates QIP undertaken, and clear evidence of where and when it was presented and the intended audience.

You must also provide evidence of your involvement in each QIP, such as email acknowledgement of registration of QIP with Clinical Governance team or response from QIP lead and/or written signed confirmation on letter headed paper from Educational Supervisor or QiP Lead for local, regional, national or international change.

Also ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
1 quality improvement project presented regionally
Score 2
Comments None at present.
Evidence required For each QIP please provide a summary including QIP details, action plan, evaluations/re-audit/assessment to quantify impact of intervention, dates QIP undertaken, and clear evidence of where and when it was presented and the intended audience.

You must also provide evidence of your involvement in each QIP, such as email acknowledgement of registration of QIP with Clinical Governance team or response from QIP lead and/or written signed confirmation on letter headed paper from Educational Supervisor or QiP Lead for local, regional, national or international change.

Also ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
1 quality improvement project presented locally
Score 1
Comments None at present.
Evidence required For each QIP please provide a summary including QIP details, action plan, evaluations/re-audit/assessment to quantify impact of intervention, dates QIP undertaken, and clear evidence of where and when it was presented and the intended audience.

You must also provide evidence of your involvement in each QIP, such as email acknowledgement of registration of QIP with Clinical Governance team or response from QIP lead and/or written signed confirmation on letter headed paper from Educational Supervisor or QiP Lead for local, regional, national or international change.

Also ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
None
Score 0

Domain 3 - Research

Completion of a PhD with original research
Score 6
Comments None at present
Evidence required Doctorate of Philosophy (PhD) certificate, if applicable.

PhD/Doctor of Medicine (MD) and other higher degrees must be awarded to get full marks.

Signed headed letter from research supervisor/project sponsor confirming your role in the research project and copy of research project summary/abstract.

Research to be evidenced by degree or publications which are first author, if applicable.

If applicable, evidence your MD is not part of a standard training programme.

Good Clinical Practice (GCP) certificate.
Maximum number of pieces of evidence required To be confirmed
Significant involvement in research or PhD awaiting submission with first author publication
Score 5
Comments None at present
Evidence required PhD certificate, if applicable.

PhD/MD and other higher degrees must be awarded to get full marks.

Signed headed letter from research supervisor/project sponsor confirming your role in the research project and copy of research project summary/abstract.

Research to be evidenced by degree or publications which are first author, if applicable.

If applicable, evidence your MD is not part of a standard training programme.

Good Clinical Practice (GCP) certificate.
Maximum number of pieces of evidence required To be confirmed
Had personal and direct involvement of leading a postgraduate research project
Score 4
Comments None at present
Evidence required PhD certificate, if applicable.

PhD/MD and other higher degrees must be awarded to get full marks.

Signed headed letter from research supervisor/project sponsor confirming your role in the research project and copy of research project summary/abstract.

Research to be evidenced by degree or publications which are first author, if applicable.

If applicable, evidence your MD is not part of a standard training programme.

Good Clinical Practice (GCP) certificate.
Maximum number of pieces of evidence required To be confirmed
Had ongoing commitment to research as a co-investigator or recruited a significant number of patients during the period of study
Score 3
Comments None at present
Evidence required PhD certificate, if applicable.

PhD/MD and other higher degrees must be awarded to get full marks.

Signed headed letter from research supervisor/project sponsor confirming your role in the research project and copy of research project summary/abstract.

Research to be evidenced by degree or publications which are first author, if applicable.

If applicable, evidence your MD is not part of a standard training programme.

Good Clinical Practice (GCP) certificate.
Maximum number of pieces of evidence required To be confirmed
Been involved with recruitment of participants to research projects and hold certified Good Clinical Practice (GCP) or assisted with data collection and hold certified Good Clinical Practice (GCP)
Score 2
Comments None at present
Evidence required PhD certificate, if applicable.

PhD/MD and other higher degrees must be awarded to get full marks.

Signed headed letter from research supervisor/project sponsor confirming your role in the research project and copy of research project summary/abstract.

Research to be evidenced by degree or publications which are first author, if applicable.

If applicable, evidence your MD is not part of a standard training programme.

Good Clinical Practice (GCP) certificate.
Maximum number of pieces of evidence required To be confirmed
Been involved with recruitment of participants to research projects
Score 1
Comments None at present
Evidence required PhD certificate, if applicable.

PhD/MD and other higher degrees must be awarded to get full marks.

Signed headed letter from research supervisor/project sponsor confirming your role in the research project and copy of research project summary/abstract.

Research to be evidenced by degree or publications which are first author, if applicable.

If applicable, evidence your MD is not part of a standard training programme.

Good Clinical Practice (GCP) certificate.
Maximum number of pieces of evidence required To be confirmed
MD linked to primary Medical qualification
Score 0
Not participated in research
Score 0

Domain 4 - Teaching

A higher degree in Medical education
Score 4
Comments None at present
Evidence required Please provide evaluation from teaching events which should include the date, time and target audience.

Signed headed letter confirming involvement in a teaching programme.

Overview of lectures delivered, and feedback received – if you do not provide this, your score will be amended to informal teaching.

Evidence of course attendance/completion/certification, as applicable.

Do not include presenting a QIP project as teaching, nor presenting own research at a meeting.

Please supply any supporting qualification/course certificates.

If applicable, evidence your MD is not part of a standard training programme.
Maximum number of pieces of evidence required To be confirmed
Made a major contribution to a local/regional/national teaching programme including organising a programme
Score 3
Comments None at present
Evidence required Please provide evaluation from teaching events which should include the date, time and target audience.

Signed headed letter confirming involvement in a teaching programme.

Overview of lectures delivered, and feedback received – if you do not provide this, your score will be amended to informal teaching.

Evidence of course attendance/completion/certification, as applicable.

Do not include presenting a QIP project as teaching, nor presenting own research at a meeting.

Please supply any supporting qualification/course certificates.

If applicable, evidence your MD is not part of a standard training programme.
Maximum number of pieces of evidence required To be confirmed
Involved in organising a multi disciplinary teaching programme, such as PRactical Obstetric Multi-Professional Training (PROMPT)
Score 3
Comments None at present
Evidence required Please provide evaluation from teaching events which should include the date, time and target audience.

Signed headed letter confirming involvement in a teaching programme.

Overview of lectures delivered, and feedback received – if you do not provide this, your score will be amended to informal teaching.

Evidence of course attendance/completion/certification, as applicable.

Do not include presenting a QIP project as teaching, nor presenting own research at a meeting.

Please supply any supporting qualification/course certificates.

If applicable, evidence your MD is not part of a standard training programme.
Maximum number of pieces of evidence required To be confirmed
Attended a Train the Trainers course, Generic Instructors course (GIC) or equivalent
Score 2
Comments None at present
Evidence required Please provide evaluation from teaching events which should include the date, time and target audience.

Signed headed letter confirming involvement in a teaching programme.

Overview of lectures delivered, and feedback received – if you do not provide this, your score will be amended to informal teaching.

Evidence of course attendance/completion/certification, as applicable.

Do not include presenting a QIP project as teaching, nor presenting own research at a meeting.

Please supply any supporting qualification/course certificates.

If applicable, evidence your MD is not part of a standard training programme.
Maximum number of pieces of evidence required To be confirmed
Carried out informal teaching of colleagues, including nurses and medical students
Score 1
Comments None at present
Evidence required Please provide evaluation from teaching events which should include the date, time and target audience.

Signed headed letter confirming involvement in a teaching programme.

Overview of lectures delivered, and feedback received – if you do not provide this, your score will be amended to informal teaching.

Evidence of course attendance/completion/certification, as applicable.

Do not include presenting a QIP project as teaching, nor presenting own research at a meeting.

Please supply any supporting qualification/course certificates.

If applicable, evidence your MD is not part of a standard training programme.
Maximum number of pieces of evidence required To be confirmed
Not contributed to teaching
Score 0

Domain 5 - Academic publications

First author in more than one peer-reviewed publication as a postgraduate, or sole author of several book chapters
Score 5
Evidence required For each publication, please include a screenshot or pdf copy of the publication or the acceptance letter from the relevant journal. 

Do not include publication of a poster or an oral presentation abstract as these will not be counted as evidence. 

Unsubmitted, or submitted but not yet accepted evidence cannot be counted.

Please ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
First author on one peer-reviewed publication as a postgraduate, or sole author of a book chapter
Score 4
Evidence required For each publication, please include a screenshot or pdf copy of the publication or the acceptance letter from the relevant journal. 

Do not include publication of a poster or an oral presentation abstract as these will not be counted as evidence. 

Unsubmitted, or submitted but not yet accepted evidence cannot be counted.

Please ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
Co-author in more than one peer-reviewed publication as a postgraduate, or co-author of a book chapter
Score 3
Evidence required For each publication, please include a screenshot or pdf copy of the publication or the acceptance letter from the relevant journal. 

Do not include publication of a poster or an oral presentation abstract as these will not be counted as evidence. 

Unsubmitted, or submitted but not yet accepted evidence cannot be counted.

Please ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
Co-author in one peer-reviewed publication as a postgraduate or I am an author of an undergraduate publication
Score 2
Evidence required For each publication, please include a screenshot or pdf copy of the publication or the acceptance letter from the relevant journal. 

Do not include publication of a poster or an oral presentation abstract as these will not be counted as evidence. 

Unsubmitted, or submitted but not yet accepted evidence cannot be counted.

Please ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
Published one or more abstracts or articles (including e-publications) or have published a letter 
Score 1
Comments None at present
Evidence required For each publication, please include a screenshot or pdf copy of the publication or the acceptance letter from the relevant journal. 

Do not include publication of a poster or an oral presentation abstract as these will not be counted as evidence. 

Unsubmitted, or submitted but not yet accepted evidence cannot be counted.

Please ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
Not published anything
Score 0

Domain 6 - Presentations and poster presentations

Presented at a regional, national or international meeting
Score 5
Evidence required Provide a copy of the relevant page or digital screenshot of the meeting programmes naming you as a presenter.

Provide a copy of the presentation material. This can include cancelled events, due to the pandemic, at which you had been invited to speak. You must provide notice of cancellation together with speaker programme as evidence, or original event confirmation acceptance letter/email.

Ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
Presented at a local meeting on more than one occasion
Score 3
Evidence required Provide a copy of the relevant page or digital screenshot of the meeting programmes naming you as a presenter.

Provide a copy of the presentation material. This can include cancelled events, due to the pandemic, at which you had been invited to speak. You must provide notice of cancellation together with speaker programme as evidence, or original event confirmation acceptance letter/email.

Ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
Made a local/departmental presentation
Score 1
Evidence required Provide a copy of the relevant page or digital screenshot of the meeting programmes naming you as a presenter.

Provide a copy of the presentation material. This can include cancelled events, due to the pandemic, at which you had been invited to speak. You must provide notice of cancellation together with speaker programme as evidence, or original event confirmation acceptance letter/email.

Ensure you have provided a copy of your employment history if you have undertaken any periods of less than full time employment and/or statutory sickness and/or have any employment gaps.
Maximum number of pieces of evidence required To be confirmed
Not made any presentations or shown any posters
Score 0

Page last reviewed: 14 November 2023
Next review due: 1 November 2024

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