ARCP / CCT requirements

Workplace based assessments/ISCP

In order to achieve CCT trainees must achieve an outcome six in final ARCP, have no probity issues, and have passed the FRCS examination.  The JCST has recently modified the mandatory workplace-based assessments.  Trainees must be able to recognise and deal with the following critical  conditions with appropriate WPBA evidence: (1) compartment syndrome (any site), (2) neurovascular injuries (any site), (3) cauda equina syndrome, (4) immediate assessment, care and referral of spinal trauma, (5) spinal infections, (6) complications of inflammatory spinal conditions, (7) metastatic spinal compression, (8) the painful spine in the child, (9) physiological response to trauma, (10) the painful hip in the child, (11) necrotising fasciitis, (12) diabetic foot  (13) primary and secondary musculoskeletal malignancy (14) major trauma resuscitation (CEX)

Operative Logbook

Trainees need to provide evidence of the following:

  • 1800 cases as an indicative number
  • 1260 (70% of the 1800 described above) cases as first surgeon
  • Multiple operations at the same sitting, in the same anatomical area, must not be unbundled (e.g. within the same foot).
  • Bilateral cases may count as two operations.
  • Injections in any site do not count as part of the indicative numbers.   PBA level 3 x Level 4 PBAs in each specific operation group listed above by two or more trainers except for supracondylar fracture and application of external fixator.
  • For supracondylar fracture and external fixator application, an indicative number of 1 x PBA level 4 in a non-simulated setting is acceptable. One PBA may be assessed in simulation with agreement of AES, TPD.


Trainees need to provide evidence of:

  • Completion of Good Clinical Practice course within 3 years of CCT
  • Evidence of Research Methods training or a research methodologies course
  • Evidence of journal club activity/literature review evidenced by a CBD or reflection on the journal club
  • Two of:-
    • A higher degree eg MSc, MPhil, MD, PhD
    • Authorship of two PubMed cited papers relevant to specialty, not including case reports
    • A minimum of two presentations at national or international meetings
    • Recruitment of 5 or more patients into a research ethics committee approved study, or ten or more to a multi-centre observational study
    • Advanced research evidence may be used if the above is deficient (see JCST website)

Quality Improvement

Minimum of one audit per year, two audits must have progressed through full audit cycle and have WBA evidence

Medical Education

Completion of Train the Trainers or similar, and minimum of one lecture/presentation per year on a teaching programme with structured written feedback

Additional Courses/qualifications

Evidence of leadership and management e.g. through courses

Educational Conferences

Evidence of commitment to CPD through courses, meetings and training

Certification of Completion of Training

Progression towards CCT should be a gradual process, and your progress towards it should be checked at every ARCP.  The critical year checklists for ST4, ST6 and ST7 are good indicators of how well you are progressing, and you should plan your rotations, projects and courses with CCT in mind.  All trainees now need to demonstrate experience and exposure to all specialties including spines, hand, paediatrics, trauma, upper limb, lower limb/arthroplasty and foot and ankle.  You can demonstrate an understanding of most of these broad areas using the workplace-based assessments offered by ISCP.

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