A winding staircase representing the path of medical training, with milestones symbolizing competency achievements.

Annual Review of Competence Progression: What Trainees Really Think

Q: What is the Annual Review of Competence Progression (ARCP) and why is it important in UK medical education?

The Annual Review of Competence Progression (ARCP) is a formal framework used in the UK to review the progress of all doctors in training. Introduced in the 'Gold Guide,' it mandates specialty trainees (ST1-6) to submit a portfolio of formative and summative assessments annually to the ARCP panel. Its importance lies in ensuring that trainees are meeting required standards and developing the necessary skills for successful medical practice, reflecting a shift towards competency-based assessments as seen in countries like the USA, Canada, and Australia. The ARCP process helps standardize and streamline the evaluation of postgraduate medical education, making it a crucial component of the UK's training system.

Q: How did the ARCP process evolve from the previous method of evaluating specialist registrars?

Before the implementation of the Annual Review of Competence Progression (ARCP), the primary method of evaluating specialist registrars in the UK was the Record of In-Training Assessment. This involved annual face-to-face meetings between trainees and assessors, supported by detailed reports from trainers or educational supervisors. These reports summarized a trainee's knowledge, skills, and achievements over the past 12 months. The ARCP process, as outlined in the 'Gold Guide,' represents a more formalized and structured approach, requiring the collection and submission of a portfolio of assessments, shifting the focus towards a comprehensive, competency-based evaluation.

Q: What were the key improvements observed in the trainee perceptions of the ARCP process between 2008 and 2009, according to the survey?

The survey conducted on psychiatry trainees revealed significant improvements in their perceptions of the Annual Review of Competence Progression (ARCP) between 2008 and 2009. Specifically, there was a notable increase in the availability of acceptable evidence for the portfolio and a decrease in the difficulty accessing the electronic portal. In 2008, 75% of respondents noted the non-availability of a list of acceptable evidence for the portfolio, which decreased to 22% in 2009. Similarly, the percentage of trainees struggling to access the electronic portal dropped significantly from 73% to 28%. These improvements reflect the efforts made to refine the ARCP process and make it more accessible and user-friendly for trainees.

Q: What ongoing challenges did trainees face, despite the improvements in the ARCP process, and what are the implications of these challenges?

Despite improvements in the Annual Review of Competence Progression (ARCP) process, trainees continued to face challenges, particularly in obtaining explicit feedback at ARCP, enhancing assessor training, and gathering evidence, including completing workplace-based assessments (WPBAs). These ongoing difficulties indicate the need for continuous refinement of the ARCP process. For example, inadequate feedback can hinder trainees' ability to understand their strengths and weaknesses, thereby impeding their professional development. Insufficient training for assessors might lead to inconsistent evaluations and create a lack of clarity in the evaluation process. Addressing these challenges is critical to ensure that the ARCP process effectively supports trainees and promotes the achievement of the competencies necessary for successful medical practice.

Q: How can the Annual Review of Competence Progression (ARCP) process be further refined to enhance the experience and outcomes for medical trainees?

To further refine the Annual Review of Competence Progression (ARCP) process and improve trainee outcomes, several key areas require attention. First, providing explicit and actionable feedback at the ARCP is crucial to help trainees understand their performance and areas needing improvement. Second, enhancing assessor training can ensure consistent, fair, and comprehensive evaluations. Additionally, streamlining and clarifying the evidence collection process, including workplace-based assessments (WPBAs), will make it easier for trainees to demonstrate their competencies. These improvements will not only enhance the trainees' experiences but also better prepare them for successful medical careers by ensuring that the ARCP process effectively supports their professional development and competency acquisition.

Beau Callahan in Mind & Education August 2025 • 4 min read.

"A two-year survey reveals how trainees perceive the ARCP process, highlighting areas of improvement and ongoing challenges in postgraduate medical education."

In the ever-evolving landscape of medical education, competency-based assessments are gaining traction worldwide. Countries like the USA, Canada, and Australia are increasingly adopting this framework to evaluate trainee doctors, ensuring they meet the required standards and skills. Within the UK, significant changes have been implemented to enhance the structure and organization of postgraduate medical education.

Historically, the Record of In-Training Assessment served as the primary method for evaluating specialist registrars in the UK. This annual process involved face-to-face meetings between trainees and assessors, accompanied by detailed reports from trainers or educational supervisors. These reports summarized the trainee's acquired knowledge and skills, along with a compilation of their achievements over the preceding 12 months.

In June 2007, the UK Health Departments introduced A Reference Guide for Postgraduate Specialty Training in the UK, commonly known as the 'Gold Guide.' This guide, updated annually, outlines the Annual Review of Competence Progression (ARCP), a formal framework designed to review the progress of all doctors in training. The ARCP process requires specialty trainees (ST1-6) to collect formative and summative assessments throughout the training year and submit them annually in a portfolio to the ARCP panel.

Key Findings from the ARCP Trainee Survey

A winding staircase representing the path of medical training, with milestones symbolizing competency achievements.

A comprehensive two-year survey was conducted to evaluate trainees' perceptions of the Annual Review of Competence Progression (ARCP). The survey, conducted across two years in the north of England, collected feedback from psychiatry trainees on their experiences with the ARCP process. In 2008, 58 out of 92 trainees (63%) completed the survey, while in 2009, 60 out of 96 trainees (63%) participated. The results revealed significant improvements in trainees' perceptions over the year, alongside persistent challenges that warrant attention.

The survey highlighted several key areas where trainees' perceptions improved significantly between 2008 and 2009:

Availability of Acceptable Evidence: In 2008, 75% of respondents noted the non-availability of a list of acceptable evidence for the portfolio. This concern decreased significantly to 22% in 2009 (P<0.001).
Access to Electronic Portal: The percentage of trainees facing difficulty in accessing the electronic portal reduced substantially from 73% to 28% (P<0.001).

Despite these improvements, trainees continued to emphasize the need for explicit feedback at ARCP and enhanced training for assessors. The survey also identified ongoing difficulties in gathering evidence and completing workplace-based assessments (WPBAs). These findings underscore the importance of continuous refinement in the ARCP process to better meet the needs of trainees.

Refining the ARCP Process for Future Success

The two-year survey provides valuable insights into the perceptions and experiences of trainee psychiatrists undergoing the Annual Review of Competence Progression (ARCP). While significant improvements have been made, ongoing challenges remain, particularly in the areas of feedback, assessor training, and evidence collection. By addressing these issues and continuously refining the ARCP process, medical education can better support trainees and ensure they achieve the competencies required for successful practice.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What is the Annual Review of Competence Progression (ARCP) and why is it important in UK medical education?

The Annual Review of Competence Progression (ARCP) is a formal framework used in the UK to review the progress of all doctors in training. Introduced in the 'Gold Guide,' it mandates specialty trainees (ST1-6) to submit a portfolio of formative and summative assessments annually to the ARCP panel. Its importance lies in ensuring that trainees are meeting required standards and developing the necessary skills for successful medical practice, reflecting a shift towards competency-based assessments as seen in countries like the USA, Canada, and Australia. The ARCP process helps standardize and streamline the evaluation of postgraduate medical education, making it a crucial component of the UK's training system.

How did the ARCP process evolve from the previous method of evaluating specialist registrars?

Before the implementation of the Annual Review of Competence Progression (ARCP), the primary method of evaluating specialist registrars in the UK was the Record of In-Training Assessment. This involved annual face-to-face meetings between trainees and assessors, supported by detailed reports from trainers or educational supervisors. These reports summarized a trainee's knowledge, skills, and achievements over the past 12 months. The ARCP process, as outlined in the 'Gold Guide,' represents a more formalized and structured approach, requiring the collection and submission of a portfolio of assessments, shifting the focus towards a comprehensive, competency-based evaluation.

What were the key improvements observed in the trainee perceptions of the ARCP process between 2008 and 2009, according to the survey?

The survey conducted on psychiatry trainees revealed significant improvements in their perceptions of the Annual Review of Competence Progression (ARCP) between 2008 and 2009. Specifically, there was a notable increase in the availability of acceptable evidence for the portfolio and a decrease in the difficulty accessing the electronic portal. In 2008, 75% of respondents noted the non-availability of a list of acceptable evidence for the portfolio, which decreased to 22% in 2009. Similarly, the percentage of trainees struggling to access the electronic portal dropped significantly from 73% to 28%. These improvements reflect the efforts made to refine the ARCP process and make it more accessible and user-friendly for trainees.

What ongoing challenges did trainees face, despite the improvements in the ARCP process, and what are the implications of these challenges?

Despite improvements in the Annual Review of Competence Progression (ARCP) process, trainees continued to face challenges, particularly in obtaining explicit feedback at ARCP, enhancing assessor training, and gathering evidence, including completing workplace-based assessments (WPBAs). These ongoing difficulties indicate the need for continuous refinement of the ARCP process. For example, inadequate feedback can hinder trainees' ability to understand their strengths and weaknesses, thereby impeding their professional development. Insufficient training for assessors might lead to inconsistent evaluations and create a lack of clarity in the evaluation process. Addressing these challenges is critical to ensure that the ARCP process effectively supports trainees and promotes the achievement of the competencies necessary for successful medical practice.

How can the Annual Review of Competence Progression (ARCP) process be further refined to enhance the experience and outcomes for medical trainees?

To further refine the Annual Review of Competence Progression (ARCP) process and improve trainee outcomes, several key areas require attention. First, providing explicit and actionable feedback at the ARCP is crucial to help trainees understand their performance and areas needing improvement. Second, enhancing assessor training can ensure consistent, fair, and comprehensive evaluations. Additionally, streamlining and clarifying the evidence collection process, including workplace-based assessments (WPBAs), will make it easier for trainees to demonstrate their competencies. These improvements will not only enhance the trainees' experiences but also better prepare them for successful medical careers by ensuring that the ARCP process effectively supports their professional development and competency acquisition.