GP training - The last six months of GP training

Dr Lynda Carter offers some suggestions for minimising the stress of the last six months of the VTS.

The last six months of GP training can be stressful. Alongside finishing the ePortfolio, and applying for your certificate of completion of training (CCT), you need to organise your CV and think about career options.

The ePortfolio
The key to completing the ePortfolio without hassle is to determine when everything has to be finished and work your planning backwards from that point.

The annual review of competence progression (ARCP) panel is a deanery panel that reviews and signs off trainees' ARCP electronically each year. It is likely to meet in month five (or the end of month four) of your last six months.

Before the ARCP panel can review your ePortfolio, you must have had your final review completed by your educational supervisor. At the start of your last six months, contact your supervisor and find out when your ARCP panel will be. Arrange a time prior to this to meet your educational supervisor and a time before that to review your ePortfolio with your clinical supervisor or trainer.

Have your evidence completed in the first three months of the post. Discuss with your trainer how many clinical observation tools (COTs) and case-based discussions (CBDs) you aim to do. It is best to do more than the minimum required.

Set a timetable with your trainer for when you are going to do your COTs, CBDs, patient satisfaction questionnaire, multi-source feedback, any remaining direct observation of procedural skills, out-of-hours sessions, and your CPR and AED certificate.

Completion of training
Once you know the ARCP panel has met, start checking 'progress to certification' on the ePortfolio. When this comes up as satisfactory in ST3, you can apply for your CCT electronically via the ePortfolio.

The RCGP will post you a card to say a recommendation on your suitability for a CCT has been sent to the Postgraduate Medical Education and Training Board (PMETB). The PMETB also requires that you submit an application to it directly, and it is best to do this before your formal recommendation from the RCGP to speed up the process.

CCTs are now applied for through the PMETB's online certification system. The first phase is to register for your application, for which you need instructions from the RCGP. Phase two is completing an application form, uploading documents including a scanned passport photo and making a payment.

When the application and RCGP recommendation have been received, a certificate will be issued, although no earlier than 10 days before your completion of training date (the last day of your job).

Once your CCT is issued, the PMETB will send your details to the GMC to be included on the GP register (if so indicated on your CCT application form).

You will be added to the register on the last day of the job and the GMC will send you a copy of this in the post. Only when the GMC has entered you on its register as a GP can you attain your primary performers' list number from your local PCT. You need to be listed on the GP register and on the performers' list of your primary care organisation before starting work in general practice in any capacity.

If you are due to start work the day after finishing your VTS, contact your local contracts department. (You will already have been on the performers' list as a GP registrar in ST3 so you should already have these details.) It will need to see your original PMETB certificate and indemnity certificate to work as a GP and can then issue your performers' list number on the last day of the job, as the GMC updates the register electronically.

CV and jobs
Prepare your CV early so you are ready if your ideal job is advertised. Arrange a tutorial on writing your CV with your trainer and ask them what they look for when selecting candidates for interview. Start looking for job advertisements if you are considering applying for partnerships, salaried or longer-term locums. If you want to do locum work, ask your practice manager to send out your CV to everyone in your PCT.

As a GP, you will be appraised every 12 months. Think about what you want to achieve in your first year as a GP just before you finish VTS. You can ask your trainer to help you plan your first PDP before you leave.

The NHS Appraisal Toolkit is currently used to record learning but in future appraisal may be based around a continuation of the ePortfolio.

  • Dr Carter is a locum GP, currently working in New Zealand
  • This topic falls under section 1 of the RCGP curriculum 'Being a GP',

Timeline for last six months of VTS training


  • Arrange ARCP final review.
  • Make a timetable for completing your COTs, CBDs, MSF, PSQ, DOPS and out-of-hours sessions, CPR and AED certificate.


  • Think about what you would like to do after finishing VTS and discuss your CV with your trainer.


  • Check you are on track to get all your ePortfolio assessments completed.


  • Look at 'review preparation' on the ePortfolio.
  • Review your ePortfolio with trainer, checking that everything is completed.
  • Have your final review meeting with your educational supervisor.


  • Complete your CCT application through PMETB's online certification system.
  • Once ARCP panel has taken place, start checking 'progress to certification' on the ePortfolio.
  • If you are planning on working as a locum, start distributing your CV.


  • Check with PMETB that your application is being processed.
  • Update your indemnity to work as a GP.
  • Contact your primary care organisation and check you will be included on the primary performers' list.
  • Plan PDP with your trainer for first 12 months.




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