This table specifically specifies the fields relevant to Form R, Part A only
As Is Form
User Journey
Assumptions
- All fields are mandatory
- Prompts should be displayed to the Trainee advising them of how to update particular fields as needed
- Appropriate field assistance should be displayed
- Photograph from the original form is not needed
Form R Part A – Guidance Text
- Displayed at the top of the form
- All underlined / emboldened text should be displayed
Current Guidance Text
If this form has been pre-populated by your Deanery/HEE local team, please check all details, cross out errors and write in amendments. By signing this document you are confirming that ALL details (pre-populated or entered by you) are correct.
It remains your own responsibility to keep your Designated Body, and the GMC, informed as soon as possible of any changes to your contact details. Your Deanery/HEE local team remains your Designated Body throughout your time in training. You can update your Designated Body on your GMC Online account under “My Revalidation”.
Updated Guidance (to be confirmed) Alistair Pringle (Unlicensed)
This form has been pre-populated using the information available against your records within the Trainee Information System (TIS). Please check all details and either amend them within the relevant system (see guidance in the form), or speak to your local office to amend them on your behalf. By singing this document you are confirming that ALL DETAILS (pre-populated or entered by you) are correct.
It remains your own responsibility to keep your Designated Body and the GMC informed as soon as possible of any changes to your contact details. Your HEE Local team remains your Designated Body throughout your time in training. You can update your Designated Body on your GMC Online account under “My Revalidation”.
Fields
| Order | Field name | DR field | Reference Table | Example value | Other fields available in DR | Type (free text, drop down, check box) & Interaction (autopopulate etc) | Mandatory (Y/N) | Validation / Error Messaging | Filter (Y/N) | Search (Y/N) | Sort (Y/N) | List (S) / Detail (D) | Notes | Delete field | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Form R - Part A | |||||||||||||||
| Section 1: DOCTOR'S DETAILS | |||||||||||||||
| 1 | Forename | Forenames | DR | vwPerson | Pre-populate Read-only | ||||||||||
| 2 | GMC-Registered Surname | LegalSurname Should be GMC surname as per guidance at top of the form | DR | vwPerson | Pre-populate Read-only | ||||||||||
| 3 | GMC Number | GMCNumber | DR | vwPerson | Pre-populate Read-only | ||||||||||
| 4 | Deanery / HEE Local Office | LocalOfficeName | DR | vwPerson | Pre-populate Read-only | ||||||||||
| 5 | Date of birth | DateOfBirth | DR | vwPerson | Pre-populate Read-only | ||||||||||
| 6 | Gender | Gender | DR | vwPerson | Pre-populate Read-only | ||||||||||
| 7 | Immigration Status | EEA Resident Permit to Work Settled | TBC | Resident/Settled/Work Permit Required | Pre-populate Read-only | In the form R it asks for the trainee's immigration status which can be 3 options listed. In Intrepid there is currently 3 fields that this information resides in which are all drop downs. | |||||||||
| 8 | Primary Qualification | Qualification | DR | vwPerson | Pre-populate Read-only | If there are multiple qualifications, which one to display? How to extract the Primary Qualification? | |||||||||
| 9 | Date Awarded | Date Attained | DR | vwPerson | Pre-populate Read-only | If there are multiple qualifications, which one to display? How to extract the Primary Qualification? | |||||||||
| 10 | Medical School Awarding Primary Qualification (name and country) | Medical School | DR | vwPerson | Pre-populate Read-only | If there are multiple qualifications, which one to display? How to extract the Primary Qualification? | |||||||||
| 11 | Home address | AddressLine1 AddressLine2 AddressLine3 AddressLine4 AddressPostCode | vwPerson | Pre-populate Read-only | Line 4 is a left over from Intrepid, if made editable, then the user should be allowed to update the whole address as an object and without a Line 4. | ||||||||||
| 12 | Contact Telephone | TelephoneNumber | vwPerson | Pre-populate Read-only | |||||||||||
| 13 | Contact Mobile | MobileNumber | vwPerson | Pre-populate Read-only | |||||||||||
| 14 | Email Address | EmailAddress | vwPerson | Pre-populate Read-only | This allows for multiple at the moment, again a left over of the merged and migrated emails from Intrepid. Consideration on which one to display and what to allow in an edit scenario. | ||||||||||
| Section 2: DECLARATIONS | |||||||||||||||
| 15A | I confirm I have been appointed to a programme leading to award of CCT | N/A | N/A | Selection Choose one between 15A - 15F | |||||||||||
| 15B | I confirm that I will be seeking specialist registration by application for a CESR | N/A | N/A | Selection Choose one between 15A - 15F | |||||||||||
| 15C | I confirm that I will be seeking specialist registration by application for a CESR CP | N/A | N/A | Selection Choose one between 15A - 15F | |||||||||||
| 15D | I confirm that I will be seeking specialist registration by application for a CEGPR | N/A | N/A | Selection Choose one between 15A - 15F | |||||||||||
| 15E | I confirm that I will be seeking specialist registration by application for a CEGPR CP | N/A | N/A | Selection Choose one between 15A - 15F | |||||||||||
| 15F | I confirm that I am a core trainee, not yet eligible for CCT | N/A | N/A | Selection Choose one between 15A - 15F | |||||||||||
| 16 | Programme Specialty | Curriculum specialty/Programme name | vwProgrammemembership | Pre-populate Read-only | There is no Programme specialty field so we could either use 'Programme name' or the main 'Curriculum Specialty' | ||||||||||
| 17 | Specialty 1 for Award of CCT | Curriculum end date of main curriculum | vwcurriculummembership | Pre-populate if 15A is selected Read-only | |||||||||||
| 18 | Specialty 2 for Award of CCT | Curriculum end date of secondary curriculum | vwcurriculummembership | Pre-populate if 15A is selected Read-only | |||||||||||
| 19 | Royal College / Faculty Assessing Training for the Award of CCT | vwCollege | College | Pre-populate Read-only | |||||||||||
| 20 | Anticipated Completion Date of Current Programme (if known) | vwAssessment | ProgrammeEndDateWithPOG | Pre-populate Calculation Read-only | |||||||||||
| SECTION 3: PROGRAMME | |||||||||||||||
| 21 | Training grade | vwPlacement | GradeName | Pre-populate Read-only | Only applicable if completed post training start date | ||||||||||
| 22 | Date Started | vwPlacement | StartDate | Pre-populate Read-only | Only applicable if completed post training start date | ||||||||||
| 23 | Post Type / Appointment | Programme Membership type | vwProgrammemembership | Pre-populate Read-only Smart Search; FTSTA / LAT / MILITARY / SUBSTANTIVE (default) / VISITOR | |||||||||||
| 24 | Full Time / % of Full Time Training | vwPlacement | WholeTimeEquivalent | Pre-populate Read-only | |||||||||||
| Section 4: SIGNATURE | |||||||||||||||
| 25 | Trainee Signature | N/A | N/A | Populate with Trainee name
| |||||||||||
| 26 | Date | N/A | N/A | Pre-populate
| |||||||||||
| Section 5: HEE ONLY | |||||||||||||||
| 27 | National Training Number / Deanery Reference Number | N/A | N/A | Hidden from trainee until post submission NTN viewable once created No view/editing for Trainee unless submitted (in Historical view) Free Text for Admin | Joanne Watson (Unlicensed), Alistair Pringle (Unlicensed) - further discussion needed; at what point is the NTN created? What is the trigger? (cc Ashley Ransoo) | ||||||||||
| 28 | GMC Programme Approval Number | N/A | N/A | No editing for Trainee No view/editing for Trainee unless submitted Free text for Admin | " | ||||||||||
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