| Order | Field name | DR field | Source 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) | Summary (S) / Detail (D) | Notes | Delete field | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Form R - Part A | |||||||||||||||
| 1 | Forename | Pre-populate | |||||||||||||
| 2 | GMC-Registered Surname | Pre-populate | |||||||||||||
| 3 | GMC Number | Pre-populate | |||||||||||||
| 4 | Deanery / HEE Local Team | Pre-populate | |||||||||||||
| 5 | DOB | Pre-populate | |||||||||||||
| 6 | Gender | Pre-populate | |||||||||||||
| 7 | Immigration Status | Pre-populate | |||||||||||||
| 8 | Primary Qualification | Pre-populate | |||||||||||||
| 9 | Date Awarded | Pre-populate | |||||||||||||
| 10 | Medical School Awarding Primary Qualification (name and country) | Pre-populate | |||||||||||||
| 11 | Home address | Pre-populate | |||||||||||||
| 12 | Contact Telephone | Pre-populate | |||||||||||||
| 13 | Contact Mobile | Pre-populate | |||||||||||||
| 14 | Email Address | Pre-populate | |||||||||||||
| 15A | I confirm I have been appointed to a programme leading to award of CCT | Selection | |||||||||||||
| 15B | I confirm that I will be seeking specialist registration by application for a CESR | Selection | |||||||||||||
| 15C | I confirm that I will be seeking specialist registration by application for a CESR CP | Selection | |||||||||||||
| 15D | I confirm that I will be seeking specialist registration by application for a CEGPR | Selection | |||||||||||||
| 15E | I confirm that I will be seeking specialist registration by application for a CEGPR CP | Selection | |||||||||||||
| 15F | I confirm that I am a core trainee, not yet eligible for CCT | Selection | |||||||||||||
| 16 | Programme Specialty | Pre-populate | |||||||||||||
| 17 | Specialty 1 for Award of CCT | Pre-populate | |||||||||||||
| 18 | Specialty 2 for Award of CCT | Pre-populate | |||||||||||||
| 19 | Royal College / Faculty Assessing Training for the Award of CCT | Pre-populate | |||||||||||||
| 20 | Anticipated Completion Date of Current Programme (if known) | Pre-populate Calculation | |||||||||||||
| 21 | Training grade | Pre-populate | |||||||||||||
| 22 | Date Started | Pre-populate | |||||||||||||
| 23 | Post Type / Appointment | Pre-populate | |||||||||||||
| 24 | Full Time / % of Full Time Training | Pre-populate | |||||||||||||
| 25 | Trainee Signature | TBC | |||||||||||||
| 26 | Date | Pre-populate Today's Date (of submission) | |||||||||||||
| 27 | National Training Number / Deanery Reference Number | No editing for Trainee Free Text for Admin | |||||||||||||
| 28 | GMC Programme Approval Number | No editing for Trainee Free text for Admin | |||||||||||||
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