What it is
The five intimate examinations
- Breast
- Rectal
- Prostate
- Male genital
- Female genital, including speculum and bimanual pelvic examination
Each needs an observer's CEPS form. They are mandatory, but on their own they do not show competence in examination. Some deaneries count speculum and bimanual separately: check locally.
The range
The portfolio has system categories for observed CEPS (typically respiratory, ENT, abdominal, cardiovascular, musculoskeletal, neurological, and child aged 1 to 5) check current RCGP guidance. The RCGP sets no fixed total. Two CEPS, or many of a single type, will not show a range.
Other useful CEPS: fundoscopy, thyroid, skin lesions and dermatoscopy, mental state examination, baby checks, joint or intramuscular injections, cervical screening, coil or implant fitting if trained, diabetic foot checks, postural blood pressure.
The numbers by year
| Requirement | ST1 | ST2 | ST3 |
|---|---|---|---|
| Clinical Examination and Procedural Skills (CEPS) | ongoing, no fixed number | ongoing, no fixed number | all 5 intimate examinations completed by end of ST3 plus a range |
Full time, per training year unless stated. Less than full time: per-year totals stay the same and each 6-month review needs a pro rata share; 6-monthly ESRs and 12-monthly certificates are not pro rata. Check with your deanery and educational supervisor.
Notes on these numbers
- Clinical Examination and Procedural Skills (CEPS), LTFT: Same final requirement.
Who can observe
A doctor at ST4 or above, an SAS doctor with equivalent experience, or another trained professional who performs that examination in their own work (for example a specialist nurse, who records their role). Never a peer at your stage. It must be a real patient in a real clinical setting: skills labs, simulation and insurance medicals do not count.
How to do it well
- Start in ST1. Gynaecology, urology, surgery and ED posts give intimate examination chances; so do GP posts with a nurse colleague observing a smear or your trainer observing a breast lump assessment.
- Offer a chaperone and record the offer and the patient's choice.
- Get the form completed the same day.
- Remember that the patient decides what is intimate to them.
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Common ARCP pitfalls
- Intimate CEPS left to the last months of ST3, when chances are unpredictable.
- Observations by a peer, or in a skills lab: they do not count.
- A "range" of two, or all of one type.
- No chaperone offer recorded.