What is different
UK GP training expects you to write openly about uncertainty, mistakes and feelings. This is seen as professional insight, not weakness. Panels also look for a steady record over time rather than a final exam.
The numbers by year
| Requirement | ST1 | ST2 | ST3 |
|---|---|---|---|
| Clinical case reviews (CCRs) | 36 per year 18 per review | 36 per year 18 per review | 36 per year 18 per review |
| Consultation Observation Tool (COT), including Audio-COT check current RCGP guidance | 4 per year 2 per review COT in GP posts, mini-CEX in hospital posts; combined total 4 | 4 per year 2 per review combined COT/mini-CEX total 4 | 7 per year all COT; e.g. 6 face-to-face + 1 Audio-COT |
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 case reviews (CCRs), LTFT: Pro rata: e.g. 60% = 36 per training year spread over 20 months, about 11 per 6-month review.
- Consultation Observation Tool (COT), including Audio-COT, LTFT: Pro rata per review period; the per-training-year total is the same.
- Consultation Observation Tool (COT), including Audio-COT, confidence: high (totals and audio rule); medium (per-review split of 2, which is a suggested spread). Our sources were partly secondary for this item: check current RCGP guidance.
How to do it well
- Reflection is a skill, not a confession. Use the five-heading CCR structure and the phrases in Reflection that scores.
- Ask to see good examples from your trainer and peers (anonymised), and read the RCGP worked examples.
- Show what you bring. Experience of other health systems, languages and cultures is strong evidence for Communication, An ethical approach and Community health. Write about it.
- Learn the NHS systems (referral pathways, urgent suspected cancer criteria, safeguarding routes, the roles of practice staff) and log what you learn: it evidences Organisation, management and leadership.
- Communication in COTs: practise signposting, checking understanding and shared decisions; ask for COTs early so feedback comes in time.
- Interpreter consultations make excellent COTs and CCRs.
- Ethics and law: consent, capacity, confidentiality and children's rights may differ from where you trained. The GMC's free "Welcome to UK practice" session helps; reflect on it.
- Support: ask your deanery about IMG and differential attainment support, including communication skills programmes. Raise concerns early: help is easier to arrange before an ESR than after.
- Visa: LTFT, time out and unpaid leave may affect sponsorship; check with your employer's sponsorship team first.
Common ARCP pitfalls
- Logs that describe cases well but never say what you will change.
- Waiting until the ESR to mention that you are struggling.
- COTs left late, so there is no time to act on feedback.