Skip to content
Login Register

Statement on continued derogations in medical education and training

20 Sep 2021

Throughout the pandemic, the General Medical Council (GMC), statutory education bodies (SEBs), Academy of Medical Royal Colleges (AoMRC) and trainee representatives have worked collaboratively to consider if and when derogations were required to postgraduate education and training.

This statement was originally published by the General Medical Council.

Throughout the pandemic, the General Medical Council (GMC), statutory education bodies (SEBs), Academy of Medical Royal Colleges (AoMRC) and trainee representatives have worked collaboratively to consider if and when derogations were required to postgraduate education and training.

Given that medical education and training continues to be disrupted by the COVID-19 pandemic, there is consensus that the temporary derogations will need to continue, relating to:

  • Postgraduate curricula and assessment.
  • The Annual Review of Competency Progression (ARCP). 
  • Adapted ARCP panels and outcomes.
  • Progression without exams.
  • Progression without having gained expected capabilities/competences or without sufficient evidence.
  • Progression with alternative evidence of capability.

The standards and expectations for achieving the certificate of completion of training (CCT) remain in place.

Postgraduate curricula and assessment

GMC-approved methods of online training and assessments have been introduced in response to the disruption caused by the pandemic. We encourage the continuation of these as far as possible, while we explore the impact of the changes. Colleges and Faculties that want to return to GMC-approved face to face clinical assessments should consider the following:

  • Equality, diversity and inclusion (ED&I) impacts.
  • Impact on trainees and trainers.
  • Changed profile of patients.
  • Impact on service delivery.
  • Efficiency and effectiveness of processes.

Annual Review of Competency Progression (ARCP)

Outcomes described in Gold Guide 8 should be used where possible. If trainees meet the GMC-approved amended decision aid requirements, then they should get an Outcome 1 or 6. If they do not meet GMC-approved amended decision aid requirements and:

  1. Can progress – they should get an Outcome 2 or an Outcome 10.1 (if COVID-19-related).
  2. Can’t progress (due to being at a critical progression point or due to patient safety issues) – they should get an Outcome 3 or Outcome 10.2 (if COVID-related).

Assurances for trainees

Trainees who have progressed during this period, where derogations have been in place, will not be asked to retrospectively complete elements of training, where the derogations had stated they were not needed at the time. Where trainees have progressed with outcome 10.1 they will only be required to complete the curricula requirements identified as part of their progression.

Period of approval

This policy and the temporary derogations will remain in place during the period of major disruption to training caused by the pandemic. We will continue to monitor and review the need for the derogations and the GMC will only remove derogations after this has been fully discussed by ourselves and the wider system including individual medical royal colleges and faculties. 

Previous statements

In March 2020, the AoMRC, four SEBs and the GMC published a joint statement, stating that we would permit derogations, to enable progression for doctors in training during the period of disruption caused by the pandemic.

In the April 2021 update, the GMC considered additional requests for temporary derogations to curriculum requirements that would maintain standards and ensure patient safety to enable doctors’ continued progression in line with the principles outlined below.

Full details on derogations in the previous statements are provided in the links above and key points are detailed below.

Principles for approving temporary derogations to curricula and assessments

The following ‘Excellence by design’ principles will continue to be used when considering derogations to curricula and assessments to support ARCP decisions during this period:

  • Patient safety is paramount. It sits at the core of education standards and trainees must not work beyond their competence.
  • Maintaining standards. The standard for entry to the specialist and GP register remains consistent. Trainees must meet all learning outcomes at the level of performance required for entry to the specialist and GP registers. 
  • We are looking to holistically assess a doctor’s competency not quantity of assessments or clinical activity completed. 
  • We are looking to assess whether outcomes are achieved not the time spent working in a particular area.
  • We need to maintain proportionality and support diversity. 

It is expected that there should be flexibility in how achievement of the curricula learning outcomes can be evidenced. The GMC Excellence by design standards enable us to use discretion in accepting a range of evidence and supporting information to show competency progression.

This might include but is not limited to courses, techniques and approaches that best meet local arrangements and resources.

Where serious patient safety concerns may exist, explicit proportional mandatory minimum curricula requirements should be specified. These generally occur at critical progression points and rationale, with clarity that there is no other alternative evidence, and the requirements should be explicit in the derogation. The expectation is that this would not apply at the point when a CCT would be awarded.

Looking forward

Changes made to medical education and training in response to the pandemic, present an opportunity to consider whether any of these changes have improved the education and training experience of training programmes and so should be embedded in the longer term. In particular, we are seeking to understand if any of these changes may help engender a:

  • More equitable training process.
  • More streamlined and flexible progression process.
  • More resilient and adaptable curricula.
  • More progressive evaluation with a reduced assessment burden.

We are undertaking this work collaboratively with other stakeholders.

The GMC, SEBs and AoMRC are mindful of the significant pressures on the health services across the UK. It is therefore important that we all, with others in the NHS, continue to strive to ensure training and progression can continue, minimising the negative impact on trainees, and maintaining patient safety standards. 

Category: Workforce

Share this story:

Latest news and statements

Key priority areas

Workforce Recovery and Transformation
Health services in many parts of the world are over-stretched due to workforce shortages, rising demand for services and difficulties in retaining staff.
Read more
A healthy healthcare workforce is essential for patient care. When the workforce is exhausted, experiencing burnout, and struggling to balance their work and personal lives, it impacts on everyone.
Read more
Equality, Diversity and Inclusion
We are committed to standing up for equality, diversity and inclusion. We want our College to reflect the diversity in the NHS workforce and in the patients that we care for.
Read more
Climate Change and Sustainability
Climate change has caused great harm to our planet and warnings of increasingly extreme heatwaves, droughts and flooding will all place a significant burden on our health outcomes.
Read more
Health Inequalities
The health inequalities in our society have been both highlighted and exacerbated by the covid pandemic. There is a need to do things differently.
Read more
The COVID-19 pandemic has had a huge impact on the lives of healthcare professionals, and the urgent need to learn whilemfocusing on delivering the best care for our patients has been an enormous challenge.
Read more



Key links

Contact us

Log in

Log in to access your Dashboard, book events, pay your subscriptions and access eLearning material.

Log in

Register an account

New users must register before logging in. You do not need to be a member of the College in order to register.



Having difficulty registering or logging in? Forgotten your username or password?

Get Help