HMT/PMST Frequently Asked Questions
BACKGROUND INFORMATION
What is Pharmaceutical Medicine?
Pharmaceutical Medicine, which became a listed specialty in the UK in April 2002, is the medical scientific discipline concerned with the discovery, development, evaluation, registration, monitoring and medical aspects of the marketing of medicines for the benefit of patients and the health of the community.
The Faculty of Pharmaceutical Medicine (FPM) of the Royal Colleges of Physicians is responsible for ensuring and maintaining standards in the discipline and has developed a curriculum for specialty training to equip physicians with the comprehensive skills and competence increasingly demanded by the industry for the public good.
What is Specialty training in Pharmaceutical Medicine?
Specialty training in Pharmaceutical Medicine is designed to produce accredited pharmaceutical physicians, who are equipped with specialist knowledge and competencies to practise to the highest ethical and professional standards, for the benefit and safety of patients and the public.
This specialty training leads to the award of a Certificate of Completion of Training (CCT) by the Postgraduate Medical Education and Training Board (PMETB). The main route to obtaining specialist registration in Pharmaceutical Medicine is by undertaking Pharmaceutical Medicine Specialty Training (PMST). Prior to 31st July 2007, this training programme was known as Higher Medical Training (HMT) in Pharmaceutical Medicine.
What is the Certificate of Completion of Training (CCT)?
A CCT is awarded to those who successfully complete a programme of specialty training recognised and approved by the PMETB, a body with overall statutory responsibility for defining standards in the specialties. Those who have a CCT can have their names placed on the Specialist Register in Pharmaceutical Medicine held by the UK General Medical Council (GMC).
What is the Specialist Register?
It is a list of names held by the member countries of the European Economic Area (EEA) to allow mutual recognition of competence to practise as a medical specialist.
Are any other countries introducing similar programmes?
There is considerable international interest in the development of HMT in the UK, and specialty recognition for pharmaceutical medicine. Other countries are moving in the same direction as ourselves, but in Europe we are acknowledged to be the leaders.
ENROLMENT
What are the entry requirements for Specialty Training?
To be considered for inclusion in PMST, medical practitioners, must be registered with the GMC and have a job in the pharmaceutical industry (including CROs) or at a regulatory agency, will be expected to have had at least 3-4 years of clinical training and experience. If the individual qualified on or after 2005 they should have completed the Foundation Programme (F1 and F2 posts) and at least two years of post-foundation clinical training in a specialty training programme or appointment before embarking on specialty training in pharmaceutical medicine.
If the individual qualified prior to 2005, they will be expected to have completed the pre-registration House Officer year plus two years as a Senior House officer in approved training posts. Prospective candidates will need to register for training with the FPM, become an Associate (Trainee) member of the FPM and be based in the UK. If you are not sure whether you have the required experience to be eligible for PMST, please contact the Faculty for advice.
Can I enrol if I am practising overseas?
In order to enrol for PMST doctors must be resident in the UK. Following enrolment, PMST may be undertaken overseas, with agreement of the Specialty Advisory Committee (SAC) on Pharmaceutical Medicine. However, a minimum of 50% of the 4-year programme must be undertaken in the UK. From 1 January 2007, doctors with non-EEA clinical training are not eligible for entry to a UK CCT programme, including PMST. Those doctors may undertake PMST training, but on completion, their entry to the GMC's Specialist Register will be determined by fulfilling the requirements of Article 14 of The General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003. Instead of a CCT they would receive a Certificate confirming Eligibility for Specialty Registration (CESR).
When can I apply to enrol in the training programme?
You can apply to be considered for enrolment into the PMST programme if you fulfil the eligibility requirements and as soon as you have commenced working in a post in pharmaceutical medicine.
Are there any exemptions from the PMST programme due to prior training?
Physicians enrolling in the PMST programme may be exempted from the training in one practical Module as a result of prior training in this field. Details of this may be obtained from the Faculty. Applications for Module exemption will be reviewed on an individual basis.
Who will oversee the enrolment?
The Joint Royal Colleges of Physicians Training Board (JRCPTB) and the Specialty Advisory Committee (SAC) in Pharmaceutical Medicine.
How can I enrol in the training programme?
You will need to register with the Faculty and submit a CV detailing, in particular, your postgraduate clinical training for review by the JRCPTB. A format for structuring your CV is available for guidance, which can be downloaded as a Word document from the FPM website if you wish to complete it electronically.
What will I have to do after that?
If approved, you will need to identify an in-practice Educational Supervisor (ES) or Associate Educational Supervisor (AES) to help and advise you through the training process. You and your Supervisor should meet with your Senior Specialty Adviser (SSA), who will be assigned by the Faculty to draw up a personalised programme of training to be submitted to the JRCPTB/SAC for approval.
PROGRESS THROUGH SPECIALTY TRAINING
What do I need to do as I progress through specialty training?
You are responsible for collecting and collating evidence to support your achievement of the required experience in the different Modules of PMST. The personal training plan will map out how such experience will be gained. The PMST curriculum presents detail on the different items within the various Modules and you should use this detail when considering which in work activities could provide relevant experience.
When documenting evidence of such experience, you should save hard copies of outputs or activities that make it obvious that you have had experience of the Module Item to which the evidence has been referenced. For example, a track changed (by yourself) patient information leaflet could be used to support experience of Regulatory, product-related literature. Your evidence will be reviewed annually at the Annual Review of Competence Progression (ARCP), previously known as the Record of in Training Assessment (RITA) Meeting.
How much evidence do I need to collect and how should I do this?
The required amount of evidence for each Item of the different Modules will vary depending on the Module and the type of activity. Clear understanding of the Item and the level of competency required will help guide the types and volume of evidence required. In general most trainees collect 1-3 pieces of evidence to support the required competency in each Module Item. Your ES/AES will be able to provide guidance on what and how much to collect.
When building your evidence folder, it would be advisable to store evidence in line with the different Modules and Items. When cross-referencing to a piece of evidence in another part of the evidence folder (i.e. when one piece of evidence is relevant to two or more Items) you could consider inserting a clear reference to the original evidence or including a copy of the evidence validation form or the evidence itself. What has proven to be useful in training records is a summary of the provided evidence for each Item within a Module, indexed to the relevant evidence, at the beginning of each Module section of the evidence file.
What are examples of appropriate evidence?
Anything that shows that you have had experience in Module Items as listed in the PMST curriculum. This may include emails, course attendance, presentations, regulatory documents, meeting minutes, trial protocols and reviews of promotional materials.
To improve clarity and to help define your role in the particular activity it may be useful for you to provide a comment or note as to how the evidence links to the Module Item and your specific role. The trainee commentary form, which should accompany a particular item of evidence, has been provided for this.
Are there any tips to ensure a successful Annual Review (ARCP)?
A well organised evidence file and well prepared supporting ARCP documents will ensure that the annual review goes smoothly. Regular interaction with the ES/AES and early and consistent collection of relevant evidence, together with clear summaries and indexing will make the ARCP Panel's role easier. A disorganised and unclear training file could reflect poorly on you even if you have been exposed to the appropriate aspects of pharmaceutical medicine - demonstrating that you've acquired the experience is as valuable as getting the experience when it comes to asking for accreditation of the training.
What are the responsibilities of the SSA and how often should we meet?
The SSA has responsibility for overseeing the PMST programme, followed by individuals, both within a training environment and across several training environments. The role of SSA is a joint appointment of the Faculty and Lead Postgraduate Dean (PGD) and he/she will normally be responsible for all trainees at a particular company or location (if the company is large and has several locations).
The SSA will normally be a Fellow of the Faculty, experienced at a senior level in pharmaceutical / regulatory medicine as well as in staff supervision, appraisal and assessment, and is committed to continuing professional development in general with a particular emphasis on PMST. Other than meeting with you at the enrolment meeting or prior to the start of PMST, to agree the training programme, there are no set rules as to when and how often a trainee should meet with their SSA. However, most trainees will meet or correspond with their organisation's SSA once or twice a year.
What are the responsibilities of the ES and how often should we meet?
The ES is responsible to the Faculty and the Postgraduate Dean (PGD) for monitoring your performance. The ES should maintain adequate records of interactions with you, including competency assessments and appraisals. The ES will normally be your medical manager and work at the same site. The ES must be a registered doctor and an experienced pharmaceutical physician who is normally a Member or Fellow of the FPM. The ES will provide guidance on how best to record and file evidence of different elements of relevant modules and also reviewing such evidence to allow appropriate confirmation that the trainee has achieved the required experience.
The ES should be in regular contact with you on a 1-2-weekly basis. More formal meetings, with a written record, should occur in the early stages of training at least monthly and might be more often. In the later stages, contact might be less frequent, and the level of supervision may be less depending on the trainee's acquisition of competencies and experience. The ES and you should undertake formal educational appraisals on a regular basis (for example, 4-monthly) and a formal annual performance appraisal for PMST prior to the annual ARCP Meeting.
What are the responsibilities of the Associate ES (AES) and how often should we meet?
The AES carries out the same role and has the same responsibilities as an ES and can act as a signatory on HMT/PMST documents and attend RITA/ARCP Meetings with their respective trainees. The one difference however, will be that the sign-off documents ('training logs') will need to be counter-signed by the ES or SSA. The Specialty Advisory Committee on Pharmaceutical Medicine (SAC) decided to create the role of the AES so that managers who are not medically qualified could supervise their trainees. The essential criteria for the AES is similar to the ES except the AES has to hold a scientific qualification and needs to identify an ES who will counter-sign the trainee's sign-off documents.
PROGRAMME
How will the programme be delivered?
An individual training plan will be developed to propose how you will achieve experience in all the various aspects of the seven modules of PMST. The individual training plan should be decided by the individual in consultation with their ES/AES and their Senior Specialty Adviser (SSA). Most training plans will be achieved through a mixture of on-the-job experience and external courses.
How long will it take?
A minimum of four years from entry into the PMST programme.
Is there a maximum time?
Yes. Eight years from the date of enrolment.
How is the programme structured?
Practical PMST comprises a modular programme in six fields of practice in pharmaceutical medicine: Medicines Regulation, Clinical Pharmacology, Statistics and Data Management, Clinical Development, Healthcare Marketplace and Drug Safety Surveillance; and a seventh, generic, module, which encompasses Interpersonal and Management Skills and the principles of Good Pharmaceutical Medical Practice, relevant to the ethical and professional work of a pharmaceutical physician practising outside the NHS. The duration of PMST will be at least four years, within which time the candidate will be expected to have passed the Diploma in Pharmaceutical Medicine (DPM) exam and have collected the evidence to document appropriate experience of the specifics of the seven modules.
Will it interfere with my day job?
The majority of trainee pharmaceutical physicians already spend 15+ days per year in off-site training, particularly if they attend one of the postgraduate courses in pharmaceutical medicine to prepare for the Diploma exam, and this will not change compared with previous years. The parts of PMST that involve on-the-job activity will require minimal additional time to ensure adequate recording of the experience gained. Where external courses are required, to fill those parts of the programme not available in-work, time away from the day job will be required.
What if I have already passed the Diploma in Pharmaceutical Medicine (DPM) exam?
You will not be required to sit the DPM exam again. You will still be required to collect evidence of completion of the modules of PMST, over the minimum 4-year duration of the programme.
What are the topics covered by PMST?
PMST comprises a modular programme in six fields of practice in pharmaceutical medicine: Medicines Regulation, Clinical Pharmacology, Statistics and Data Management, Clinical Development, Healthcare Marketplace and Drug Safety Surveillance; and a seventh, generic, module, which encompasses Interpersonal and Management Skills and the principles of Good Pharmaceutical Medical Practice relevant to the ethical and professional work of a pharmaceutical physician practising outside the NHS.
Where can I find more details of the Specialty Training curriculum?
By visiting the FPM web site and clicking on PMST/HMT or Exams. The PMST curriculum contains within it the Syllabus for Pharmaceutical Medicine, which is the syllabus for the DPM, the knowledge base of PMST.
Will everyone have the opportunity to do the minimum of two on-the-job Modules?
Widespread consultation has indicated that, given a flexible approach, this should be possible.
What about staff in highly specialised posts?
Each individual will have his or her job plan reviewed by a SSA to confirm areas, which match the curriculum. A personal plan will then be developed to encompass on-the-job-training and internal and external courses. However, it has also to be expected that not all such specialised posts will be considered appropriate for physicians undertaking PMST.
Do I have to cover the Modules that I will not experience on the job?
Yes, to ensure breadth of experience.
COURSES
Why might I need to do an external course?
You will develop your own personal training plan in consultation with your SSA and ES/AES. If it is believed that the required level of experience in any particular Module is not achievable through in-work experience, an external course will be included in your plan. For each of the six operational Modules approved interactive courses are available, offered by independent course providers under contract with the FPM. The SAC, on advice from the FPM, approves each course. The course programme must be mapped against the requirements of the module curriculum.
Who will provide these?
Current course providers are academic, public, professional or commercial bodies.
Will these courses be quality managed (QM) by the FPM?
For each of the six operational Modules, approved interactive courses are available, offered by independent course providers under contract with the FPM. The SAC, on advice from the FPM, approves each course. The course programme must be mapped against the requirements of the Module curriculum. Each course is quality managed through a QM Panel chaired by a QM Convenor. Typically the QM Panel provides observers for the courses and, together with feedback on course content, conduct and candidates, fulfils the QM requirements for the SAC and PGD on quality and standards of the courses.
Where can I find information about these courses?
Course information will be added to and maintained on the FPM website as it becomes available.
Will there be any sort of assessment?
External courses have their own assessment of achievement for the course. With respect to adequate experience in a Module undertaken through in-work experience, competency in each area will be assessed by your ES/AES. Additionally, an annual review of your progress will be undertaken.
Will the Faculty have a role in Module course assessment?
Yes, it will ensure that standards are maintained by monitoring the performance of participants and by approving and providing QM of the Module courses.
What about other courses?
Not all the Items of an in-work Module may be offered in the workplace, and it may be necessary to attend a course to complete the Module. Courses can be in the workplace or external. Attendance on them is decided between the trainee and ES/AES as fit-for-purpose, and assessments of competencies or learning acquired are conducted, not by the course provider as for an approved Module course, but by the ES/AES, as for in-work activity. Such courses are usually short, 1-2 days, and are provided by pharmaceutical companies, industry and professional bodies, academic and commercial providers.
What is the Industry and the Regulatory Authorities' position on PMST?
The proposals have been supported by the Association of the British Pharmaceutical Industry (ABPI) and the Medicines and Healthcare products Regulatory Agency (MHRA).
How can I learn of further developments?
By reviewing the FPM web site, and by registering your e-mail address with the Faculty.
ADVANTAGES / DISADVANTAGES
What are the advantages of going through the PMST programme for pharmaceutical medicine?
The PMST programme provides an approved and structured plan to help Pharmaceutical Physicians gain knowledge of and experience in all important aspects of the specialty. It will be of benefit to those who have recently joined the specialty either in industry or the regulatory authorities, giving them a more thorough and much broader view of the specialty than they will gain simply by carrying out their jobs. Evidence of progression through the PMST programme will also provide potential employers with a benchmark for the capabilities of applicants.
What are the benefits to my employer?
By offering specialty training it is expected that employers will attract and retain high calibre staff. In addition, it is expected that pharmaceutical physicians will be able to provide benefits to the organisation in terms of higher quality contributions based on broader knowledge and insights.
Are there any other advantages?
Yes. The programme is structured and quality managed by the FPM, the standard-setting body for the specialty in the UK.
Will I have to be on the Specialist Register to engage in Regulatory activities?
No.
Will my career be affected if I don't engage in PMST?
At the moment no, but the GMC may consider the Specialty Training Record as part of the process of revalidation.
Can I use the PMST programme for Continuing Professional Development (CPD) and for keeping up to date?
Yes. Furthermore, it will help you to meet some of the requirements of revalidation. Please inform the FPM's Education Department if you wish to use your PMST programme for CPD.
Are there any drawbacks?
Only the time spent in completing any assigned work to fulfil the PMST programme.
Who will pay for it?
In other Medical Specialties, it is the individual that usually pays for their specialty training. However, in the majority of cases the participant's employer will fund PMST.
Updated October 2008
If you have further questions, please contact the Faculty office.
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