Maintaining Competence & Continuous Professional Development (CPD)

SJT Textbook: Maintaining Competence & CPD

Maintaining Competence and CPD (GMC)

This maintaining competence and CPD GMC guide explains how limits of practice, escalation, supervision and time-bound PDP planning are tested in MSRA SJT scenarios.

🎥 Video Lesson (YouTube)

🎧 Podcast Lesson (Spotify / Apple / Amazon)

🎯 THE CORE PRINCIPLE

Maintaining competence means practising safely within your current abilities and only undertaking tasks for which you have the necessary skills, knowledge, and supervision. When a situation exceeds your competence, you must stabilise the patient within your scope and ensure someone more experienced takes over or directly supervises.

Continuous professional development (CPD) is the planned, ongoing learning that keeps your practice up to date and responsive to new evidence, feedback, and incidents. It feeds into appraisal and revalidation and should address real gaps identified in day-to-day work.

In MSRA SJT questions, competent behaviour looks like early recognition of limits, honest communication with colleagues (and patients where relevant), prompt escalation, clear documentation, and converting learning needs into a specific, realistic CPD plan. Unsafe “have a go” behaviour, working with lapsed critical certification, or ignoring feedback will score poorly.

The maintaining competence and CPD GMC standards require doctors to recognise limits and seek supervision early.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Perform a quick risk check: ask “Can I safely do this now with my current skills and available support?” and act accordingly.
2. Escalate early to a suitably experienced clinician for tasks beyond your competence.
3. Stabilise the patient using protocols and interventions you are competent to deliver while waiting for help.
4. Be honest about your level of experience with colleagues and, where relevant, with patients for valid consent.
5. Document your assessment, who you escalated to, agreed thresholds for review, and the management plan.
6. Translate incidents, near-misses, and feedback into specific PDP actions (e.g. named course, supervised list, simulation, reading with reflection).
7. Keep essential certifications (e.g. ILS/BLS) in date and seek immediate cover plus urgent renewal if they lapse.
8. Delegate tasks only to people with appropriate skills and ensure adequate supervision is in place.

MSRA SJT scenarios often expose failures in maintaining competence and CPD GMC through unsafe “have a go” behaviour.

Avoid any option that trades immediate safety for pride, speed, or convenience, or that hides limitations instead of addressing them.

Lapsed ILS/BLS and acute on-call shifts are classic maintaining competence and CPD GMC problems.

💬 MODEL PHRASES (Use These in SJT Logic)

* “My ILS has expired; I have informed the rota and duty consultant, arranged competent cover, and booked the earliest renewal.”
* “I have documented my assessment, escalation, and will add a PDP action for supervised practice and simulation.”
* “I am not experienced enough to perform this alone; we need someone competent to perform or supervise it.”
* “I will complete the sepsis bundle I am competent to deliver while an experienced colleague comes to review.”

Turning incidents into PDP actions is central to maintaining competence and CPD GMC guidance.

Check competence • Plan learning • Document • Supervise/seek help • Act for safety • Feedback/Evaluate

📋 QUICK FAQ

What should I do if my ILS/BLS certificate has expired before an acute shift?
Inform the rota coordinator and duty consultant immediately, arrange competent cover for emergencies, book urgent renewal, and record a PDP action so the situation does not recur.

Can I rely on phone supervision for a complex invasive procedure?
Usually not. For high-risk or technically demanding tasks, stabilise the patient and insist on in-person supervision or a competent practitioner to perform the procedure.

What counts as meaningful CPD for appraisal?
Courses, simulation, supervised learning events, guideline updates, QI/audit, teaching, and concise reflective entries, all clearly linked to your PDP and real learning needs.

Should I tell patients if I am inexperienced with a procedure?
Yes if it materially affects risk or consent. Involve a suitably experienced colleague, explain the situation honestly, and document the discussion and plan.

How do I demonstrate learning in SJT-style answers?
Show that you record events factually, escalate appropriately, and convert gaps into specific, time-bound CPD actions that will be revisited at supervision or appraisal.

Safe delegation and escalation form part of maintaining competence and CPD GMC expectations in practice.

📚 GMC ANCHOR POINTS

• Keep your knowledge and skills up to date; work within your competence and seek supervision (GMC Good Medical Practice 2024, paras 6–8).
• Take part in CPD and appraisal to maintain and improve your performance (Continuing professional development guidance).
• Delegate and refer safely, ensuring the person has the right skills and supervision (Delegation and referral guidance).
• Raise and act on concerns promptly when patient safety may be compromised (Raising and acting on concerns about patient safety).
• Maintain accurate, timely records that support safe ongoing care (record-keeping sections in GMC and NHS documentation guidance).

💡 MINI PRACTICE SCENARIO

You discover on the day that your Immediate Life Support (ILS) certificate has expired, but you are rota’d to cover the acute medical take that evening. The rota is tight, and colleagues suggest you “just get on with it”.

Best action: Inform the rota coordinator and duty consultant immediately, arrange competent cover for resuscitation and acute emergencies, and book urgent ILS renewal with a documented PDP plan.
Why: This protects patient safety, is honest about your limits, and provides a concrete CPD solution rather than working unsafely or hiding the problem.

🎯 KEY TAKEAWAYS

✓ Safety and supervision always come before speed and convenience
✓ Recognising and admitting limits is professional, not weak
✓ Escalate early, stabilise within your competence, and do not bluff
✓ Document assessment, escalation, and follow-up plans clearly
✓ Use incidents, feedback, and near-misses to drive specific CPD and PDP actions

🔗 RELATED TOPICS

* → Self-awareness & Insight
* → Delegation and Supervision
* → Raising and Acting on Concerns
* → Managing Fatigue & Impairment
* → Documentation and Record-Keeping

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

Your Immediate Life Support (ILS) certificate has expired. You notice this on the morning rota, which has you down to cover the acute take tonight, including potential cardiac arrest calls. The rota is already stretched and colleagues tell you that “everyone is in the same boat” and you should just carry on.

Options:
A. Work the shift as planned and arrange ILS renewal next week when things are quieter.
B. Inform the rota coordinator and duty consultant now and arrange competent cover for arrest calls and acute take.
C. Book urgent ILS renewal and complete any required e-learning, confirming the earliest available course date.
D. Attend the shift but avoid responding to any arrest calls and hope others can cover them.
E. Document the issue and email your educational or clinical supervisor with a PDP to prevent this happening again.
F. Ask a colleague to sign you off informally so you appear in-date on the system.
G. Request a swap to a non-acute area while competent cover is organised, even if it means cancelling teaching.
H. Only tell someone if a cardiac arrest actually occurs during your shift.

Example SJT — Rank 5 (best → worst)

You are covering the Acute Medical Unit. Three tasks appear simultaneously:

1. A new sepsis case needing urgent IV antibiotics and possible central venous access, which you have never performed in a real patient.
2. A bedside teaching session you arranged for medical students.
3. An e-learning module on safe prescribing that expires at midnight and is required for your appraisal.

Options:
A. Escalate the sepsis case to an experienced clinician immediately, commence the sepsis bundle you are competent to deliver, and defer central access to a trained practitioner.
B. Attend your teaching session to avoid cancelling, then review the sepsis case afterwards once students are finished.
C. Attempt central venous access yourself, having watched an online video, and call for help only if complications arise.
D. Delay antibiotics until you complete the prescribing e-learning so your training record is up to date first.
E. Prioritise assessment and treatment of the sepsis patient now, planning to complete the e-learning after your shift and documenting this if needed.