Development of a competency framework for general practitioners with a special interest in musculoskeletal/rheumatology practice.

This document outlines a competency framework for general practitioners with a special interest (GPwSI) in musculoskeletal/ rheumatology practice, which has been developed by a working group, consisting of clinicians from general practice, musculoskeletal medicine and rheumatology including representatives from the Primary Care Rheumatology Society, the Royal College of General Practitioners, the British Institute for Musculoskeletal Medicine, the British Society for Rheumatology, The Royal College of Physicians and the Arthritis Research Campaign (GP Working Party of the Education Subcommittee). The objective of this working group was to bring together appropriate expertise to debate the content of a curriculum for GPwSI’s working within the musculoskeletal/rheumatology field, and to produce a framework of appropriate competencies (knowledge and skills) to inform the content of such a curriculum. The Working Party acknowledged that the confusion still exists about the definition of a GPwSI [1]. For this piece of work the following definition was agreed: A GPwSI is defined as a general practitioner who supplements their core professional role, and/or undertakes advanced procedures not normally undertaken by their peers. They will have demonstrated appropriate skills and competencies to deliver an enhanced service, be able to work independently within a defined quality framework, in a clinical area outside the normal general practice setting and be able to accept referrals from colleagues. Robust procedures for clinical governance will be developed locally to assure patients and commissioners that they operate within a coherent and quality assured clinical pathway. In approaching this work, the working group acknowledged that there were different levels of GP competence to be aware of. For example, in 2000 arc produced a Learning Guide for GPs and GP Registrars, which outlined a curriculum and competencies required to achieve a summative assessment level of competence [2]. This will subsequently be referred to as the generalist level of competence. The Royal College of General Practitioners (RCGP) has written a GP curriculum for general practice training (see RCGP website). This will come into effect from August 2007. The current piece of work concerns competencies to be achieved by all musculoskeletal/ rheumatology GPwSIs. The group acknowledged that there may also be a further level of competencies for GPwSI working within specialist areas within a musculoskeletal/rheumatology service (e.g. paediatrics, inflammatory arthritis, sports medicine). The working group did not address this latter area. Hence, the aim of this working group was to develop a specialty-specific set of competencies required by a GPwSI working within the field of musculoskeletal/rheumatology practice. Other agencies are developing the generic competencies common to all GPwSIs and are considering what mechanisms are appropriate for GPwSIs to demonstrate acquisition of appropriate competencies.