Trials and tribulations of the annual review of competence progression - lessons learned from core medical training in London.

The annual review of competence progression (ARCP) was introduced as a way of keeping records and reviewing satisfactory progress through a medical curriculum for doctors in training. It provides public assurance that doctors are trained to a satisfactory standard and are fit for purpose. A routine external review of the core medical training (CMT) ARCPs in London revealed documentation of satisfactory progression of trainees to the next level of training without the evidence to support their completion of the curriculum. An internal review and series of process interventions were subsequently conducted and implemented to improve the quality and standardisation of the ARCPs. This paper reviews these interventions, discusses the lessons learned from the internal review and highlights issues applicable to any ARCP process.