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The Royal College of Physicians (London) has long had in place, a network of Regional Specialty Advisers to provide advice to the College on service and training issues within the regions of England, and in Northern Ireland and Wales.

In Scotland there exist Specialty Training Advisers whose names I have listed below and whose function would cover matters similar to those contained under Higher Specialist Training in the RCP London job description quoted below. Likewise in respect of the Republic of Ireland. The purpose of this article however is to provide information, and hopefully clarity over the role of the Specialty Advisers and their mode of appointment south and south-west of the border.

Terminology
At one time the advisory functions were, for geriatric medicine, in each region combined into one single function. Since 1997 the BGS has in half the regions, divided the workload between two separate advisers. Thus were created:

The Specialty College Adviser (whom the College call Regional Specialty Adviser - Service) to advise on job descriptions for planned consultant appointments, on the suitability of individuals for election to Fellowship and on advisory committees, on service standards and service delivery.

The Specialty Training Adviser to handle the many issues appertaining to training, listed in the RCP’s job description. Whereas this was once called the Dean’s Adviser and still includes this element, it is now very much a joint appointment to the College and the Post Graduate Dean.

In addition, the BGS has in 11 regions an Academic Adviser to assist members on research and academic development. Unlike the previous two appointments, the Academic Adviser appointment is independent of the College, being peculiar to the Specialty.

The RCP job description and the BGS
The central RCP job description, quoted in full below, relates to a combined role of Regional Specialty Adviser - Service and Training Adviser, giving a more detailed description of the training role. In the case of the service role, advisers would be sent consultants’ job descriptions by the College’s main Regional Advisers, and asked to comment on any aspect of the job description which seemed unreasonable or unacceptable on specific grounds. They would also be asked to comment on nominations to Fellowship of the College - this request would come either from the Regional Adviser or from the College’s Membership Department.

What the RCP central job description emphasises is that ‘it is essential that’ the Regional Specialty Adviser - Service and Specialty Training Adviser liaise closely together.

Appointment; the BGS proposes, the RCP disposes
It is customary for the regional officers in each BGS region to put forward to the College a candidate to fulfil the role(s) of Specialty Adviser(s). So far the College has always seen fit to accept the recommendations, which is no doubt evidence that the BGS regional officers have put forward appropriate and suitably qualified candidates to fill the post(s).

How the regional officers decide on their recommendation is a regional affair and neither the College nor the BGS centrally has sought to influence this. However, clearly it is in the interests of both the Society and the Specialty that the College be given the best possible advice on both service and training matters, so it is the quality of the appointee that counts. For this reason it may be more appropriate to select the person(s) generally recognised as leading in service and training, rather than inviting nominations and holding an election, unless it be to decide between two particularly outstanding candidates.
The appointments are for three years, but may, with College approval, be extended.

Richard Lynham
Administrative Director

Royal College of Physicians London

Functions of Regional Specialty Advisers

Introduction
These appointees have a major role in overseeing Higher Specialty Training in the relevant specialty or specialties. They are also able to advise the Regional Adviser on matters relevant to the specialty such as consultant job descriptions and Advisory Appointment Committees.

Higher specialist training
For Higher Specialist Training Programmes, Specialty Advisers are responsible for the following:-

a) The development of the new training programmes.
b) The supervision of higher trainees during their rotation through the programme.
c) Representation on Appointments Committees for specialist registrars.
d) Making arrangements for trainee assessment meetings, providing appropriate feedback to trainees and for ensuring relevant documentation is made available to the College.
e) Ensuring that systems of appraisal are in place and in particular that trainees are aware of a confidential channel through which they can draw attention to anxieties they may have about the programme or its supervision.
f) Liaising closely with the JCHMT through the SACs.
g) Facilitating arrangements for SAC inspections of programmes in collaboration with Postgraduate Deans.
h) Attending regional Specialty Training Committees, as chairman where possible and, since they are joint appointees with the Postgraduate Deans, acting as a channel of communication between the Postgraduate Deans and the College.
i) Contributing to the first stage of appeals procedures relating to annual assessment decisions.
j) They are expected to play an important role for both over-seas doctors and for those in academic and research posts. For the former they should facilitate their placement in suitable, relevant training programmes as well as their supervision, appraisal and assessment.They should support and encourage trainees wishing to enter a period of research and should facilitate entry into such a period and exit back into clinical training programmes. They are involved in assessing the training credit to be recommended in respect of service undertaken during periods of research. With regard to non-training activities, Specialty Advisers are able to provide advice for the Regional Advisers on such matters as consultant job descriptions and Fellowship proposals. The membership of the SACs of the JCHMT includes representatives from the Specialty Advisers.

Appointment
In view of the vital role to be played by Specialty Advisers for specialty training it is clear that close working relationships with the Postgraduate Dean are essential. The College has agreed with the Postgraduate Deans that Specialty Advisers should be joint appointments and Advisers will then work on behalf of both the Deans and the College on training matters in their specialty.

The Specialist Societies also have a strong interest in regional specialty matters and it is hoped that in most instances, the Specialty Adviser will be the same person who acts as the Specialist Society’s representative. Where this is not possible, or where the workload is heavy, the responsibility for advice on job descriptions and other clinical practice matters could be undertaken by the Specialist Society’s representatives where they exist. In this case it will be essential for the appointee for specialty training matters to liaise closely with the representative responsible for other specialty matters.

Term of Office
The term of office of Specialty Advisers should be three years and appointment should be agreed between the Postgraduate Dean and College.

Lines of communication and reponsibility
As well as a line of responsibility to the Postgraduate Dean, Specialty Advisers communicate directly with the relevant SAC and JCHMT for all higher training matters. Specialty Advisers communicate with Regional Advisers on matters relating to AACs, Fellowship proposals etc. and through them to the College Registrar.

Regional Specialty Advisors