Assessment of progress through training is carried out by a panel that reviews the trainee's written evidence for this progress.
Those in training as SpRs or SpTs will know this review as the Record of In Training Assessment or RITA.
Overview of RITA
Assessment of progress through training is carried out by a panel that reviews the trainee's written evidence for this progress. This evidence is known as the Record of in Training Assessment or RITA.
'Progress' means the continued acquisition of public health competencies throughout training. Evidence for this is demonstrated by passing of FPH examinations and successful in-work assessments of competencies.
As the purpose of the panel is to review the record of evidence, technically, it is not absolutely essential that it meets the trainee. However, most deaneries arrange for the panels to meet trainees so that they can explore any areas of doubt around the evidence presented.
The RITA panel determines whether a trainee has completed training satisfactorily. If a trainee completes training satisfactorily, then the panel makes a recommendation to the FPH for the issue of a Certificate of Completion of Training (CCT).
Organisation of RITA panels
Deaneries arrange for each trainee to be reviewed by a RITA panel. Trainees are normally reviewed annually. A new trainee would have a first review within 12 months of starting, but not usually earlier than 6 months. All assessments must be consistent with the requirements laid out in A Guide to Specialist Registrar Training (Orange Book).
Providing the evidence
Trainees need to provide a portfolio of evidence to reflect the training, assessment and evidence that has been acquired since the last RITA panel and the competencies that they have achieved during that time. The panel will review this evidence and reach an agreed view regarding the progress in training and proposed outcomes.
The outcome of a RITA
Progress for most trainees is satisfactory and this is recorded by the panel issuing a RITA form C.
The RITA process, however, also provides a formal process whereby more specific and targeted help can be provided for trainees who are experiencing difficulty. In these cases the panel can recommend, for example, a period of focused training or that training is repeated in a particular area of work. Very occasionally, after other forms of support have not proved successful, it may be concluded that public health may not be the specialty in which an individual is most suited and training should be discontinued. This decision will be made by the Training Programme Director (TPD) and Deanery; decisions of this nature are usually supported by outcomes advised by the RITA panel.
Documents required for a RITA review
Standard documentation is considered by the RITA panel at each review and this should include the following documents, which are circulated at least two weeks prior to the review panel members:
- Section A of the Training Portfolio.
- Any recommendations for action arising from previous RITA assessment and progress on achievement of objectives of the last assessment.
- Progress on examinations.
- Structured and up-to-date CV - maximum 3 pages, highlighting academic and service achievements and publications.
- Record of courses/conferences attended and a record of study leave.
- Report from lead service trainer and academic tutor.
- Any further appropriate evidence of activity during training.
Further documentation could be included with the evidence submitted. Wherever a reference is taken, it must be an open and structured reference from the service trainer, or academic tutor where appropriate. This is only beneficial if it contributes to an assessment of competencies in the training portfolio.
There are a number of forms that are used in the RITA process.
The RITA forms are generic documents for all specialties as set out in the Department of Health's A Guide to Specialist Registrar Training.
Instructions for completion are on the forms themselves. Completed originals of these forms will be held by the Postgraduate Dean along with the forms for all the other specialties. Copies are required by the FPH Education and Training department as part of the evidence required to recommend the award of the CCT on completion of training. Note: some deaneries have produced their own versions of these forms. Descriptions of each form are as follows:
Forms A & B - Core information
Forms A and B are records of core information about the trainee.
Form A is completed when the trainee joins the training programme and must be forwarded to the FPH Education and Training department.
Form B is used when any item of information provided within Form A is changed in the central records (e.g. change of address, change of provisional CCT date).
Forms C – F - Records of assessment and subsequent decisions
Forms C to F are records of assessment and subsequent decisions (but the forms are not themselves the means of assessment).
RITA Form C states that progress since the last annual assessment was satisfactory.
RITA form D indicates the need for targeted training with clearly identified objectives.
RITA form E requires the trainee to repeat a period of training and extends the time to CCT. It identifies the need for intensified supervision or the need to repeat experience.
If a Form D and/or E is issued it must be followed by a Form C before a Form G can be issued.
RITA Form F is used to replace Form C when out-of-programme experience is being assessed as satisfactory.
Form G - Completion of training
Form G is a statement that the local specialty training committee advises that training has been satisfactorily completed and the trainee should be recommended for the award of the CCT. The attached Completion of Training form is a Faculty of Public Health checklist for those who have completed training.
- Form G and Form 3
Additional documents for RITA
There are additional documents which have been developed to aid the feedback process of RITA.
Feedback from the RITA review
A RITA Summary of Annual Review Form [pdf] has been designed to ensure that all trainees receive structured feedback in a consistent format following the RITA process/annual review.
Structured written feedback should be given to the trainee within a month of the meeting of the review panel, with a copy also set to the lead trainer. Information should be provided under the following headings:
- Current anticipated CCT date, and details of any changes made and reason for changes made at review.
- Feedback on achievements and progress against recommendations made since last review.
- Recommendations and action for follow up from the present review.
Copy of RITA Form C, D, E, F or G
- Timing of next review.
- Information on appeal procedures.
All trainees should be given the opportunity to comment back to the Chair of their RITA review panel on factual inaccuracies arising from the document and recommendations arising from the review.
If trainees disagree with the assessment results, the local Deanery will have an appeal process in place to hear any appeals against the judgment of the Annual Assessment Panel. The Appeal Panel will advise the Postgraduate Dean, and its structure will vary slightly between Form D & Form E appeals. Its membership is determined by the Dean and could comprise, for example, of a Chair, a Deputy Faculty Adviser, a Service Trainer and an Academic Trainer.
Composition of the RITA review panel
The public health RITA review panel should consist of the following:
- Faculty Adviser or Deputy.
- Training Programme Director or Deputy.
- Representation from Academic Department.
- Chair of the Regional Specialist Training Committee/Education and Training Committee. External Assessor*
- Representative of the Post Graduate Medical Dean.
- Health Protection Specialist**
*mandatory for penultimate RITA assessments (year before the final year of training), recommended for all assessments.
**recommended for those wishing to specialise in Health Protection, this should be considered good practice for all assessments.
It is recommended that all RITA panel members should be trained prior to taking part in any annual assessments.
Guidance for external assessors
- The Education Committee (Ed Comm) recommends that an external RITA assessor should attend each penultimate RITA assessment.
- Deaneries are not expected to pay expenses of external RITA assessors, since they will receive them as well as send them. The Ed Comm has agreed that the simplest way to administer this process is for each Deanery to cover the expenses of the assessors they send to other Deaneries.
- Every effort will be made to have an external assessor present at each penultimate RITA, but if circumstances prevent that, the assessment will nevertheless take place.
- The GMC hopes that every RITA will involve an external assessor, and Deaneries should be moving in that direction.
Person specification for external assessors
- Be committed to achieving high standards of training in public health.
- Have passed MFPH examinations, MRCPath, or equivalent and be on the Specialist Register.
- Be a consultant of at least three years, have broad experience of public health practice and be an accredited trainer.
- Must have participated in the RITA review process within their home Deanery.
- Have had experience as an Educational Supervisor and attended an Educational Supervisor
- development module or update within the past three years.
- Be up-to-date with their CPD commitment and take an active part in audit, including clinical governance.
- Appropriately trained and have experience of the RITA process, be familiar with the documentation and purpose of the review.
- To act as the external assessor for the RITA review process for trainees in public health training.
- To provide independent advice and support to the review panel on the standards achieved by the trainee and contribute to the formulation of advice and recommendations for training planned/required in the remainder of training.
- To monitor the process of the RITA review ensuring that the review is objective and fair.
- To provide support to the review panel in following up recommendations made at the RITA review.
- Report to FPH via host Faculty Adviser if there are problems.
- Represents the FPH on the RITA panel, the conduct of which is the responsibility of the postgraduate dean.
- Faculty Advisers nominate individuals meeting the criteria, for three years, with possible extension of two years.
- Indemnified by host postgraduate dean