Workforce, training and education
Yorkshire and Humber

Recommended Activities

Supported Return to Training (or SuppoRTT for short) is a centrally funded NHS England programme which aims to support all postgraduate doctors and dentists in training (including Public Health registrars) to safely and confidently return to training after a sustained period of absence.

Other pages in this section:

SuppoRTT Overview | Guidance | Meetings and Forms | Frequently Asked Questions | Contacts | CPD Funding | Courses and Events | Recommended Activities | Online Resources | Counselling and Wellbeing | Coaching | Peer Mentoring | Health Toolbox | Parental Leave | Long-Term Sick Leave | Information for Supervisors | Resources and Courses for Supervisors | Bidding Rounds


This page lists recommended activities to help residents and supervisors plan their return. The activities recommended have been submitted by residents and clinical faculty. They include suggested activities for the short supernumerary or enhanced supervision period, key competencies and skills to focus on, and relevant courses and resources. If you are a resident or clincal faculty and would like to contribute to this page, please contact england.supportt.yh@nhs.net.


Preparing for your return

Residents due to return from an absence of 3 months or more should complete a Pre-Return Planning Meeting and Form with the relevant supervisor or Training Programme Director about 12 weeks before their return date. This is an opportunity to plan your return to clinical practice and training, including identifying any learning or training needs, and any support or activities that will be helpful for your return.

We recommend that all residents returning from a prolonged absense have a short supernumerary period and or an enhanced supervision period on their return. This can be requested through the Pre-Return Planning Meeting and Form. The supernumerary period is normally up to 3 days, but up to 10 days can be requested in exceptional circumstances. The length of the enhanced supervision period should be appropriate to your individual needs.

Supernumerary Period:
A supernumerary period is where the resident is considered as an additional member of the team with no fixed work commitments, enabling them to complete a programme of focused learning and clinical activities. On call duties would not normally be expected during this period.

Enhanced Supervision:
An enhanced supervision period is a short period where the resident is given a greater level of supervision in their practice, which may include focused learning activities and direct observation of clinical activities. Out of hours duties would not normally be expected during this period if adequate supervision is not available.

For more information about supernumerary and enhanced supervision periods, including funding, see the SuppoRTT guidance.


SuppoRTT Courses

The SuppoRTT team organises a variety of courses to support trainees with their return to training and the clinical environment. You can access these courses before and during your return to training. (SuppoRTT courses can be accessed within the first three months of returning to training.) Please see the SuppoRTT Courses page for more information about our courses. All courses can be booked through the LSFD Maxcourse site.


Recommended Activities

The recommended activities under the expanding headers below have been submitted by residents and clinical faculty. They include suggested activities for the short supernumerary or enhanced supervision period, key competencies and skills to focus on, and relevant courses and resources.

We recommend discussing these activities with your Educational Supervisior as part of your Pre-Return Planning Meeting. Similarly, if your programme or school is not included here, please speak to your Educational Supervisor for their recommendations.

Please note: Any funding for any external events or resources listed below must be requested and is subject to approval. SuppoRTT CPD Funding may be requested for courses or resoures which meet the eligibility criteria. Residents on maternity leave and OOPT retain their eligibility for study leave and may request study leave funding for curriculum activity.

Contents


General Practice

All GP registrars returning to a GP post will have a period of induction. They will have an induction timetable drawn up by their Clinical Supervisor based on their individual needs and circumstance. The duration is typically between one and three weeks. Discussion with other educators such as ES/TPD in addition may be necessary. 

A General Practice induction timetable may involve:
  • Welcome to the practice
  • Introduction to IT systems
  • Clinical Introduction
  • GP Observation surgeries
  • Workflow and test results management
  • Joint visits
  • Practice Nurse, Community nurse, reception and pharmacist role observation
  • VTS educational session

If you are returning to the same practice that you were in before your leave, your induction period may look different. 

Relevant recommended courses and or practical skills:

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Anaesthetics and ICM

Anaesthetics

Recommended activities for a short supernumerary period:
  • Complete mandatory training
  • Simulation drills of emergency situations
  • MDT training
  • Directly supervised list
  • Shadow on-call team
Recommended activities for an enhanced supervision period:
  • Move to more independent practice e.g. list with consultant in coffee room
  • Seeing referrals
  • Covering on call bleep
  • Taking a leadership role with regard to the theatre list
  • Discuss with supervising consultant how to manage specific emergency situations
Key competencies and skills recommended to focus on:
  • Theatre time to practice intubation
  • Shadowing on call team to seeing ICU referrals or emergency obstetric cases
  • Arterial line; central line; epidural; ALS; paediatric resuscitation; supraglottic airway insertion
Relevant recommended courses and or practical skills:

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Intensive Care Medicine / Paediatric ICM

Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT 

  • General holding of bleep: referrals, practical procedures including CVC/vascath, any emergency intubations  

  • Shadow the on call StR to get more confidence in dealing with referrals and initially observing, then actively managing patients with close supervision and support 

  • Paediatric ICM: Shadow one of the ACPs or more experienced junior doctors e.g. GRID trainee on PICU to ease back into work

Recommended activities for an enhanced supervision period:
  • Senior trainees might wish to refresh leading ward round with support  

  • Bronchoscopy  

  • Attend a couple of theatre acute lists to get more practise in a controlled environment with close supervision. 

  • Shadow the ICU StR on call on 1 or 2 days to get back to speed 

Key competencies and skills recommended to focus on:
  • Resuscitation, stabilization and transfer 

  • Advanced Airway management: including supraglottic devices, Endotracheal intubation and videolaryngeoscopy  

  • Central/dialysis lines insertion and US guided peripheral cannulation  

  • Central venous access/vascaths  

  • Peripheral IV cannulation

Relevant recommended courses and or practical skills:
  • Difficult Airway course

  • Up-to-date with resuscitation courses (ALS/ATLS/PALS; or APLS for Paediatric ICM)

  • Practical procedures courses (lines/ chest drains/cardioversions)

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Medicine

Acute Internal Medicine
Recommended activities for a short supernumerary period:
  • Complete mandatory training 
  • Familiarise with IT systems 
  • Shadow the on-call medical registrar out of hours 
  • Attend practical skills refresher sessions 
  • ALS certification
Recommended activities for an enhanced supervision period:
  • See patients with supervision 
  • Frequent check-ins with consultants 
  • Have assessment on managing acute unselected cases by consultants
Key competencies and skills recommended to focus on:
  • Chest drain (and other emergency procedures), USS skills, lumbar puncture, ascitic tap 
  • Clinical decision making, dealing with urgent/critical cases, being able to lead a cardiac arrest team 
  • Working under indirect supervision 
  • ALS certification
Relevant recommended courses and or practical skills:
  • ALS certification
  • Procedural courses 
  • Human factors courses 
  • Simulation courses
  • Practical skills refresher sessions

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Cardiology
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Simulation drills of emergency situations 

  • Shadow a colleague 

  • Skills lab training for practical procedures

Recommended activities for an enhanced supervision period:
  • Discuss with supervising consultant how to manage specific emergency situations 

  • Do directly supervised invasive procedures in the cath lab

Key competencies and skills recommended to focus on:
  • Cannulation, phlebotomy, emergency echo, ALS, central venous line insertion, arterial access, transcutaneous pacing 

  • Echocardiography (ST6+) 

  • Emergency CIED interrogation 

  • Management of acutely unwell patient in the coronary care unit and following cardiac intervention

Relevant recommended courses and or practical skills:
  • Regional cardiology simulation course

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Clinical Oncology / Medical Oncology
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT 

  • Refamiliarise with chemo prescribing system and/or radiotherapy planning software 

  • Shadowing and observing a clinic and a ward round

Recommended activities for an enhanced supervision period:
  • Attend clinics 

  • Deliver half a clinic under supervision 

  • Deliver a ward round under supervision

Key competencies and skills recommended to focus on:
  • Assessing acute cases. Evidence-based decision-making is key

Relevant recommended courses and or practical skills:
  • Consider undertaking a communication skills course if not done previously

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Endocrinology and Diabetes Mellitus
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Shadowing a colleague 

  • Exposure to acute medicine, including same-day emergency care (depending on seniority)

Recommended activities for an enhanced supervision period:
  • Tertiary level clinics and referrals  

  • Present in mortality, morbidity or audit meetings and MDTs

Key competencies and skills recommended to focus on:
  • Level 4 in all competencies 

  • ALS, CPR, DC cardioversion, lumbar puncture, diagnostic pleural aspiration, ascitic tap, knee effusions 

  • Endocrine emergencies

Relevant recommended courses and or practical skills:
  • Society for Endocrinology clinical update meeting 

  • Diabetes UK Conferences and Events 

  • Pump course Young diabetes and endocrinology forum 

  • Local teaching

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Gastroenterology
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT systems 

  • Sit in in clinics and shadow on-call

Recommended activities for an enhanced supervision period:
  • Supervised clinics 

  • Broad view of acute gastroenterology and hepatology 

  • Management of complex ward patients (incl. nutrition, IBD, and functional disease) with WPBA 

  • Internal medicine competencies

Key competencies and skills recommended to focus on:
  • Return to endoscopic training

Relevant recommended courses and or practical skills:

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Geriatric Medicine
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT systems 

  • Shadow ward round and clinic 

  • Set PDP 

  • Meet supervisor and local SuppoRTT champion

Recommended activities for an enhanced supervision period:
  • Direct observation of basic clinical duties e.g. patient assessment 

Key competencies and skills recommended to focus on:
  • Resus update in trust 

  • Leadership skills (including working within and running the MDT, delegation and supervision of ward medical team, and leading safety huddle) 

  • ALS 

  • Management of the acutely unwell adult

Relevant recommended courses and or practical skills:
  • Advanced communication at end of life via hospice 

  • ALS

  • Medical procedures refresher

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Haematology
Recommended activities for a short supernumerary period:
  • Complete mandatory training and (re)take local induction 

  • Familiarise with IT 

  • Shadowing a colleague 

  • Refresher learning on blood film morphology 

  • SACT competency assessment to get back onto SACT prescriber register 

  • Read or review local neutropenic sepsis protocol 

  • Read tumour lysis management guidelines & anticoagulation reversal guidelines

Recommended activities for an enhanced supervision period:
  • Liaison, laboratory and ward cover with additional support and supervision 

  • Outpatient clinics with additional support and supervision

Key competencies and skills recommended to focus on:
  • Management of haematological emergencies 

  • Blood film morphology 

  • Management of inpatient and outpatient haematology patients

Relevant recommended courses and or practical skills:
  • Refresher learning on blood film morphology

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Palliative Medicine
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT systems 

  • Re-engaging with the MDT processes  

  • Updating on medicines development  

  • Practical procedures according to stage and placements 

Recommended activities for an enhanced supervision period:
  • Joint clinical reviews with the Consultant/ Specialty doctors 

  • Shadow Consultant in OPD clinic (if applicable) 

  • Attend MDT 

  • Seek feedback by way of WPBA e.g. CBDs, mini-cex, ACATs etc. 

  • Spend time with different Clinical Nurse specialists/ attend Gold Standard Framework meetings if community placement

Key competencies and skills recommended to focus on:
  • Holistic assessment of patients for senior review 

  • Managing palliative care emergencies 

  • Ability to see patient independently in clinic (with end of clinic debrief) if applicable

Relevant recommended courses and or practical skills:
  • Advanced Communication Skills

  • Simulation DOPS in skills lab

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Respiratory Medicine
Recommended activities for a short supernumerary period:
  • Mandatory training 

  • Familiarizing with IT system 

  • Shadowing on acute unselected take

Recommended activities for an enhanced supervision period:
  • On call medical StR covering acute unselected take 

  • Clinic and ward rounds with close supervision and WPBA

Key competencies and skills recommended to focus on:
  • Procedural competence in line with ARCP decision aid 

  • Competent and comfortable in acute unselected take management 

  • Chest drain/pleural USS

Relevant recommended courses and or practical skills:
  • Medical procedures refresher course  

  • ALS

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Rheumatology
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT

  • Shadow in clinic or reduced clinic numbers to allow additional supervision 

  • Shadowing on call sessions for rheumatology or GIM

Recommended activities for an enhanced supervision period:
  • Shadowing in clinic or reduced clinic numbers to allow additional supervision 

  • For GIM – working alongside colleague for the first 1-2 on call shifts

Key competencies and skills recommended to focus on:
  • Joint injections 

  • Clinical assessment of new and follow up outpatients and ward patients

Relevant recommended courses and or practical skills:
  • Online BSR educational modules to refresh knowledge 

  • Ensure ALS is up to date

  • Refresh joint injection skills with DOPs if needed

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Obstetrics and Gynaecology

Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT systems 

  • Time on Labour Ward 

  • Ensure time in both Obstetrics and Gynaecology 

  • Shadow in surgery and clinics

Recommended activities for an enhanced supervision period:
  • Do day shifts in acute obstetrics and acute gynae where there is consultant supervision and a supervised elective section list  

  • Sub-speciality antenatal care

Key competencies and skills recommended to focus on:
  • Operative obstetrics and surgical skills: forceps/vacuum deliveries and LSCS

  • Basic laparoscopy 

  • Surgical management of miscarriage/MVA 

  • Entrustibility matrix at RCOG 

  • CTG interpretation 

  • Ventouse 

  • Management of emergencies

Relevant recommended courses and or practical skills:
  • ST3-5 benefit from Robust instrumental delivery course or mMOET 

  • CTG training and Prompt  

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Paediatrics

Recommended activities for a short supernumerary period:
  • Complete mandatory training

  • Familiarise with IT systems 

  • Familiarise with geography and bleeps/alertive system  

  • Review guidelines  

  • Resus/defib update  

  • At Level 1, all basic competencies as per ARCP requirements would need to be revised 

Recommended activities for an enhanced supervision period:
  • As above with additional clinical observation

  • Ward round, prescribing, discharge summary, review of history and examination skills

  • BLS algorithms

Key competencies and skills recommended to focus on:
  • Core Training (ST1-4): Paediatric prescribing (e.g. RCPCH SCRIPT modules), Mandatory DOPS as per ARCP (e.g. cannulation, UVC insertion, lumbar puncture)

Relevant recommended courses and or practical skills:
  • Core Training (ST1-4):  Neonatal Life Support, Advanced Paediatric Life Support

  • Speciality Training (ST5-7): Neonatal Life Support, Advanced Paediatric Life Support, Management and Leadership training (e.g. Train the Trainers)

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Pathology

Histopathology
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT systems & departmental rota 

  • Contact consultant you will be working with in your first rotation and agree a plan for cut-up and checking cases 

  • Re-read any relevant clinical guidelines in the area you are working in 

Recommended activities for an enhanced supervision period:
  • Spend time being directly observed on practical skills such as specimen dissection, or performing a post-mortem 

Key competencies and skills recommended to focus on:
  • Dissect surgical pathology specimens 

  • Produce microscopy reports 

  • Ability to perform post-mortems (if applicable)

Relevant recommended courses and or practical skills:
  • Trainees who are going to be preparing for an exam after returning may wish to take preparation courses in histology and/or cytology

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Infectious Diseases
Recommended activities for a short supernumerary period:
  • Ensure IT access is up to date (including practicing laboratory computer system) 

  • Complete mandatory training, and additional training where needed 

  • Refamiliarize yourself with antibiotic guidelines 

  • Supervised time on the ward and seeing referrals  

  • Get fit tested and do PPE training if possible 

  • Attend an LP simulation course if possible 

  • Review key HCID guidelines and algorithms (e.g. VHF/MERS etc...)

Recommended activities for an enhanced supervision period:
  • Join the consultant of the week on the ward round 

  • Sit in with consultant in clinic 

  • Hold the on-call bleep during a day shift with another registrar nearby to support  

  • Attend various MDTs e.g. TB, HIV, Radiology etc. 

  • Seek feedback by way of WPBA e.g. CBDs, ACATs etc.

Key competencies and skills recommended to focus on:
  • Assessing acute admissions for senior review 

  • Leading a ward round 

  • Ability to assess and look after acutely unwell patients on the ward 

  • Ability to see patient independently in clinic (with end of clinic debrief)

Relevant recommended courses and or practical skills:

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Medical Microbiology
Recommended activities for a short supernumerary period:
  • Ensure mandatory training up to date.  

  • Ensure access to all IT systems 

  • Re-familiarise yourself with the LIMS 

  • Shadow a BMS in the laboratory

  • Shadow a consultant/trainee colleague to refamiliarize oneself with proactive, reactive and IPC work 

  • Have an induction to the department including a tour of the lab and meeting with lab staff 

  • Refamiliarise yourself with the antibiotic/IPC guidelines

Recommended activities for an enhanced supervision period:
  • Direct supervision by consultant or senior colleague in proactive work e.g. liaising of blood cultures and critical specimens, MDTs and ward rounds 

  • Direct supervision by consultant or senior colleague in reactive work e.g. taking phone calls, referrals etc… 

  • If no on-call during OOP then here should be no on call for 2-4 weeks.  

  • Seek feedback by way of WPBA e.g. CBDs, ACATs etc….  

  • Attend laboratories to re-gain understanding of laboratory processes

Relevant recommended courses and or practical skills:

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Psychiatry

Recommended activities for a short supernumerary period:
  • Complete mandatory training

  • Shadow assessments of patients with acute mental heath presentation (might include: self-harm, acute psychosis, depressed mood, neurodevelopmental disorders, anxiety disorders etc.) 

  • Shadow a clinic where patients’ psychiatric medication is being reviewed

Recommended activities for an enhanced supervision period:
  • Assess undifferentiated patients

  • Complete risk assessments 

  • Create management plans 

  • Peer support

Key competencies and skills recommended to focus on:
  • Completing a mental health assessment in an emergency situation 

  • Prescribing psychotropic medication in a range of situations (e.g. affective disorders, anxiety disorders, psychosis, ADHD and acute behavioural disturbances) 

  • Those competencies in line with specific stage of training for completion of HLOs from the preceding ARCP

Relevant recommended courses and or practical skills:
  • Refresher course mental health law

  • Simulation CPD if available

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Radiology

Recommended activities for a short supernumerary period:
  • Mandatory training 

  • Familiarizing with IT system 

  • Shadow duty radiologist

An enhanced supervision period of at least 4 weeks is recommended
Key competencies and skills recommended to focus on:
  • Plain film reporting

  • USS 

  • Image guided intervention 

  • Acute CT list 

  • Being the duty radiologist 

  • Shadowing on call

Relevant recommended courses and or practical skills:

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Surgery

All Programmes
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT systems 

  • Attend theatres, familiarise with theatre for your subspeciality

Recommended activities for an enhanced supervision period:
  • Hold the on-call bleep and manage referrals from ED and ward queries with support from peers/consultant  

  • Shadow On call emergency take

Key competencies and skills recommended to focus on:
  • Rigid sigmoidoscopy, draining an abscess, lap appendix (if relevant to subspeciality) 

  • Managing the emergency take

Relevant recommended courses and or practical skills:
  • CCRISP

  • ATLS

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Oral and Maxillofacial Surgery
Recommended activities for a short supernumerary period:
  • Complete mandatory training 

  • Familiarise with IT systems 

  • Simulated airway management  

  • Model surgery for trauma 

  • Lateral canthotomy practice on animal models

Recommended activities for an enhanced supervision period:
  • Experiential learning with consultant supervision of the procedures mentioned below

Key competencies and skills recommended to focus on:
  • Plating of simple mandibles using drills/screws/plates 

  • Drainage of space-occupying abscess of the head and neck 

  • Closure of lacerations 

  • Airway management including tracheostomy changes 

  • Lateral canthotomy 

  • Line placement; NGT placement 

  • Ward management and the ability to look after major trauma referrals and oncology  

  • Cases

Relevant recommended courses and or practical skills:
  • CMF principles course (September every year in Leeds Weetwood Hall) 

  • Anaesthetic shadowing courses  

  • YORTRACH course

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