Rehabilitation Medicine CESR Portfolio Guide

• Aware of, and adheres to, the GMC professional requirements
• Aware of public health issues including population health, social determinants of health and global health perspectives
• Demonstrates effective clinical leadership
• Demonstrates promotion of an open and transparent culture
• Keeps up to date through learning and teaching
• Demonstrates engagement in career planning
• Demonstrates capabilities in dealing with complexity and uncertainty
• Aware of the role and processes for commissioning
• Aware of the need to use resources wisely

• Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
• Behaves in accordance with ethical and legal requirements
• Demonstrates ability to offer apology or explanation when appropriate
• Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently

• Communicates clearly with patients and carers in a variety of settings
• Communicates effectively with clinical and other professional colleagues
• Identifies and manages barriers to communication (e.g. cognitive impairment, speech and hearing problems, capacity issues)
• Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
• Shares decision making by informing the patient, prioritising the patient’s goals and wishes, and respecting the patient’s beliefs, concerns and expectations
• Shares decision making with children and young people
• Applies management and team working skills appropriately, including influencing, negotiating, re-assessing priorities and effectively managing complex, dynamic situations

• Makes patient safety a priority in clinical practice
• Raises and escalates concerns where there is an issue with patient safety or quality of care
• Demonstrates commitment to learning from patient safety investigations and complaints
• Shares good practice appropriately
• Contributes to and delivers quality improvement
• Understands basic Human Factors principles and practice at individual, team, organisational and system levels
• Understands the importance of non-technical skills and crisis resource management
• Recognises and works within limit of personal competence
• Avoids organising unnecessary investigations or prescribing poorly evidenced treatments

• Manages clinical information / data appropriately
• Understands principles of research and academic writing
• Demonstrates ability to carry out critical appraisal of the literature
• Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
• Understands public health epidemiology and global health patterns
• Demonstrates appropriate knowledge of research methods, including qualitative and quantitative approaches in scientific enquiry
• Demonstrates appropriate knowledge of research principles and concepts and the translation of research into practice
• Follows guidelines on ethical conduct in research and consent for research
• Recognises potential of applied informatics, genomics, stratified risk and personalised medicine and seeks advice for patient benefit when appropriate

• Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
• Delivers effective feedback with action plan
• Able to supervise less experienced trainees in their clinical assessment and management of patients
• Able to supervise less experienced trainees in carrying out appropriate practical procedures
• Able to act as a clinical supervisor to doctors in earlier stages of training

• Uses holistic biopsychosocial model of illness for all areas of professional practice
• Identifies the patient’s disease(s) and which losses are attributable to the disease(s), and which may have other explanations
• Identifies factors outside the disease that may be causing / exacerbating disabilities
• Considers what physical, social or personal factors may be influencing the nature and/or extent of disabilities

• Considers and shows awareness of reasons for referral and expectations of all interested parties, not just the referring person/organisation
• Always undertakes a full assessment and provides a clear, reasoned analysis (formulation) of the case in the letter or report
• Shows awareness of all other relevant and potentially appropriate services
• Always offers a plan for future management when asked for advice, even if rehabilitation in the service is approached is not the appropriate solution
• Explains clearly if a patient is considered unlikely to benefit from the rehabilitation service
• Outlines processes and actions required if a patient is accepted into the rehabilitation service

• Communicates well with all team members verbally and in any other appropriate way
• Documents significant meetings with conclusions and actions specified
• Acts as leader (chair) of a meeting
• Respects and learns from the knowledge and skills of all team members
• Contributes information, advice and analysis when not acting as a leader of a meeting and gives constructive feedback if appropriate
• In team meetings where goals are considered and set
• Educates team members routinely during normal clinical work; explains or refers to evidence about some topic
• Liaises with appropriate team members about any specific medical problems or treatments
• Participates in team and service management and educational activities

• In team rehabilitation planning meetings ensures long-term outcome goals and discharge from/transfer to services are considered
• Recognises when a discussion is focused on immediate and achievable actions without thought of long-term matters
• Able to open out a discussion without causing distress
• Can identify, articulate and negotiate priorities
• Introduces new goals, previously overlooked, and/or reduces or removes goals that are unnecessary or of low importance

• Recognises when a patient has been referred with an incorrect disease diagnosis and/or has developed a new disease
• Recognises when a patient, usually an in-patient, is acutely unwell and needs urgent attention
• Initiates urgent investigations, treatment and other management needed to establish he cause, stabilise the patient’s state to maintain life, reduce and control any pain or distress
• Recognises when assistance is needed from other specialist services, makes a referral with appropriate urgency; ensures smooth transfer of responsibility with full handover of all information
• In situations when a patient lacks capacity considers what is in the patient’s best interests
• Communicates clearly with patient and/or family covering diagnosis, investigations, and treatment and/or prognosis and/or transfer to other services

• Correctly identifies patients who may benefit from specific rehabilitation medical treatments documenting
• Does not offer to undertake a specific rehabilitation medical treatment to patients who will not have a net benefit; explain and document reasoning clearly; offer to seek a second opinion, if appropriate

• Knows, sufficiently to engage constructively, how all other relevant organisations function (e.g. social services, housing, department for work and pensions, etc)
• Demonstrates engagement working with other services within NHS and partner organisations, both outside the NHS and outside healthcare attending meetings called by other services, contributing to/leading any meeting organised by other services and ensuring relevant documentation is copied to services/organisation involved with a patient in compliance with any relevant legislation
• Considers possible involvement of other organisations in rehabilitation plans for all patients with complex needs

• Accepts personal responsibility for resolving complex problems in people with disability which involve health services, even if admission to, or major involvement of, the rehabilitation service is not the solution
• Identifies the many factors that need to be considered in a complex case: clinical, cultural, organisational, political legal, ethical
• Able to get necessary information on the relevant factors inviting people to attend a meeting and/or researching and documenting the relevant information
• Able to negotiate and mediate between conflicting or competing parties in a meeting and/or individually
• Reaches an agreed decision with a plan, and/or an agreed way forward to achieve an agreed solution later
• Documents the process to ensure that others understand the facts, influences and reasoning behind the resolution

Currency Window

Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents