Reflection on CEPs

Proficient Clinical Examination and Procedural Skills are fundamental to effective general practice. Relevant evidence for this Capability needs to be gathered regularly throughout each review period and recorded in your Portfolio. As with the other Capabilities, there are sets of word descriptors to help you reflect on your progression as you acquire these skills. 

There are 5 intimate examinations which need to be specifically included, as these are mandated by the GMC. These include breast, rectal, prostate, male genital examination and female genital examination (which includes a speculum and bimanual pelvic examination).

You need to be observed performing the intimate examinations by a suitably trained professional. The assessor records their observation on the CEPS evidence form. If this is another doctor they must be at ST4 level or above, or an SAS equivalent. If the colleague is another health professional, such as a specialist nurse, they must confirm their role and training so that your Educational Supervisor can be satisfied that they have been appropriately trained. You may also decide to write a separate log entry on any of these specific skills.

Important: You are also required to complete reflective log entries relating to each of the 5 mandatory CEPS to complete the assessment and have them signed off.  Without the reflection, the CEPs will not be signed off.

Is it sufficient to just do each mandatory CEPS once in training?

Yes, if the observer states you are competent to perform that specific CEPS unsupervised, if not it will need repeating.

How many CEPS do I need?

here is no set number. There needs to be enough to demonstrate, to your Educational Supervisor’s satisfaction, your competence in CEPS.

What is the standard of the clinical examination expected?

The standard is that of an independent fully qualified General Practitioner. As well as the technical aspects of examination and the ability to recognise abnormal physical signs, it includes the choice of examination best suited to the clinical context. For instance, a competent GP very rarely performs an extensive neurological examination but will perform a limited neurological examination as determined by the history taken from the patient.

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