PMST Training Site Self-Assessment Form

PMST Training Site Self-Assessment Form

This form must be completed by potential and existing training sites as part of our ongoing quality management of the PMST programme.
Training site and point of contact
Name of training site*
Training site address*
Name of point of contact*

TitleFirst NameLast Name
Job title*
Main telephone number of point of contact*
Main email address of point of contact*
example@example.com
Why are you completing this form?*

We want to become a training site.We want to retain our status as a training site.We want to relinquish our status as a training site.
Why does your organisation want to relinquish its status as a training site?

Pharmaceutical medicine trainees
Number of pharmaceutical medicine trainees based at the training site
Enter 0 if none.
Number of pharmaceutical medicine trainees without a GMC-approved educational supervisor
Enter 0 if none.
Approved educational supervisors and associate educational supervisors
Number of GMC-approved educational supervisors
Enter 0 if none.
Number of approved associate educational supervisors
Enter 0 if none.
Training locations

Please list the training site's locations that pharmaceutical medicine trainees can rotate.
Address of location 1
Address of location 2
Address of location 3
Address of location 4
Address of location 5
Address of location 6

Declaration

The declaration must be signed by the point of contact (e.g. medical director, director of manager of human resources or training department or administrator/manager responsible for managing the training site's delivery of the PMST programme).
I declare on behalf of my organisation that:

i) the information entered on this PMST training site self-assessment form is accurate and true to the best of our knowledge;

ii) we understand the requirements of the ‘Curriculum for Pharmaceutical Medicine Specialty Training’ (August 2021) and the ‘Specialty Training Curriculum for Pharmaceutical Medicine’ (August 2010, amended 2014);

iii) we fully support the delivery of the Pharmaceutical Medicine Specialty Training (PMST) as defined by the two curricula;

iv) we have read and understand our responsibilities as a GMC-approved training site as detailed in the GMC’s ‘Promoting excellence: standards for medical education and training’ and we will meet/work towards meeting our responsibilities and the standards detailed in ‘Promoting excellence’;

v) we will participate in and engage with all GMC quality assurance and FPM/Pharmaceutical Medicine Deanery quality management activities that relate to the delivery of the PMST programme such as supporting pharmaceutical medicine trainees and educational supervisors;

vi) we understand that FPM and the deanery may ask the GMC to remove approval of our organisation for administrative reasons (e.g. the organisation is dissolved, merges with another organisation, no longer has any pharmaceutical medicine trainees) as well as not meeting GMC standards and the requirements of the PMST programme;

vii) we will update FPM and the deanery if our point of contact changes; and

viii) we will update FPM and the deanery if our organisation’s business address or business name changes or we merge with another organisation and our status as a separate legal entity changes.
Point of contact signature*

Clear
Name of point of contact*

First NameLast Name
Date*

DayMonthYear
Date

Declaration

The declaration must be signed by the point of contact (e.g. medical director, director of manager of human resources or training department or administrator/manager responsible for managing the training site's delivery of the PMST programme).
I declare on behalf of my organisation that we have decided to relinquish our status as a training site for the PMST programme in full knowledge that:
- FPM will ask the GMC to remove us from its list of training sites for the PMST programme;
- we must inform pharmaceutical physicians employed by us and who want to undertake PMST that they must postpone submitting a PMST application until we become a training site;
- we must re-apply to FPM to become a training site before we can support a pharmaceutical physician employed by us to undertake PMST; and
- we may have to participate in an assessment process to determine our suitability to become a training site before FPM decides to apply to the GMC to approve us as a training site.
Point of contact signature

Clear
Point of contact name

First NameLast Name
Date

DayMonthYear
Date
Should be Empty: