Breast clinicians credential - FAQs

£90k is the total amount available regardless of the duration of training, and £30k should support one full-time equivalent (FTE) year worked. The specific payment schedule will be agreed between the host trust and NBIA, but there are typically three annual payments of £30k. If a trainee is working LTFT, the host trust may opt to receive three annual payments of £30k, or they may opt for the annual payments to reflect the whole-time equivalent (WTE) hours worked. For example, funding for a trainee working 0.6 WTE could be allocated as follows:

Payments are made at the start of the year of employment, in advance of the whole year. Therefore if a trainee should leave part way through a year, a calculation will be made as to how much funding should be recouped on the basis of £30k supporting one full-time equivalent year worked, and this will then be returned to Health Education England (HEE) e.g. if a full-time trainee leaves after 6 months, the NBIA will invoice the host trust for £15k, and this will be returned to HEE.

Funding beyond the £30k per annum trainee post would be subject by negotiation within each trust. We would recommend speaking to colleagues within the surgical and radiology departments with a view to potentially split any additional costs e.g. surgical budget to cover the first 18 months when the emphasis on training is clinical skills and family history, with radiology covering the final 18 months of training when imaging becomes the main focus.

The new breast clinician trainee should be employed as a Specialty Doctor MC75 and will continue on this salary trajectory once fully qualified. Current trainees and breast clinicians should have had the opportunity to move from the old contract MC46 to the new contract MC75 when this changed in 2021. Please find more information in the links below:

• NHS Employers - Pay and Conditions 2023
• NHS Employers - SAS Contract Reform 2021 FAQs

Some trainees will have FY2 competencies and no more, but many may have much more experience. Historically many breast clinicians have been GPs who have changed career, and while some trainees will be former GPs, others will have a wide range of experience in both hospital and community settings. Some have previous imaging experience including Part 1 of the FRCR. Not all trainees will have NHS experience, but all will be eligible to work in the UK.

Please refer to this sample job plan based on 0.6 WTE.

Family history clinic consultations - Please refer to Table 11: Progression grid for specialty-specific CiPs (p43 in the Curriculum) and specialty-specific CiPs 11, 12 and 13.

Surgical consultations - Please refer to Table 11: Progression grid for specialty-specific CiPs (p43) and specialty-specific CiPs 9, 11, 12 and 14.

Performing ultrasound and intervention - Please refer to Table 11: Progression grid for specialty-specific CiPs (p43) and specialty-specific CiPs 7, 8, 9, 10, 11, 12 and 14. In addition, please refer to Table 12: Progression grid for imaging examination and procedures (p44) and Table 14: Minimum number of workplace-based assesssments (p50).

Screen reading - Please refer to Table 11: Progression grid for specialty-specific CiPs (p43), and specialty-specific CiPs 7, 8, 9, 10, 11, 12 and 14.

In addition, please refer to Table 14: Minimum number of imaging investigations and procedures (p50).

A single educational supervisor is required. Your educational supervisor is likely to be a consultant breast radiologist or a senior breast clinician, and your clinical supervisors should ideally be consultants, working in an area of practice related to the element of training they are supervising - this may be a surgeon, radiologist or an established breast clinician.

Educational and clinical supervisors should also be recognised on the GMC register as GMC-approved trainers. Non-GMC accredited practitioners may also act as clinical supervisors (particularly for the family history element), provided it is within their area of expertise.

The vast majority of the teaching will be apprenticeship-style training on the job similar to other senior specialist training programmes (e.g. surgery, radiology etc). As with other training programmes, this apprenticeship-style training has to be supplemented with individual study, external meetings and the use of relevant resources.

A wide range of resources are already available to all trainees, such as study days dedicated to their needs, as well as online modules and the usual recommended courses such as advanced communication courses.

Host sites are encouraged to contact the training programme director (TPD) responsible for physics teaching provided for radiology specialty trainees. Breast clinician trainees should access this same teaching to prepare themselves for the FRCR Part 1A examination.

Study leave and appropriate timetabling should be permitted to allow the breast clinician trainee to attend all/as many sessions as possible. Additional online/virtual resources such as those provided by the RCR and e-LfH should supplement this face-to-face element of teaching.

The use of a buddy system, pairing trainees together for revision purposes, either within the deanery or with another breast clinician trainee nationally should also be considered.

We recommend that trainees have 1 day study leave per week for physics teaching and associated travel in the lead-up to the exam. Some courses are specified in the SLA, and these will be funded by the host site; other courses will be provided for free e.g. courses arranged through the National Breast Imaging Academy (NBIA).

Please note that although the NBIA has previously funded advanced communication courses for Cohort 1, this funding for future cohorts is not guaranteed.

Please contact your educational supervisor if you have any concerns around training and support. If you would like more general advice, the Association of Breast Clinicians will be happy to hear from you. For any concerns regarding your employment or any other matter, we would advise you to contact your trust’s Professional Support Unit.

Employing trusts are responsible for arranging sponsorship of Tier 2 visas for applicants already registered with the GMC and who have passed the Professional and Linguistic Assessments Board (PLAB) test.

Yes, but any less than three full clinical days per week would make training very difficult.

The viability of creating another intake of trainees will be established once the evaluation is complete. Please email your expression of interest in future recruitment opportunities to credentials@rcr.ac.uk and breastacademy@mft.nhs.uk.

The three year training programme will equip you with the necessary skills to lead screening services, family history clinics and work in symptomatic clinics. Job plans will vary across trusts and may include screening assessments, observations, supervised radiology skills, mammography reading, symptomatic and FHx clinics.

Trainees are also expected to sit the “Scientific Basis of Imaging” or “Physics” module of the First FRCR examination within the first year of training. To prepare you for the examination, it is recommended that you attend local radiology physics teaching. This will be negotiated with the local radiology Head of School and study time will be factored into your job plan.

No on-call commitment will be required as part of the training programme.

No. The pilot programme is not within the remit of deaneries, so please contact your educational supervisor or the Workforce Development and Training team at the RCR using the email credentials@rcr.ac.uk if you need further support with your training and/or placement.

Similar to the Annual Review of Competence Progression (ARCP) process for specialty training, the review of credential trainees will be carried out by a national panel, convened by the Credential Oversight Board. A national review panel will ensure that a consistent standard is applied to all trainees across all training sites within the pilot programme. It will be independent of the pilot sites, ensuring impartiality and avoiding decisions on progression being made by the same people responsible for the training of an individual trainee.

The Process for the Review of Trainee Performance and Progression document gives full details of the process and the panel.

Yes. The same training routes and guidelines will still apply, however gaining agreement from your employer to allow you the necessary time and support to train will be entirely up to you.  Training and supervision will also need to be arranged and resourced locally, as will access to local physics teaching. Neither the RCR nor the Credential Oversight Board, will be able to offer any assistance in these local discussions or guarantee that this will be available. Before being accepted onto the credential programme, you will need to provide a letter from your employer confirming that they will support you undertaking the credential and that appropriate educational and clinical supervision will be provided.

Upon satisfactory completion of the credential, participants will be able to practice as a breast clinician and apply for permanent substantive posts. If you are interested in pursuing the credential outside of the pilot, please email credentials@rcr.ac.uk for more information.

Yes. Please refer to the response above for details of what is required. Please note, however, that because the credential is still in a pilot phase, there is currently no mechanism for counting prior learning and experience as a breast clinician towards the credential. Anyone undertaking the credential will be required to complete the full three-year programme and meet all requirements of the curriculum. There is currently no equivalence process.

Trainees are required to pass the Physics module of the First FRCR Examination in their first year of training. In addition to the physics examination, assessment is workplace-based and formative in nature leading to an annual review. Full details of the assessment programme are included in the Credential curriculum.

Trainee breast clinicians will be given access to the RCR’s e-portfolio to document progress.

Risr/advance is the RCR’s trainee e-portfolio. You and your supervisors will be able to record learning in all its forms, such as workplace-based assessments and appraisal meetings, and monitor progress through the Credential curriculum. You will also be encouraged to maintain a personal portfolio on Risr/advance for self-assessment, reflective learning, and personal development plans. A user guide for trainees and a user guide for supervisors are available and will be sent by email to all involved.

Yes. Credential trainees must become Associate Members of the RCR in order to access the e-portfolio and have their training recognised for award of the Credential.

We strongly encourage all credential trainees to join the ABC. The ABC offers a range of online resources as well as useful meetings and a supportive network. Details on how to join are on the ABC website.

The syllabus for the physics exam can be found in section 2.2 of the Clinical Radiology Specialty Training Curriculum. Details of the exam including dates, venues and how to apply are published when available on the website.

The Physics exam can be retaken up to 3 times. If after a third attempt, the trainee has not passed, but is progressing well in all other elements of training, discussion with the Credential Oversight Board may allow a further attempt.

At each progression review meeting, an extension to training may be permitted to allow the trainee to complete the credential. This is at the discretion of the panel, who will take into consideration the working pattern of the trainee, the stage in training and level of additional work required to complete training. Time out of training for health or other reasons does not fall into this category.

Regular progression reviews provide opportunities to identify and support trainees not meeting the expectations or generic capabilities of the credential programme.

In addition to this, trainees and supervisors can contact the Credential team at the College regarding any concerns. Queries may be directed to an appropriate clinical member of the Credential Oversight Board for informal or formal discussions with the trainee or supervisor.

Annual feedback sessions are held with trainees and supervisors separately to enable them to speak with members of the Board, discuss any issues and share good practice. Host sites should also utilise local resources and expertise to support any trainee in difficulty, and the local appraisal process to ensure they are fit to continue training.

Following successful completion confirmed by a final review panel, trainees will be awarded an RCR-Certified Credential Certificate following completion of training. A formal record of training will also be maintained by the RCR.

Upon successful completion of the programme, trainees will be awarded the Credential in Breast Disease Management and can be appointed as qualified breast clinicians.

Traditionally breast clinicians have tended to continue employment at the same Trust in which they trained. However, with the standardisation of training that this credential offers, breast clinicians may become more mobile, and, depending on their personal circumstances, seek employment elsewhere. 

It is important to note that the credential does not lead to a Certificate of Completion of Training (CCT) and credential holders will not be eligible to apply for consultant posts. This role is currently recognised as a Specialty Doctor and with advancing seniority, an Associate Specialist or Specialist (2021 contract).

Although the credential holder will have achieved independent practice in all components in which they have been trained, they may choose to pursue a career which is primarily focused on one or even two of these, rather than the full complement.