Passing the ARCP as an EM trainee
TL;DR — Passing the ARCP as an EM trainee is a year-round evidence-gathering exercise, not a six-week scramble. The panel only sees what is in your e-portfolio on the cut-off date, judged against the RCEM Higher Training ARCP Requirement Guide and the relevant SLOs from the 2021 curriculum (updated to v1.5 in August 2025). Outcome 1 is the goal; outcomes 2, 3, 5 and 7.2 to 7.4 are the recoverable ones; outcome 4 is rare and means the end of programme. Plan SLEs, ESLEs, MCRs, MSF, life-support currency, QI, teaching and leadership across the training year, lock everything down before the cut-off, and treat your educational supervisor as the early-warning system.
Facts last verified:
The Annual Review of Competence Progression is the one assessment that genuinely controls your training. The FRCEM exams matter, but a passed exam with a half-built portfolio still produces an adverse outcome, while a well-built portfolio with a deferred exam usually produces an outcome 1 with a flag rather than an outcome 3. This article walks through what the panel actually does, what each outcome code means in practice, how much workplace-based assessment volume is realistic at each year of EM training, the curriculum v1.5 changes that came in on 6 August 2025, and what to do if your outcome is not the one you wanted. It is written for trainees on the 2021 curriculum (now v1.5), in ACCS-EM, the ST3 transition year, and higher EM training from ST4 onwards.
flowchart LR
Q1[Quarter 1
MSF + PDP
Set learning goals] --> Q2[Quarter 2
WPBAs + procedures
Half-year review]
Q2 --> Q3[Quarter 3
QIP + teaching evidence
Audit upload]
Q3 --> Q4[Quarter 4
e-portfolio polish
ESR meeting]
Q4 --> ARCP([ARCP panel])
What does the ARCP panel actually look for?
The ARCP panel reviews only what is on your e-portfolio on the published cut-off date. They do not see your character, your reputation in the department, or anything held by the deanery. They check your evidence against a regional checklist derived from the COPMeD Gold Guide 10th edition and the RCEM Higher Training ARCP Requirement Guide. The decision is evidence-led. Missing evidence is treated as failure to demonstrate the competence, not as a presumption that you can do the thing but did not write it down.
The panel is checking that you have evidence across all twelve SLOs at the entrustment level expected for your year, that mandatory courses and revalidation paperwork are current, that there is no unresolved concern from your educational supervisor structured report (the ESR or equivalent), and that there are no gaps that need additional training time. The educational supervisor report is the single most important document in the portfolio, because the panel relies on it to interpret everything else.
What are the ARCP outcome codes and what do they mean?
The Gold Guide defines a fixed set of outcome codes. The table below is the working reference for the EM-relevant ones. The full definitions are in the COPMeD Gold Guide 10th edition.
| Outcome | What it means | What happens next |
|---|---|---|
| 1 | Satisfactory progress at the expected rate. | Move on to the next year of training. The flagged Outcome 1 (with recommendations) still allows progression. |
| 2 | Development of specific capabilities required. No additional training time needed. | Targeted action plan with your educational supervisor, evidence those capabilities by the next ARCP. Progression continues. |
| 3 | Inadequate progress. Additional training time required. | Formal extension to the programme, normally up to 12 months, with a documented action plan. Repeated outcome 3 escalates rapidly. |
| 4 | Released from the training programme, with or without recorded capabilities. | End of the programme. Reserved for situations where remediation has failed or fitness to practise concerns sit alongside training concerns. |
| 5 | Incomplete evidence. No judgement on progress. | Short window (typically two to four weeks) to upload the missing evidence. If you do, it usually converts to outcome 1. If not, the panel reconvenes and you receive a 2, 3 or 4. |
| 6 | Recommendation for completion of training. | The CCT-eligibility outcome at the final ARCP of higher EM training. Triggers GMC notification. |
| 7.1 to 7.4 | LAT-equivalent outcomes for fixed-term training appointments: satisfactory (7.1), capabilities to develop (7.2), insufficient progress (7.3), incomplete evidence (7.4). | Same operational meaning as 1, 2, 3 and 5 respectively, but recorded against a LAT post rather than a numbered training year. |
| 8 | Out of programme (OOPR/OOPE/OOPC/career break). | Used while you are formally out of programme; no judgement is being made on training progress for the period covered. |
The single most important practical point is that outcome 5 is not a failure outcome. It is a deferral while you upload the things you forgot. Treat any outcome 5 as a 24-hour priority because the window is short.
How much WBA volume do I actually need?
The RCEM does not publish absolute numbers in the way that some other royal colleges do. The Higher Training ARCP Requirement Guide is explicit that quality of evidence matters more than absolute count, and individual trainees receive a bespoke programme negotiated with their educational supervisor. That said, every ARCP panel works from a regional checklist that does have effective minimum numbers, and the published RCEM guidance plus the higher training requirement guide gives a workable target.
| Year | Typical minimum WBA targets | Mandatory courses and reports |
|---|---|---|
| ACCS-EM CT1 / CT2 | Around one observed episode per week across the relevant clinical SLOs (mix of mini-CEX, CBD, DOPS). One MSF in the first six months of each year. First ESLE within three months of post commencement, then at least three ESLEs per year from intermediate training onwards. | ALS by end of CT1 if not already held. ATLS or equivalent by end of CT2. APLS planned for ST3 or later. Form R Part B at every ARCP. |
| ST3 (intermediate) | At least three ESLEs in the year, MCR equivalent from supervisors covering all clinical SLOs, MSF, balanced SLE evidence across SLOs 1 to 8, demonstrable engagement with SLOs 9 to 12. | APLS (or equivalent) typically expected by end of ST3. MRCEM Primary, MRCEM SBA and MRCEM OSCE all complete to progress to ST4. Form R Part B. |
| ST4 to ST5 (higher) | At least three ESLEs per year, MSF, evidence for every SLO at the entrustment level expected for the year, at least one leadership/management activity per year for SLO 12 (one of the three mandatory projects: critical incident investigation, rota management/recruitment/induction, or interspecialty meeting). | Life-support currency maintained (ALS, ATLS, APLS). FRCEM Final SBA usually attempted across ST4 to ST6. Form R Part B. |
| ST6 (final ARCP) | Six ESLEs from the last three years (three of which must be in the last 12 months), evidence across all twelve SLOs at the level needed for independent consultant practice, all three mandatory SLO 12 projects complete, QI portfolio, teaching portfolio, MSF. | FRCEM Final SBA passed, FRCEM Final OSCE passed, all life-support qualifications current. Final ARCP issues outcome 6 if everything is in place. |
The Higher Training ARCP Requirement Guide also references a minimum of 36 WPBAs across higher training in the form of DOPS (12), mini-CEX (12) and CBDs (12) for CESR/Portfolio Pathway applicants, which gives a useful sense of the floor expected over the ST4 to ST6 window. The ESLE expectation in higher training is six in the last three years, of which three must be within the last 12 months, with the first ESLE in any new post done with the educational or clinical supervisor within three months of starting.
What changed in the RCEM curriculum 2025 v1.5?
The GMC formally approved an updated version of the RCEM 2021 curriculum that took effect on 6 August 2025. The clinical syllabus and the overall structure of twelve SLOs are unchanged. The v1.5 update is a set of corrections, rebalancing and clarifications. The changes most likely to affect your ARCP evidence are:
- SLO 5 (Care for children of all ages in the ED). Key capabilities and descriptors were brought into line with SLO 3 (Adult Resuscitation) so that the resuscitation and severely-unwell-child content is consistent across the curriculum.
- SLO 6 (Procedural skills). Assessment of sedation was moved from ACCS LO7 (Anaesthetic Care) into the ACCS procedural skills domain so it can be assessed in any of the four ACCS placements, with final entrustment awarded at the end of the two-year ACCS period.
- SLO 8 (Lead the ED shift). Adolescent care and the specific issues that arise in that group were explicitly added across relevant SLOs without altering the clinical syllabus.
- SLO 11 (Participate in and promote activity to improve the quality and safety of patient care). A separate guidance document was issued to strengthen and clarify how SLO 11 should be evidenced, including signposting to QI educational resources and tools.
- SLO 12. Now styled as Lead and manage in the RCEM curriculum portal and the v1.5 wording, with the three mandatory higher-training projects (critical incident investigation, rota management/recruitment/induction, and interspecialty meeting) reinforced, plus at least one leadership/management activity per year of intermediate and higher training.
If your portfolio still uses the v1.4 language for SLO 11 or 12, that is not a problem in itself, but your ESR should reference the v1.5 update for any evidence dated after 6 August 2025.
Does failing FRCEM SBA mean an Outcome 3?
Not automatically. The Gold Guide treats exam failure as one input among several. A single failed attempt at FRCEM Final SBA with the rest of the portfolio intact, a clear remediation plan, and time remaining in the indicative training period typically attracts an Outcome 2, with a flag and an action plan, rather than an Outcome 3. Repeated failure, or failure that has consumed the indicative training time so that additional time is now required to attempt the exam again, is the situation that produces Outcome 3.
The practical implication is that the portfolio matters most when the exam has not gone well. If you sit and fail the SBA in your ST5 year, the panel will look at whether the rest of your evidence is on track. A clean portfolio with a single exam fail looks completely different from a thin portfolio with a single exam fail, even though the exam result is the same. For specifics on what to do after a difficult result, see our piece on appealing an RCEM exam result.
What is the year-round evidence-gathering plan?
The single biggest predictor of an outcome 1 is starting early. Most outcome 5s are not lazy trainees; they are trainees who left too much for the last month. Use the following month-by-month plan as a default and adjust to your local ARCP window.
| Month after starting the year | Focus | Concrete actions |
|---|---|---|
| 1 | Induction and supervisor sign-up | Initial educational supervisor meeting, learning agreement, PDP, identify the SLOs you most need evidence in this year, book the first ESLE within three months. |
| 2 to 3 | First ESLE and baseline WBAs | Complete the first ESLE with your educational or clinical supervisor, start a regular rhythm of SLEs (mini-CEX, CBD, DOPS), issue MSF tickets early enough to allow chasing. |
| 4 to 6 | Mid-year review and corrections | Mid-year ES meeting, second ESLE, audit your SLO coverage and target the weak ones, start or formalise your QI project for SLO 11, start your SLO 12 mandatory project. |
| 7 to 9 | Volume and breadth | Third ESLE, second MSF if required, life-support currency renewals booked, teaching activity logged, complete or near-complete QI project, leadership project written up. |
| 10 to 11 | Lock-down | Final ES meeting and ESR. Cross-check every SLO against the regional checklist. Form R Part B drafted and uploaded. Reflective notes filed against any significant clinical incident. |
| 12 (cut-off) | Submit | Nothing should be added in the final week. Confirm portfolio is locked, all certificates are uploaded as PDFs (not photos of phone screens), and your ESR is signed off. |
What are the common panel pitfalls?
The recurring patterns that cost trainees an outcome 1 are predictable. The published RCEMLearning piece Passing the ARCP, or how to keep your TPD happy sets out most of these and the same themes recur in trainee VOC on r/JuniorDoctorsUK and in EMTA chat threads.
- Late uploads. Adding evidence the day before the panel is treated as if it had not arrived. Panel members need time to read and verify.
- Expired courses. An ALS or ATLS certificate that lapsed two weeks before the cut-off is a flag the panel cannot ignore.
- Reflective notes that are not reflective. A two-line description of a case is not a reflection. The panel is looking for explicit insight, learning needs and a planned change in practice.
- Lopsided SLO coverage. Heavy evidence in SLO 1 and SLO 3 with nothing in SLO 9, 11 or 12 is the classic profile that triggers an outcome 2.
- Educational supervisor report that does not endorse progression. The ESR is the single most influential document. A hesitant or hedged ESR usually drives the outcome regardless of the rest of the evidence.
- Form R Part B missing or out of date. Non-clinical, but it is a hard requirement for revalidation and will trigger an outcome 5 if absent.
- Portfolio disorganisation. Untagged evidence, files labelled Scan_001.pdf, evidence in the wrong SLO. The panel will not hunt for it.
What if I receive an Outcome 2?
An outcome 2 is recoverable. You progress to the next year, but with a documented set of capabilities the panel wants to see by the next ARCP. The practical actions are: meet your educational supervisor within two weeks to agree a written action plan against the specific capabilities named in the outcome form, schedule the specific WBAs that will evidence them, and ask for an interim review at three to six months. Treat the action plan as a contract. Most outcome 2s become an outcome 1 the next year if the action plan is followed.
What if I receive an Outcome 3?
Outcome 3 means inadequate progress and additional training time required, normally up to 12 months and exceptionally up to a maximum of two years over the full programme at the discretion of the postgraduate dean. The action plan is more formal, the educational supervisor relationship intensifies, and the deanery typically appoints a named individual to track progress. The CCT date moves. The CESR or Portfolio Pathway timeline is also affected if you are on that route.
You should meet your educational supervisor within two weeks of the outcome to agree the action plan, in writing, on the deanery template. You also have the right to request a review and, if the review does not resolve it, a formal appeal. The appeal request must be made in writing within ten working days of being notified of the outcome, on the correct pro forma, and must specifically state the grounds. The review is normally undertaken by the original panel within 15 working days. If the review upholds the outcome, the appeal hearing should normally be scheduled within 30 working days. Most outcome 3s do not go to appeal; they go to remediation. Save the appeal route for when you genuinely believe the panel got the evidence wrong, not for when you disagree with the panel’s judgement.
What if I disagree with my outcome?
Two formal routes exist. A review is the first step and is normally heard by the same panel, looking at whether the original decision was procedurally correct on the evidence supplied. An appeal is the second step and is heard by a different panel, with the right to representation, focused on procedural fairness and on whether the evidence supports the outcome. The grounds for appeal are tightly defined and do not include simple disagreement. Speak to your educational supervisor and your training programme director before initiating either route, and consider BMA or defence union support. The full appeal route is the right tool for genuine procedural error or new evidence the panel did not see; it is the wrong tool for an outcome you accept on the evidence but wish had been kinder.
What about ARCPs during out-of-programme time?
An Outcome 8 covers approved out-of-programme periods (OOPR, OOPE, OOPC, or a career break). You still need an ARCP within the standard 15-month window, but the panel is making no judgement on training progress for the OOP period itself. You should still hold evidence of the OOP activity (publications, course outputs, employer letters) and your educational supervisor will need to summarise the period for the panel.
How does the ARCP fit with the CCT pathway?
The final ARCP of higher EM training is the gateway to CCT. An outcome 6 is the recommendation for completion of training, which RCEM and the deanery then communicate to the GMC. The CCT date is the date your training programme ends, not the date the certificate arrives, and the gap between the two is normally a few weeks. For the specifics of the transition, see our companion piece on the FRCEM CCT pathway after passing and on becoming an ST3 after FRCEM Final portfolio prep.
Key Takeaways
- The ARCP panel sees only what is in the e-portfolio on the cut-off date, judged against the Gold Guide 10th edition and the RCEM Higher Training ARCP Requirement Guide.
- Outcomes 1 and 6 are progression. Outcome 5 is a short deferral. Outcomes 2 and 3 are recoverable. Outcome 4 is rare and means the end of programme. Outcomes 7.1 to 7.4 are LAT-equivalents.
- The 2021 curriculum updated to v1.5 on 6 August 2025. The clinical syllabus is unchanged; SLOs 5, 6, 8, 11 and 12 were refined, with SLO 12 styled as Lead and manage.
- Higher training expects six ESLEs in the last three years (three in the last 12 months), with the first ESLE in any new post done within three months of starting, plus regular SLEs, MSF, and SLO 12 mandatory projects.
- Failing FRCEM SBA does not automatically produce an Outcome 3. A clean portfolio with one exam fail typically attracts an Outcome 2 with an action plan.
- The single biggest predictor of an Outcome 1 is starting early, with a structured year-round evidence-gathering plan and a strong educational supervisor relationship.
- Outcome 2 is fixed with a written action plan. Outcome 3 means additional training time. Both have formal review and appeal routes, with strict ten-working-day deadlines.
Further Reading
- COPMeD Gold Guide 10th edition (August 2024)
- RCEM Higher Training ARCP Requirement Guide
- RCEM Emergency Medicine Training Curriculum 2021, v1.5 update (August 2025)
- RCEM Curriculum Update 2025 Transition Advice
- ESLEs and ACATs guidance (RCEM, January 2025)
- RCEMLearning: Passing the ARCP, or how to keep your TPD happy
Related on EM Final Exams
- Appealing an RCEM exam result
- FRCEM CCT pathway after passing
- Becoming an ST3 after FRCEM Final portfolio prep
Authoritative Sources
- COPMeD Gold Guide 10th edition
- RCEM Emergency Medicine Curriculum
- RCEM Curriculum v1.5 Final (August 2025)
- RCEM Higher Training ARCP Requirement Guide
- RCEM Specialty Learning Outcomes (SLOs)
- SLO 12 – Lead and manage (RCEM Curriculum portal)
- RCEMLearning: Passing the ARCP, or how to keep your TPD happy
- UK Foundation Programme: ARCP outcomes reference
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