Supervised practice

Regulators sometimes let a professional practise before they meet every requirement for independent registration, on condition that a named, registered colleague oversees their work. The supervision is part of the legal basis for practising, not just a feature of the job. If the supervised post ends, the right to practise usually ends with it.

The term covers several different arrangements, so it matters which one applies to you.

The supervisor's role is also defined. The HCPC, for example, says a supervisor should only supervise activities within their own scope of practice, and that it cannot help arrange placements, so finding a supervisor is your responsibility. In Ireland, the clinical site submits a form to the Medical Council giving details of the supervised post, and CORU's adaptation periods may be accompanied by academic modules where needed.

• Ireland, doctors: the Medical Council grants registration in the Supervised Division only to doctors offered a post approved by the Health Service Executive (HSE) with specific supervisory arrangements. It lasts for an aggregate of two years, and applicants must pass or be exempt from PRES. If you leave the post early, you must stop practising medicine in Ireland. See IMC registration divisions.
• Ireland and the EU, recognition: where an overseas qualification falls short, CORU can offer a choice between a period of adaptation, which is supervised clinical experience in Ireland, and an aptitude test. The Dutch BIG procedure can also require an adaptation internship. See adaptation period.
• UK, HCPC returners: professionals out of practice for two years or more must complete 30 or 60 days of updating, which can include supervised practice under a registered professional.
• USA, physicians: several states now offer provisional licences for internationally trained physicians. The FSMB describes, for example, an Arkansas route with a provisional licence tied to a sponsoring physician and a qualifying employer.

1. A post or placement is offered and approved for supervision.
2. You apply to the regulator for the matching registration category.
3. A named supervisor oversees your practice and may file reports.
4. You complete the time or assessment required.
5. You move to full registration, or the permission ends with the post.

Keep a record of your supervised time, the supervisor's details and any reports, because regulators ask for this evidence when you apply to move on to full registration or readmission.

• Applying for supervised registration before a supervised post is offered. The Irish Medical Council warns that its application fees are non-refundable.
• Assuming supervised time automatically leads to full registration. Each regulator sets its own transfer rules.
• Changing employer mid-way without telling the regulator.
• Confusing supervision with preceptorship, which is support for newly registered staff, not a condition of registration.

Our PRES guide and NMBI aptitude test and adaptation guide cover two common Irish routes.