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T-CARQ: a BASHH trainee collaborative for audit, research and quality improvement
  1. Helen Wiggins1,
  2. Anna Joceline Hartley2,
  3. Nadia Ahmed3
  1. 1 Genito-Urinary Medicine, Watford Sexual Health Clinic, Central London Community Healthcare NHS Trust, Watford, UK
  2. 2 Genito-Urinary Medicine, Barts Health NHS Trust, London, UK
  3. 3 Genitourinary Medicine and HIV, Mortimer Market Centre, London, UK
  1. Correspondence to Dr Helen Wiggins, Genito-Urinary Medicine, Central London Community Healthcare NHS Trust, Watford sexual health clinic, first floor annexe, Town Hall, Watford, Watford wd17 3ex, UK; helenwiggins{at}

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Genitourinary medicine (GUM) is a relatively small and rapidly evolving specialty. The specialty is currently facing several challenges including tendering of services and changes to the GUM specialty training programme to encompass internal medicine. Due to the nature of the specialty, sexual health clinics are often run quite differently. They serve different patient groups with different clinical needs. Therefore, trainees can have variable training with inconsistent opportunities in clinical exposure, teaching and research. For example, trainees in London are exposed to a much larger HIV cohort than trainees in smaller cities, allowing them more easily to gain both clinical and research experience in this area.

The BASHH Trainees Collaborative for Audit,  Research and Quality Improvement Projects (T-CARQ) is a relatively new subgroup of ‘BASHH Doctors in Training.’ It was set up in 2015 by GUM trainees for trainees to encourage multicentre, national collaborative work. It aims to enable trainees who work with smaller patient cohorts to collaborate with trainees in other centres to produce larger, higher impact projects with more clinical relevance at national rather than local level. Such collaborations have been very successful in other specialties such as general surgery (WMRC)1 and anaesthetics (RAFT).2

T-CARQ is supported by BASHH. Trainees leading projects have access to peer-to-peer support as well as expert advice from the vast knowledge base of the relevant BASHH specialist interest groups. Support with study design, implementation, statistical analysis and write up is also offered. One of the main roles of the collaborative is to link trainees across the country, enabling more collaborative work.

Trainees may put forward an idea to T-CARQ via email ( or at organised meetings (advertised via BASHH trainee representatives) and in some cases T-CARQ will advertise directly to trainees to get involved in a specific project. A project lead will be appointed (usually the individual who proposed the idea) and a proposal drawn up. Trainees from different areas will be invited to collaborate via a variety of ways depending on the project need; the T-CARQ committee will facilitate this process.

For the first project, T-CARQ focused on an issue affecting many current trainees; tendering and its potential impact on training via a national survey. Of trainees who responded, 63% (45/72) had experienced tendering and 59% (24/41) felt their training was not considered in this process, 44% (18/41) felt adequately supported and 30% (12/40) reported active involvement in this process.3 Some trainees were able to share personal experiences and advice on how to make the most of the tendering process and minimise any negative impact on training. Such examples included actively involving trainees and education partners in the tendering process, inclusion of specialist GUM training in service specifications and the development of guidance for commissioners and services around the management of GUM training within tendering. Our ability to share these experiences will hopefully have a direct positive impact on trainees who may go through this process in the future.

We are currently working with trainees and Public Health England on a national, large-scale chemsex project and a project looking at services within prisons.

By encouraging collaborative working, T-CARQ hopes to bring trainees closer together in what is a turbulent time within the GUM specialty and indeed the National Health Service and to enable trainees who may have less exposure to research to address this via multicentre, collaborative projects. Trainees will be supported by both peers and experts within the relevant clinical field, and this will facilitate trainees meeting many of the core curriculum requirements including those in research, audit, statistics, presentations, publications, team working, communication and leadership.

For further information please visit the T-CARQ page on the BASHH website ( or contact the committee via or via twitter (@BASHH_TCARQ).


  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.