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Maggie EisnerTraining Programme Director, Bradford GP Training
SchemeNovember 2010
Benefits to practice How does someone train to be a GP? How is GP training organised? Infrastructure for training practice Trainee’s timetable Roles of practice team members Trainer’s time Part time trainers Salaried doctors as trainers Patients
Helps with recruitment of GPs Trainer’s educational skills useful for the
practice Improves trainer’s morale and makes
burnout less likely Keeps all doctors in touch with new
developments Financial benefit = trainee’s salary paid,
trainer’s grant ‘Kudos’ of being a training practice Stimulus to maintain clinical standards and
standards of record keeping Deanery may support improvement to
premises (Nov 2010 – very unlikely now!) Extra pair of medical hands
5 yrs medical school, 2 yrs Foundation Training, then 3 year GP training scheme including GP posts and specialties (eg paeds, psych etc)
18m in GP, of which 6m in year 1 or 2 and 12m in year 3; Teaching in GP posts
On-the-job teaching and after-surgery discussions Tutorials in practice from trainer and others Group tutorials (Weds lunchtime) Half Day Release (Tues pm) Courses, e g Induction, Family Planning
Assessments for nMRCGP(recorded on e portfolio) Applied Knowledge Test (machine marked exam) Clinical Skills Assessment (simulated surgery exam) WorkPlace Based Assessments incl COT (observed consultations), CBD
(case based discussion), DOPS (observed procedures), MSF (multisource feedback), PSQ (patient satisfaction questionnaires)
Regular meetings with Educational Supervisor (another trainer, or TPD) to check progress
ARCP panels once a year to formally assess progress and recommend Deanery re awarding nMRCGP and CCT
National system, overseen by PMETB which has criteria and requires a timetable for each post
Regionally by Yorkshire and the Humber Deanery
Locally by Training Programme Directors with administrators Sofya Loren and Safina Akhtar at Field House, BRI
Room for the trainee to consult Records summarised to Deanery standards Library – only a few books needed, should
be up to date Video camera Commitment by whole practice to be an
educational organisation
(one-off grant paid to new training practices, after trainer successfully appointed)
Induction programme at start 7 surgeries per week (start with long appt
interval and gradually reduce to 10 mins) Timetabled debriefs after surgeries Home visits – not usually more than 1-2 ½ day with trainer – teaching and assessments ½ day private study HDR Tuesday 2 – 4.45, group tutorial Weds 1 –
2 15d study leave in 6m (usually HDR + 1w, can
use discretion)
Trainer Pastoral care Support during surgeries After-surgery debriefs Tutorials Assessments
Practice manager Employment of trainee: WYCSA forms, management of trainee’s employment stuff Teaching about practice management
Other doctors Clinical supervision for trainee (support during surgeries, debriefs) when trainer
absent ? Timetabled for debriefs ? Tutorials ? Assessments (DOPS, COT and CBD)
Practice nurses DOPS (esp cervical smears) ? Teaching (esp chronic disease management)
Receptionists Making appropriate appointments ( e g not booking patients in for things a
particular trainee can’t do, e g joint injections or smears) Patient satisfaction questionnaires Consent forms for video sessions
Intending trainer 3 x 2 day seminars at Deanery, or 4 x 2 day modules for Cert in Med Ed Sessions with mentor 6-24 HDR sessions in 6m Some Trainers’ Workshops
Established trainer Min ½ day/week protected time with trainee Time for debriefings Occasional HDR sessions (paid) Trainers’ Workshops (monthly Tues lunchtime, 1/2d x4/yr, annual 2 day
Time Out) Deanery seminars (TQA every 3y) Other stuff e g Recruitment, ARCP panels, Educational Supervision
(paid) Recommended 5 days’ extra study leave for continuing development as
educator After 1st year as trainer, protected time for meeting with Educational
Supervisees (2 in trainee’s 1st 6m, then 1 every 6m) (paid, but not well)
For FT trainee, need explicit, agreed arrangements for trainee’s supervision & debriefs when trainer not there
For PT trainee, ideal to work the same days but often hard to arrange
If PT trainer and PT trainee work different days, best to have another practice doctor consistently involved
PT trainers need same amount of extra study time etc as FT trainers
Increasing trend If salaried doctor is the only trainer in the
practice, important to involve them in practice decisions affecting training
Need support of partners and PM when there is potential divergence between business and educational interests
Most like the idea of helping young people learn
Some conflict of interest between patients’ needs and trainees’ educational needs
Possible problems Some patients may only see a succession of
trainees and not get properly sorted out Other docs booked up in advance so trainee only
sees patients who book at short notice (more acute illness, more trivia, less chronic disease AND some more vulnerable patients e g children at risk)
So the practice may need a policy
Helps with recruitment of GPs Trainer’s educational skills useful for the
practice Improves trainer’s morale and makes
burnout less likely Keeps all doctors in touch with new
developments Financial benefit = trainee’s salary paid,
trainer’s grant ‘Kudos’ of being a training practice Stimulus to maintain clinical standards and
standards of record keeping Deanery may support improvement to
premises (Nov 2010 – not so likely now) Extra pair of medical hands
www.bradfordvts.co.uk Intending Trainers’ section Practice Managers’ section
www.yorksandhumberdeanery.nhs.uk/general_practice/
Intending Trainers’ section