dr mark attah mba, mcmi, mrcgp gp partner & commissioning lead, bretton medical practice,...
TRANSCRIPT
Dr Mark Attah MBA, MCMI, MRCGP
GP Partner & Commissioning Lead,
Bretton Medical Practice, Peterborough
Programme Director, GP Speciality Training,
North Cambridgeshire
GENERAL PRACTICE: TRAINING, OPPORTUNITIES &
LIFESTYLE
AIMS
To provide an overview of General Practice and the role of GPs
To discuss General Practice Training
To identify the various opportunities available in General Practice
To understand the lifestyle of GPs
“An approach orientated to the individual, their family and their community; provision and co-ordination of care from birth to death; and promotion of health and wellbeing.” So in addition to “general” interest in the body and mind, there must in these circumstances be an overriding interest in the person rather than the illness, a commitment to continuity of care through the life term, an ability to manage the boundaries of different forms of care and support, and an understanding of the health needs of the wider community.
‘Generalist practice is decision-making which is person-, not disease-focused, which is continuous and not episodic, which integrates the biographical and the biotechnical knowledge … all with a view to supporting health as a resource for living and not an end in itself.’
Joanne Reeve, NIHR Clinical Scientist in Primary Care, University of Liverpool
‘The difference between generalists and specialists is important because it depends which lens is in front: the disease lens or the patient’s lens. Young doctors need to decide (and both decisions are legitimate) whether they are more interested in the science of disease or the way in which disease affects individual people.’
Iona Heath, President, Royal College of General Practitioners
GPs are uniqueSimultaneously manage physical, psychological and social problemsOffer care in the patients communityManage undifferentiated symptoms & uncertaintyExpertise in risk managementSimultaneously manage acute & chronic problems and multiple problemsAddress both individual and public health issuesCo-ordinate the patients overall care and offer advocacyPersonalised, focused individual care founded on mutual trust also family care
GP Speciality Training
Selection process
Training
Assessment
Certification
GP ST Selection
Based on criteria needed to make a successful GP
Assessment of criteria by-• Stage I (Long-list) Online application• Stage II (Short List) MCQ- Clinical, Situational
Judgement and Professional dilemma paper• Stage III (Selection) 3 Communication Skills
Scenarios (Patient/ Patient Relation/ Health professional)
Qualities needed for GP
Clinical competenceCommunication skillsOrganisation and planningProblem solvingAble to cope with pressureProfessional integrity/ ProbityEmpathy and sensitivityTeam working, managing conflict and negotiationProfessional development
GP Speciality TrainingCurrently 3 years (4 years from 2014)
Minimum of 18 months F/T GP training under supervision of a GP Trainer
Rotation through various Secondary care and community departments (4-6 Months each) e.g. Med, A&E, O&G, Paeds, Palliative care, Public Health, Psychiatry
Innovative posts- Combining GP practice + clinics e.g. Ophthalmology, ENT, GUM
Protected teaching times
AssessmentWorkplace-based Assessment- WPBA
• e-portfolio
Applied Knowledge Test- AKT Computer based. Clinical 80%, Critical appraisal/EBM 10%, Admin/IT 10%
Clinical Skills Assessment- CSA Consultation skills 13 patients encounter
Regulars assessment by clinical & educational supervisors
Certification/ Licensing
MRCGP
CCT General Practice
PCT Performers list
Annual appraisal
Revalidation
What does General Practice offer as a career?
An opportunity to have a real impact on people’s lives
The chance to become directly involved with patients and families
Flexible working practices
Independent working patterns and autonomy
General Practice as a career II
Involvement in teamwork with other health professionalsScope to develop specialist interest within general practiceA key role in decision makingDirect involvement in health at the grass roots levelA rewarding career with an involvement in people and medicine
Career options
Full Time/ Part- Time GP
Partner/ Salaried/ Locum
GP Practice/ Community/ Hospital/ OOH
Portfolio careers- becoming increasingly popular
GP Career OptionsWithin the practice-GPWSI- Diabetes, Minor Surgery, Dermatology, Sports Medicine, Education
Outside practice- Hospital Clinical assistant e.g. Endoscopy, Community Services e.g. Dermatology, FME
Academic/ Legal, MDU adviser, Journalism, Occupational health
Management- PCT, Commissioning
Case Studies
RD Part time Salaried
RS P/T Portfolio Management
KW Locum Education
JL Locum OOH
ROLE OF A GP
CarerEmployerTeacherLeaderTeam memberAdvocateGate keeper (navigator)ResearcherHealth promoterResource allocatorPublic Health Practitioner
Role of a Partner
Business owner
Employer
NHS Manager
Public Health Physician
Diplomat
Investor-(property, staff, Risk)
Becoming a Partner
PROS
Stability
Own boss
Decision making
Financial reward
Flexibility
CONS
Hard work
Long hours
More responsibilities
Financial risks
Joint and several liability
Tied down
Partnership Case Study: Bretton Medical Practice
Suburban GP practice 12,000 patients
4 partners (6 WTE) GPs
Premises practice owned with 12 consulting Rooms, Large treatment Room, Operating Theatre, Pharmacy and Dental Surgery
Various provider services using different models of strategic partnerships, commissioning and delivery
Bretton Medical Practice
Full GMS (GP) services• Contraception, Child Health, minor surgery
Education /Training Practice• GP Registrar, Cambridge Medical
students, Paramedics, Nurse Prescribers
Research-RCGP Accreditation, Level 2 PCRN
• DECISION, EUDREGENE, PACE, 3CS
Bretton Medical PracticeCommissioned / Ext ServicesUpper and Lower GI Endoscopy
No Scalpel Vasectomy
Plastic & Aesthetic Surgery
Ultrasound Scan Services
Physiotherapy
Counselling
Lifestyle
4 day week- No on calls / OOH optional
Flexibility- Career options / portfolio
Job security & Career prospects with good income
Opportunities- Business, Ext interests, hobbies, transferrable skills
Sabbatical
Case Study
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