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