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Becoming a training practice. Maggie Eisner Training Programme Director, Bradford GP Training Scheme November 2010. Things to consider. Benefits to practice How does someone train to be a GP? How is GP training organised? Infrastructure for training practice Trainee’s timetable

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becoming a training practice

Becoming a training practice

Maggie Eisner

Training Programme Director, Bradford GP Training Scheme

November 2010

things to consider
Things to consider
  • 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
benefits to practice
Benefits to practice
  • 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
how does someone train to be a gp
How does someone train to be a GP?
  • 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
how is gp training organised
How is GP training organised?
  • 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
infrastructure for training practice
Infrastructure for training practice
  • 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)

trainee s timetable
Trainee’s timetable
  • 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)
roles of practice team members
Roles of practice team members
  • 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
trainer s time
Trainer’s time
  • 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)
part time trainers
Part time trainers
  • 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
salaried doctors as trainers
Salaried doctors as 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
what about patients
What about patients?
  • 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
benefits to practice1
Benefits to practice
  • 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
further information from
Further information from
  • www.bradfordvts.co.uk
    • Intending Trainers’ section
    • Practice Managers’ section
  • www.yorksandhumberdeanery.nhs.uk/general_practice/
      • Intending Trainers’ section
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