Becoming a training practice
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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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