GP trainee training plan

 

Aims and objectives

Mission statement

  1. To enable a GP registrar to aspire to a standard of excellence.
  2. To enable the practice to aspire to a standard of excellence.
  3. To achieve a personal standard of excellence.

The “standard of excellence” is defined by:

  • Personal beliefs
  • Standards set by trainee in conjunction with me.
  • Standards set by the Royal College of General Practitioners.
  • Standards set by the  Trainers Group.
  • Standards set by the VTS.
  • Standards set by other agencies.

Philosophy

  • Learner-centred education – “You get out what you put in”.
  • Problem-based learning.
  • Emphasis on attitudes – shared feelings.
  • Generally counselling, heuristic or neo-socratic style.
  • Personal learning, depending on strengths and areas for improvement for each trainee.
  • The GP registrar is part of the practice team, and encouraged to become involved as such.
  • Life long learning

Aims

  • To show how attitudes modify behaviour.
  • To encourage the development of appropriate attitudes which will benefit doctor and patient.
  • To aid the process of accreditation by the GMC and RCGP.
  • To generate a sense of “belonging” within general practice.

Objectives

  • To explore the diagnostic triad (physical, social, psychological).
  • To demonstrate personal care (how the individual patient modifies the doctor’s behaviour).
  • To demonstrate family care (how the behaviour of one family member modifies another).
  • To demonstrate patient-centred medicine and promote patient autonomy.
  • To explore decision-making in general practice.
  • To show the concept of teamwork in practice, and to explore how this comes about.
  • To understand the use of time as a tool.
  • To explore the concepts of probability and uncertainty in general practice.
  • To explore the wide range of available options for patient care in general practice.
  • To demonstrate practice management.
  • To demonstrate the need for good communication skills.
  • To explore the structure and process of the consultation.
  • To show preventive care in action, and encourage its use.
  • To demonstrate the use of computers in general practice.
  • To demonstrate the need for audit and self-assessment.
  • To demonstrate the need for continuing education.
  • To explore self-awareness, and the effect of this on inter-personal communication.

Training plan

This is planned individually with the GP Registrar at the beginning of the attachment, and revisited monthly. The list below is a starting point.

At the start (or before)

  • A learning styles questionnaire
  • Topic-based confidence rating 1 (North Northumberland Rating Scale), designed by the North Northumberland trainer group.
  • Information CD-ROM and handbook providing information about the practice, protocols, contact addresses, phone numbers etc.

Weekly

  • Joint surgery every Friday afternoon. During joint surgeries, the trainer and GP registrar consult alternately, watching each others consultation techniques. Extra time is allowed between patients to explore the issues raised by the consultation. GP registrars find the concept a little threatening at first sometimes, but soon find this session the highlight of the week. Patients find it acceptable and have been very supportive. From the training point of view it has obvious benefits for modelling, assessment and learning as well as teaching.
  • Joint visits
  • Tutorials: Monday, Tuesday, alternate Thursdays, Friday.

Month 1

  • Trainee contract
  • Exposure to trainer on video
  • Videotape surgery
  • Team attachments
    • Receptionist
    • Health visitor
    • District nurse
    • Pharmacist
    • Practice nurse
    • Nurse practitoner
    • CPN
    • Social worker
    • Undertaker
    • Youth support service
    • Hospice
    • Drug rehabilitation agency
  • Sitting-in with each of partners
  • PEP MCQ/MEQ program

Month 2

  • Videotape surgery 2

Month 3

Month 4

  • Prescribing
  • Videotape surgery 4
  • Leicester video assessment package

Month 5

Month 6

Other assessment tools

  • MCQ
  • MEQ
  • Self-rating and peer standard-setting
  • Personality inventories
  • MRCGP study day
  • The “walk”

Essential Topics

Month 1

  • Practice management basics – Sheila Steele
  • Computing skills
  • Forms
  • Red book basics
  • Mechanism of consultation
  • Study and reading strategies
  • Black bag
  • Multiple agendas
  • Simple illnesses
    • URTI
    • Sore throat
    • Otitis media
    • Muscular sprains
    • Cystitis

Month 2

  • Depression
  • Sudden death and the coroner
  • Controlled drugs
  • Menstrual problems
  • Vaginal examination
  • Tiredness
  • Insomnia

Month 3

  • Bereavement
  • Dizziness
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