- Early and thorough assessment is critical, including sitting-in, joint surgeries and/or video of consultations, and the views of other members of the team.
- Regular assessment and feedback to the registrar, coupled with documented development planning and scheduled review.
- Explicit expectations – practices should be explicit about the behaviour expected of the registrar e.g. working hours, participation in practice meetings etc, and what the registrar can expect from the practice.
- Understand that registrars may be going through an important transitional phase of their lives. Their background and culture e.g. a longish spell hospital medicine, may be relevant.
- If there are problems focus on behaviour and expected behaviour change.
- Document and share all documentation with the registrar. In case of disagreement the registrar can register their view in writing to be kept with the documentation.
- Seek help early from colleagues in the practice, trainer group, course organiser and/or scheme organiser.
- Identify any need for an extra six months early. It should not be seen as failure, but as an opportunity to hone the skills of being a really good GP.
- Consider need for an occupational health assessment (the schemes have the details).
- Trainer groups and schemes need to consider how best to provide structured and early support for new trainers.
Resources
- See www.bmjlearning.com for useful advice on dealing with difficult doctors, ill doctors etc
- Action plan for future registrars outcome of a practices critical event discussion