A Glimpse into General Practise Training in the UK By: Dr Fatima Kapacee GPST1 UK

Pre GP training Foundation years 1 and 2 During F2, application for GP Training commences in November – via National Recruitment Office via ORIEL Exam (Situational judgement test) around January and then Interviews in February Offers made in March Training commences in August *training can also commence in Feb with offers made in October

GP Training – The Process Apply for posts typically 6 monthly over the first 2 years 18 months Hospital placements and 18 months in GP 1st year in hospital and 3rd year fully in GP. Flexible 2nd year MRCGP – 3 parts: 2 Exams in total: 1st to be done during ST2 – AKT (Applied Knowledge test) 2nd to be done during ST3 – CSA (Clinical Skills Assessment) Workplace based assessment - Eportfolio maintenance and annual ARCP (Annual Review of Competence Progress) After completing both exams and successful ARCP Apply for CCT to GMC and RCGP * 4 year Programmes can also be done to incorporate academic clinical fellowships or a global health fellowship year

Exams AKT Computer based exam 3hrs and 10mins 200 questions 80% clinical medicine 10% on critical appraisal – Using evidence and data to underpin clinical decision making and being able to critically appraise good evidence and adopt guidelines 10% on health informatics, ethics and administrative issues e.g. completion of insurance reports, sick notes All questions relate to UK General Practise and focus on higher problem solving CSA Based largely on OSCE format Each candidate is assigned a consultation room and has 13 10minute consultations Main focus areas Primary care management – recognition and management Problem solving skills – including data gathering Comprehensive approach – co-morbidity and risk Person-centred care Practising ethically and professionally Clinical practical skills

Work Place Based Assessments Tools include: Case Based Discussions (CBD) Consultation Observation Tool (COT) (in Primary Care) Multi-source feedback (MSF) Patient satisfaction questionnaire (PSQ) (in Primary Care) Clinical Examination and Procedural Skills (CEPS) Clinical Evaluation exercise (mini CEX) Clinical Supervisors Report (CSR) - to be undertaken in all hospital posts, but can also be used in the primary care setting Learning Log Personal Development Plan (PDP)

Post CCT Options of working as a GP: GP Partner Salaried GP Locum GP Sessional GP Porfolio GP: GPwSI in most specialities including dermatology, diabetes and minor surgery CCG roles (Clinical Commissioning Group) from chair to Director level Teaching and training roles GP leadership roles including Associate medical director or Medical Director of Community Health Trusts Working for Prison Health services as a GP Working exclusively in out of hours GP services Other Extra curricular interests: Explore areas of clinical interest Joining the RCGP team in various areas including JIC (Junior International Committee) Take part in projects worldwide e.g volunteer in Bwindi Community Hospital, Uganda Taking part in Conference Exchanges

My Journey so far… Born in Kenya Moved to the UK at age 15 Went to Medical School in London Did my foundation training in Oxford Did my Elective in Kathmandu, Nepal and then 1 day of shadowing during my EBC trek at Periche while acclimatising F1 – 6 months General Medicine and 6 Months in Surgery F2 – 4 months in Neonatology, 4 months in GP and 4 months in Care of the Elderly Spent some time locuming to develop my interest in Paediatrics Relocated to Canada – did a shadowing placement there in GP Moved back to the UK and started locuming in paediatrics while I awaiting commencement of application process Realised that I was not getting any family life balance and barely seeing my daughter – spent time discussing options with colleagues and decided to look into GP training Applied for GP training Realised the opportunities I have for global work, balancing family life and overall happiness without having a pay cut (by part time work)

My Future plans To join the JIC and help to find ways to improve GP training in the UK To continue to partake in exchange programmes and increase my knowledge and experience of GP practise in other Countries To do a diploma in child health and thus pursue my interest in paediatrics To look into and prepare to work and volunteer abroad in resource deprived areas as much as possible after completion of training To expand my family