GENERAL PRACTICE: TRAINING, OPPORTUNITIES & LIFESTYLE

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Presentation transcript:

GENERAL PRACTICE: TRAINING, OPPORTUNITIES & LIFESTYLE Dr Mark Attah MBA, MCMI, MRCGP GP Partner & Commissioning Lead, Bretton Medical Practice, Peterborough Programme Director, GP Speciality Training, North Cambridgeshire

AIMS To provide an overview of General Practice and the role of GPs To discuss General Practice Training To identify the various opportunities available in General Practice To understand the lifestyle of GPs

“An approach orientated to the individual, their family and their community; provision and co-ordination of care from birth to death; and promotion of health and wellbeing.” So in addition to “general” interest in the body and mind, there must in these circumstances be an overriding interest in the person rather than the illness, a commitment to continuity of care through the life term, an ability to manage the boundaries of different forms of care and support, and an understanding of the health needs of the wider community.

‘Generalist practice is decision-making which is person-, not disease-focused, which is continuous and not episodic, which integrates the biographical and the biotechnical knowledge … all with a view to supporting health as a resource for living and not an end in itself.’ Joanne Reeve, NIHR Clinical Scientist in Primary Care, University of Liverpool

‘The difference between generalists and specialists is important because it depends which lens is in front: the disease lens or the patient’s lens. Young doctors need to decide (and both decisions are legitimate) whether they are more interested in the science of disease or the way in which disease affects individual people.’ Iona Heath, President, Royal College of General Practitioners

GPs are unique Simultaneously manage physical, psychological and social problems Offer care in the patients community Manage undifferentiated symptoms & uncertainty Expertise in risk management Simultaneously manage acute & chronic problems and multiple problems Address both individual and public health issues Co-ordinate the patients overall care and offer advocacy Personalised, focused individual care founded on mutual trust also family care

GP Speciality Training Selection process Training Assessment Certification

GP ST Selection Based on criteria needed to make a successful GP Assessment of criteria by- Stage I (Long-list) Online application Stage II (Short List) MCQ- Clinical, Situational Judgement and Professional dilemma paper Stage III (Selection) 3 Communication Skills Scenarios (Patient/ Patient Relation/ Health professional)

Qualities needed for GP Clinical competence Communication skills Organisation and planning Problem solving Able to cope with pressure Professional integrity/ Probity Empathy and sensitivity Team working, managing conflict and negotiation Professional development

GP Speciality Training Currently 3 years (4 years from 2014) Minimum of 18 months F/T GP training under supervision of a GP Trainer Rotation through various Secondary care and community departments (4-6 Months each) e.g. Med, A&E, O&G, Paeds, Palliative care, Public Health, Psychiatry Innovative posts- Combining GP practice + clinics e.g. Ophthalmology, ENT, GUM Protected teaching times

Assessment Workplace-based Assessment- WPBA e-portfolio Applied Knowledge Test- AKT Computer based. Clinical 80%, Critical appraisal/EBM 10%, Admin/IT 10% Clinical Skills Assessment- CSA Consultation skills 13 patients encounter Regulars assessment by clinical & educational supervisors

Certification/ Licensing MRCGP CCT General Practice PCT Performers list Annual appraisal Revalidation

What does General Practice offer as a career? An opportunity to have a real impact on people’s lives The chance to become directly involved with patients and families Flexible working practices Independent working patterns and autonomy

General Practice as a career II Involvement in teamwork with other health professionals Scope to develop specialist interest within general practice A key role in decision making Direct involvement in health at the grass roots level A rewarding career with an involvement in people and medicine

Career options Full Time/ Part- Time GP Partner/ Salaried/ Locum GP Practice/ Community/ Hospital/ OOH Portfolio careers- becoming increasingly popular

GP Career Options Within the practice-GPWSI- Diabetes, Minor Surgery, Dermatology, Sports Medicine, Education Outside practice- Hospital Clinical assistant e.g. Endoscopy, Community Services e.g. Dermatology, FME Academic/ Legal, MDU adviser, Journalism, Occupational health Management- PCT, Commissioning

Case Studies RD Part time Salaried RS P/T Portfolio Management KW Locum Education JL Locum OOH

ROLE OF A GP Carer Employer Teacher Leader Team member Advocate Gate keeper (navigator) Researcher Health promoter Resource allocator Public Health Practitioner

Role of a Partner Business owner Employer NHS Manager Public Health Physician Diplomat Investor-(property, staff, Risk)

Becoming a Partner PROS Stability Own boss Decision making Financial reward Flexibility CONS Hard work Long hours More responsibilities Financial risks Joint and several liability Tied down

Partnership Case Study: Bretton Medical Practice Suburban GP practice 12,000 patients 4 partners (6 WTE) GPs Premises practice owned with 12 consulting Rooms, Large treatment Room, Operating Theatre, Pharmacy and Dental Surgery Various provider services using different models of strategic partnerships, commissioning and delivery

Bretton Medical Practice Full GMS (GP) services Contraception, Child Health, minor surgery Education /Training Practice GP Registrar, Cambridge Medical students, Paramedics, Nurse Prescribers Research-RCGP Accreditation, Level 2 PCRN DECISION, EUDREGENE, PACE, 3CS

Bretton Medical Practice Commissioned / Ext Services Upper and Lower GI Endoscopy No Scalpel Vasectomy Plastic & Aesthetic Surgery Ultrasound Scan Services Physiotherapy Counselling

Lifestyle 4 day week- No on calls / OOH optional Flexibility- Career options / portfolio Job security & Career prospects with good income Opportunities- Business, Ext interests, hobbies, transferrable skills Sabbatical Case Study

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