GP Training in Swindon and Bath high quality innovative effective

A team approach Promoting GP as a career Jane Savage, CO The VTS Jon Elliman, PO The DRC Steve Pigott, CO Other issues Martyn Hewett, CO Resources Michael Harris, PO & CO

Promoting General Practice as a career Jane Savage

Promotion by… Our website PRHO talks Career advice Pre-interview open morning

Our website - good response

from GCSE students…

… to SpRs

PRHO talks Six-monthly talks to PRHOs General Practice as a career

Career advice 2 or 3 enquiries a week face-to-face phone

Open morning for VTS & GPR applicants

Swindon & Bath - innovative Vocational Training Schemes Jon Elliman

Swindon & Bath - innovative Vocational Training Schemes Structure Teaching Trainer Involvement Pastoral Care Quality Assurance Integration With The Day Release Course Some Challenges

Structure 8 three-year rotations starting every 6 months Swindon 2 have a middle year as a TAGPR and 2 have 6 months as a TAGPR

Structure TAGPRs (Trust attached GP Registrar) 3 days in hospital speciality 2 days attached to their training practice Bath 2 successful TAGPR schemes cancelled because of lack of GPR funding

Structure of the Swindon VTS

Teaching/Integration Traditionally half day per month for VTS SHOs/TAGs over their 2 hospital years

Teaching/Integration Now: 2 inductions/year for new VTS SHOs 2 days/year SHOs/TAGs jointly with DRC 2 days per year Swindon/Bath SHOs/TAGs 2 trainers days/year (GPRs/SHOs/TAGs) 2 joint communication days/year TAGs/GPRs 1 or 2 Swindon/Bath TAG days/year 2 half or whole days for Swindon TAGs/SHOs

Trainer Involvement Enthusiastic Trainers’ Groups TAGPRs Contact During SHO year Trainers’ Days in Bath and Swindon Use Of GPs/GP Trainers in teaching MRCGP exam Ophthalmology Dermatology Headache Risk Management etc

Pastoral Care Hospital Consultants Trainers Programme Organisers AD Mentor

Quality Assurance Structured Exit Interviews SEAP (SHO Educational Audit Project) Annual SWACPO Report HRC/Deanery Visiting Structure

Challenges/The Future Increase the number of training practices in Swindon Maintain Trainer Morale TAGPRs New scheme, consultants/trainers often unsure of their role Ability to integrate when only part time in dept. Isolation from GPRs/SHOs

Challenges/The Future TAGPR rotations cancelled in Bath Demographic changes (part time working, career breaks often taken during VTS) Modernising Medical Careers Increased pressure on training practices Increased pressure on consultants

Challenges/The Future Academy status Increased pressure on practices Increased pressure on consultants Time pressure on Programme Organisers expectation to be involved in F2 scheme (no time allowed for this) Department Of General Practice In Swindon

The Bath and Swindon Day Release Course Steve Pigott

The Bath and Swindon Day Release Course A typical day Planning the course On-line support Quality Assurance.

A Typical Day Hot topics Critical appraisal Politics Soapbox Workshops Group work

Special Days Residential modules Away days Trainers’ days Patch days

Curriculum Planning Outcome-based educational framework Swindon and Bath Trainers Groups. Sept 2002 MRCGP Exam blueprint The planning process

Web-based support Timetable and plan for the term Hot topics: critical appraisal Preparation guides for group work topic 40+ on-line study guides

Quality Assurance Weekly feedback GPR representatives Appraisals DREEMS

Other issues Martyn Hewett Features of the team Falling numbers of GPRs attending DRC Supplementing Deanery funding with contributions from pharmaceutical companies

Features of the team Postgraduate teaching qualifications Michael Harris – MMEd Jon Elliman - ) both completing Martyn Hewett - ) TLHP Cert Med Ed

Publications Numerous papers published in green journal Books

Ongoing educational research programme Currently palliative care evaluation of course in terms of outcomes (progress of GPRs through MRCGP and Summative Assessment modules, career choices)

Teambuilding day November 2004

Falling numbers of GPRs attending DRC

Reasons for falling numbers TAGPR posts do not routinely attend DRC during TAGPR attachment Budget for GPRs in Bath/Swindon not increased when Bath TAGPR posts were created, and Swindon TAGPR posts were included in 3 year rotations No funding for standalone GPR posts

Supplementing Deanery Funding with contributions from pharma Core costs of running DRC (speakers fees only):£12,605 Amount received from Deanery: £6,000 this has not changed for over 10 years amounts to £8 per GPR per day Remainder from pharmaceutical sponsorship This requires 3 representatives each DRC day

Disadvantages of encouraging exposure of GPRs to pharma reps Unpopular with GPRs Adversely affects peer support Affects the prescribing habits of GPRs (and therefore new GPs) thereby increasing prescribing costs

Disadvantages of encouraging exposure of GPRs to pharma reps Sabotages attempts of Course Organisers and Trainers to encourage critical appraisal and ethical approach to professionalism Produces a whole generation of GPs who believe that they are dependent upon the pharmaceutical industry for their education information about new developments

And finally … Presentation available at Any questions?