West Herts GP Specialist Training Programme ST1 Induction Meeting 14 th August

Programme Directors (TPDs) ST1 Group –Paul Heatley & Bruce Covell ST3 Group –Pauline & Nick Foreman GPSTP Administrator –Gemma Sleet Postgraduate Centre Manager –Kim Hull

West Herts GPSTP – a very brief history NW Herts VTS (Hemel/St Albans/Radlett/Kings Langley/Berkhamsted) Programme Directors: Paul Heatley & Bruce Covell Watford VTS Programme Directors: Pauline & Nick Foreman Merged August 2007 Trainers workshops currently separate

NHS Stuctures Health Education: East of England –Formerly East of England Deanery Herts Valleys Clinical Commissioning Group (HVCCG) Formerly Herts PCT NHS England – Herts and South Midlands Area –Formerly East of England SHA

VTS Teaching Programme ST1 and ST3 groups have a weekly half day meeting, usually at Watford Hospital Postgraduate Centre from 2.15 to 5pm. Broadly follows school terms ST2 group have three study days per year but no weekly programme. Programme will be circulated and is displayed on our website

Content of Teaching Programme Guided by GP Curriculum –See RCGP website –Condensed curriculum guide External speakers Case discussion E-portfolio Journal Club Preparation for MRCGP Your views are important and will be sought

Residential Course June 18 th & 19 th 2015

Cumberland Lodge 2014 ST1 Group

Visit to Nice

GPSTP Training Rotation Intake of 18 ST1s per year 18 months in general practice and 18 months in a variety of secondary care posts The local trusts have four month posts In order to achieve the 18:18 month split one of your posts will be 50%GP and 50% secondary care

Rotation – ST1 year 4/12 full time general practice 4/12 medicine/geriatrics/A&E 4/12 part-time GP and part-time GU/Derm/Palliative Care/MSK medicine

Rotation – ST2 & ST3 ST2 –4/12 Paediatrics –4/12 Obstetrics and Gynaecology –4/12 Psychiatry ST3 –12/12 full time General Practice Usually the practice where you did ST1

Part-time working Job sharing in hospital posts (50% only) Flexibility in GP posts (50-90%) LTFT –apply to Deanery for approval –Granted for changes to family circumstances –Apply to change back

Monitoring of training posts July 2014 visit from the Deanery –Generally very positive We need your feedback –Informally to us –Formally On line survey at the end of each post for HEEoE Twice yearly survey of posts by GMC Please respond to both – they don’t take long

Interruptions to training You have an obligation to report sick leave to Southend >14 days sick leave per year may trigger review of finishing date Returning to work following prolonged sickness or Mat Leave –TPDs will help to find training posts that satisfy requirements for CCT –TPDs will re-calculate your finishing date

Career Break When is the best time? –After ST3 is best –Between ST2 and ST3 is possible –We do not advise this between ST1 and ST2

Working week in GP attachments (HEEoE Guidelines) 40 hours Ten sessions –Seven sessions consulting with patients –One session of formal teaching –One session at the half-day release –One session of private study Plus out of hours experience (approx one session per month). Experience of extended hours

Out of Hours Training Herts Urgent Care GP Registrar induction training on September 4 th 2014 Submit your application form today if you have not already done so!

Specimen timetable for full time GP attachment MondayTuesdayWedsThursFri SurgeryTutorialSurgery Private Study GPSTPSurgery

Your Employer New arrangements from August 2013 –Formerly Trainer/Hospital or Community Trust You are employed by Southend University Hospital Trust during your GP training

Educational Supervisor Same person throughout the three year training Usually your ST1 GP trainer Educational Supervision review at end of November and end of May each year

If you have a problem… Do talk to……….. – Other members of the group –Consultant or Trainer –Programme Director –Patch Director (Dr Keith Cockburn) –Deanery Director of Postgraduate General Practice (Dr John Howard) Don’t…

What we expect of you Attendance at the half day meetings is part of your paid working week A register is maintained and attendance figures are reported to Southend and the Deanery. Sign the register or Gemma if you are on days off, nights, sick etc Prompt response to s about the programme

MRCGP

Applied Knowledge Test (AKT) Clinical Skills Assessment (CSA) Workplace Based Assessment (WPBA)

Applied Knowledge Test (AKT) Can be done in ST2 or ST3 Maximum of four attempts 200 multiple choice questions in 3 hours 80% clinical medicine, 10% critical appraisal and EBM, 10% health informatics & administration Sample questions on rcgp web site Held at one of 150 Pearson Vue testing centres; Oct, Jan & April each year

Things that come up in the AKT Legal aspects, e.g. DVLA Professional regulation, e.g. GMC Business aspects, e.g. GP contract Prescribing, e.g. Controlled drugs Appropriate use of resources, e.g. drugs Health & Safety, e.g. needlestick injury Ethical, e.g. Mental capacity, consent

Clinical Skills Assessment - CSA Can only be done in the ST3 year Simulated surgery with actors and trained assessors 13 patients, 10 minutes each, 2 minute break The three domains on which you will be marked are: 1.Data Gathering, Technical and Assessment Skills 2.Clinical Management Skills 3.Interpersonal Skills

DATA-GATHERING, TECHNICAL & ASSESSMENT SKILLS: Gathering & using data for clinical judgement, choice of examination, investigations & their interpretation. Demonstrating proficiency in performing physical examinations & using diagnostic and therapeutic instruments

CLINICAL MANAGEMENT SKILLS: Recognition & management of common medical conditions in primary care. Demonstrating a structured & flexible approach to decision-making. Demonstrating the ability to deal with multiple complaints and co-morbidity. Demonstrating the ability to promote a positive approach to health

INTERPERSONAL SKILLS: Demonstrating the use of recognised communication techniques to gain understanding of the patient's illness experience and develop a shared approach to managing problems. Practising ethically with respect for equality & diversity issues, in line with the accepted codes of professional conduct.

CSA - III Three marks for each domain Maximum of 9 per case 13 cases x 9 = 117 marks Pass mark varies, usually Held at RCGP HQ Euston Previously Nov, Feb & May each year, in future will be held more often Maximum of four attempts

Workplace Based Assessment (WPBA) E-portfolio – starts now and you must register with the RCGP to get access Curriculum Case Based Discussions (CBD) Consultation Observation Tool (COT) Multi-Source Feedback (MSF) Patient Satisfaction Questionnaire (PSQ)

WPBA – Timetable for ST1 Year Prior to review at 4 months (end Nov 2014) –CBD x3 –COT or mini CEX x3 –MSF 5 clinicians –Clinical supervisors report (secondary care only) –PSQ (primary care only) –DOPS (opportunistic) Prior to review at 10 months (end May 2015) –CBD x3 –COT or mini CEX x3 –MSF (5 clinicians) –Clinical supervisors report (secondary care only) –PSQ (primary care only) –DOPS (opportunistic)

Educational Supervision - timing Your 4 month review will take place in November 2014 – time is tight! –Register with the RCGP now Your 10 month review will take place in May 2015 The “Annual Review of Competence Progression” ARCP Panel meets in June and December

E-portfolio Shared Learning Log: regular reflective recording of two or three entries per week –Clinical encounters –Tutorial –Thursday afternoon teaching Trainee Self-Rating

E-portfolio continued… Personal Development Plan (PDP) –Regular entries and review “SMART” format Specific Measurable Achievable Relevant Time Bounded

Associate in Training (AiT) Cost AiT joining fee £167 AiT annual fee £240 (each April) AKT £465 (AiT rate) CSA £1563 (AiT rate) CCT (GMC)£390 Fees checked

What I wish I’d known when I started….. E-portfolio – what to put in and what is meant by reflective learning The AiT journal “InnovAit” is excellent Make a learning plan at each stage Get to know the other members of the group early on – valuable resource Learn about consultation models early on

What I wish I’d known continued.. What to expect from your trainer –Educational Contract –Learning needs analysis –One to one teaching –Supervision and support

Useful web sites Royal College of General Practitioners –rcgp.org.uk Health Education:East of England – php?page_id=1757 Bradford VTS – Pennine VTS –

Useful Web Sites RCGP Curriculum curriculum.org.ukwww.rcgp- curriculum.org.uk - quick,concise clinical guidancewww.gpnotebook.co.uk - leaflets & support groupswww.patient.co.uk - address, discussion fora and clinical advicewww.doctors.net.uk - excellent learning modules; £70 if not a BMA memberwww.bmjlearning.com