ST3 Introduction Programme Directors: Dr Christine Marshall Dr Richard de Ferrars Dr Andrew Cochrane Introduces self Clarifies roles

Name the Musical and Song… Greets patient Demonstrates interest & respect

Daft Diversion... Greets patient Demonstrates interest & respect Watch the bottom right... Meaning and relevance to follow

What Would YOU Like To Know About? We have several areas to run through but what is on your mind? Opening question Identifies the reason for the consultation Agenda setting

ST3 Introduction Enhanced ST3 MRCGP Exam Overview Year Planning KSS Policies Overview of the VTS E-Portfolio & Learning Log OOH Training Local Training Agreement. Provides structure to the consultation Sequencing

ST3 Representative Dr Hannah Pedley expressed interest Deputy please? VTS Rep at KSS Trainee’s Committee –Vicky Goodall. Encourages the patient to contribute

Enhanced ST3 First real step towards ST4 Additional 3 months as ST3 Details TBC… Last year - AKT score over 70% CSA early (Dec/ Jan) Develop further skills –CCG work –Stage 1 Educators Pathway. Sequencing Timing

MRCGP Overview Provides Rationale

AKT Hurrah - Majority have negotiated this challenge If not:2-3 attempts left?= please take it in October final attempt? = take it May 2016 (focus on CSA first) AKT Failed Twice? If you had problems with written exams at medical school, consider a dyslexia assessment Costs about £300 Gain additional time in exam (30 or 45min). Sharing of thought

CSA – Lots of Choice! Now held monthly from October to May KSS and VTS set a pace aimed at Jan / Feb / Mar - November: Cumberland Lodge - December: KSS day at the RCGP exam centre - January: Thursday pm sessions Enhanced ST3 – need to work ahead of the pace. Provides rationale Examination

CSA – Lots of Choice! Nov/ Dec- risk wasting £1700 (and one of your 4 attempts) - needed by some (maternity, enhanced ST3) - results come out mid December Jan/ Mar- Makes sense for most - Allows Apr/ May re-sit without extension - But result is not out until early March… May- Will need extension to re-sit VTS teaching is aimed at January - March date Take your trainer’s advice!. Offers choice

WPBA Assessments Portfolio close will be end of May –Get ES review 1 done by mid January Half the assessments before review 1 –Get ES review 2 done by mid May Half the assessments before review 2 Full year =CBD x12 COT x12 (some kept on video please) MSF x2 (Need 10 back: 5 clinical, 5 non-clinical) PSQ x1 (Feb/ March/ April) DOPS replaced by CEPS. Clarification

CEPS Clinical Examination & Procedural Skills Now 13 th DoC replacing skills log Evidence tagging includes COT, CSR, log, MSF CEPS form more flexible than DOPS Should still have a “form” for intimate exams

Planning the Year The tube map - looks complex at first glance but is very useful….. Uses visual methods of conveying information

ConsultingOOHCSATutorials / LearningWork-place Based AssessmentsOther MRCGP Formative Assessment Aug Sitting-in VTS - Intro Session Introduction to WPBA 1 Survival skills, computer training Start Knowledge Checklist (25) 20 min appts Educational framework Video COT1 CBD1 Initial Plan Sept Communication Skills 2 15 min appts Session 1 (26) COT2CBD2 Oct Session 2 VTS - Telephone Triage min appts CSAAKT (27) (if CSA early) Session 3 VTS – EBM & critical appraisal COT3CBD3 Nov Session 4 4 VTS – CSA simulation (actors) CSA (28) Session 5 COT4CBD4 Dec Session 6 5 Deanery CSA study day MSFCOT5CBD5 CSA (29) Session 7 Jan Confident with Session min appts COT6CBD6 CSA AKT ES Review (30) Session 9 Feb Session 10 7 COT7CBD7 CSA (31) Session 11 PSQ Mar Session 12 COT8CBD8 8 MSF CSA (32) Session 13 PSQCOT9CBD9 Apr All Session min appts Finding a practice PSQCOT10CBD10 CSA AKT (33) Session 15 Working as a locum May Session 16 COT11CBD11 10 Practice finance & admin CSA ES Final Review (34) Session 17 COT12CBD12 Jun Session 18 NHS Appraisal 11 (35) Session … Jul 12 VTS Website – ST3 MRCGP Page

MRCGP Summary AKT- well done if passed in ST2 - others, please take in October - delay any final attempt until May CSA- Nov & Dec for some - Jan Feb Mar for most WPBA- use the planner and keep to speed. Chunks & checks Uses repitition & summary Offers choices

KSS Policies & Plans Chaperone policy Dress code Car allowance Contracting

Chaperone Policy Sensitivity Assesses patient’s starting point Encourages patient to contribute

Dress Code Sensitivity Assesses patient’s starting point Encourages patient to contribute “Conventionally in the UK, formal professional practice between doctors and patients is appropriately marked by a certain formality of dress. It is, therefore, legitimate to require trainees to dress in this fashion.”

KSS Policies & Plans Chaperone policy Dress code Car allowance –Mileage for home visits, travel to teaching –Up to 20 miles to & from home when NEED car… –NEED car if you do a visit or travel to teaching… –Must keep daily record to complete a claim Contracting

VTS Overview Much mystery surrounds the activities of the GP trainees on Thursday afternoons….. Elicits patient’s health beliefs

VTS Overview How can we all get the most out of the VTS? Time-keeping Participation Cumberland Lodge Cumberland Lodge dates: November March June PASS THESE DATES TO PMs Ideas & concerns

The Learning Log/ PDP Shares own thoughts Picks up verbal & non-verbal cues

Categories of Log Entries How should Trainees use the learning log? 1) Simple list of useful information from teaching: CURB scoring Causes of amenorrhoea 2) Recording of a “required event” Audit projectChild protectionStatement of Leave OOH sessionLeadershipCPR/ AED 3) Genuine educational activity Tutorials, VTS sessions Interesting cases, followed by reading up 4) “Domains of competence” event Reflection from a competency, not a clinical, perspective Organises explanation

Categories of Log Entries How should Trainees use the learning log? 1) Simple list of useful information from teaching: OK to record but don’t bother sharing (unless you want to see how sarcastic your ES can be) 2) Recording of a “required event” As and when appropriate Do count towards 2-per-week target 3) Genuine educational activity Tutorials, VTS sessions, interesting cases & reading No more than 1-per-week about a teaching session 4) “Domains of competence” event Reflection from a competency, not a clinical, perspective Superb for ES Reviews – try and write 2-3 per month

Required/ Mandatory Events Level 3 Child Protection VTS session, e-modules if on leave ST3 GP Audit One 8-stage audit cycle – see website Leadership event See VTS website for options Form to complete is on KSS website CPR/ AED certificate Usually done in term 3 Two Significant Events [Complaints], near misses, cancer diagnoses All of these MUST be shared. Uses explicit categorisation

Audit & Leadership Move away from 8-point audit Move towards CCG project work (QIP) Mandatory move if doing enhanced ST3 Offers choices

E-Portfolio Non-verbal behaviour

Practice Swaps We encourage ST3s to try another practice for 1 week W/C June 2 nd 2016 Avoid A/L that week please. Offers choices

Out-of-Hours You all hate it Hard work for supervisors Look at the VTS website 25% pay supplement £50 supervision fee 72 hours is mandatory (may increase) Good preparation for CSA so NO GAPS PLEASE Log-entry at end of each shift OOH sheet from supervisor IF NOT YOUR TRAINER Ask your supervisor to work through the FPCS Induction Forms with you – on the VTS website PROFESSIONALISM Booked shift = be there (unless you have died) Empathy & support

Out-of-Hours Traffic Light – PLEASE DISCUSS WITH YOUR ES Red = ST1/2 (observe only) Amber = first few ST3 months. Avoid phone triage until after training Can see patients at base from the start Supervisor can go on a visit with you If left at base, must have phone or alternative Green = last 5 shifts You take a slot on the rota Do everything including solo visits Supervisor could be by phone. Empathy & support

Admin Required for OOH Medical Indemnity Insurance GMC Number BLS certificate Safeguarding Level 3 Certificate Information Governance Certificate DBS certificate Hep B status

OOH – Key Points New shift e-booking system to try out Must compete admin checklist Must complete clinical induction checklist with supervisor Must discuss RAG with trainer/ ES Must keep back FIVE green shifts for last 3 months of training

Local Trainers Agreement Use of notes

Local Trainers Agreement The Working Week Annual Leave VTS & Educational Activities Study Leave Private Study (Flexible Education Session) Out-of-Hours Training Read through NOW. Any questions? Checks patient’s understanding of information

Daft Diversion... Greets patient Demonstrates interest & respect Any answers?

Daft Diversion... Calgary-Cambridge consultation model Doctor-patient relationship and patient-centred consulting Does NOT mean doing what the patient wants Facilitating them to reach agreement on what is best for them Trainer-trainee relationship and adult learning Does NOT mean doing what the trainee wants Facilitating them to reach agreement on what is best for them.

Trainer-Trainee Relationship Consider the analogy to the doctor-patient relationship? Develop relationship & rapport – chat time! What can go wrong at the start? What happens over time? What happens when Dr & patients disagree? GPs can have a bad day and take it out on patients Trainers can have bad days…

ST3 Introduction Enhanced ST3 MRCGP Exam Overview Year Planning Chaperones Overview of the VTS E-Portfolio& Learning Log OOH Training Local Training Agreement Checks with patient End summary

The End Safety netting Final checking