Hospital Posts on the Bradford Scheme how to make the most of them

Hospital Posts  You will gain useful clinical knowledge  But how else can you make your experience useful for your future in GP?  What could you reflect on and put in your eportfolio?

Generic Aspects of Hospital Practice Useful for your Future as a GP  Medical teamwork  Safe prescribing  Multidisciplinary teamwork  Communication skills  How families behave  Significant event analysis  Ethical issues  The hospital-GP interface

Medical Teamwork  Support for colleagues  Allocation of work  Effective handover of important information – essential in hospital shift system, especially useful in GP if you work LTFT

Safe Prescribing  Hospital ‘zero tolerance’ policy for prescribing in allergic patients  Easier in GP when prescribing on computer  Sounds obvious but - look it up if its an unfamiliar drug  Be extra careful when prescribing for children

Multidisciplinary Teamwork  Understand the roles of team members  Especially other health professionals  Respect their skills and contribution to patient care  Ensure effective communication with other team members

Communication Skills  With patients  With relatives  With colleagues  With other team member  Record keeping

How Families Behave  Many family interactions visible in hospital specialties especially A&E, Paediatrics, Medicine for the Elderly and Palliative Care  In GP family are generally in the background – but in hospital they’re often there for you to observe  Exceptions in GP – patients with dementia, children

Significant Event Analysis  Looking at what’s happened when something went wrong or nearly did so  Looking at the feelings of everyone involved  Reviewing the organisational systems involved  Working out how to prevent a recurrence

Ethical Issues  Capacity to consent  Informed consent  Confidentiality  End of life issues  Reproductive health issues (in O&G)  Take responsibility – if you have misgivings about a practice, even if it is well established, talk to your supervisor or TPD advisor

The GP-Secondary Care Interface  Understanding what secondary care has to offer  Communication between GPs and hospital doctors  Understanding referral pathways, and what you’ll be referring patients for, when you’re a GP

What Previous Registrars Say  “It's important to realise, even though you’re doing a hospital rotation, you really need to get out what GP's actually need to know”  “For instance, in Obs and Gynae instead of being in theatres a lot, spend more times in Gynae outpatient clinics - see what GPs refer, learn acute assessments in MAC, learn how to insert a speculum etc"

What Previous Registrars Say  “HDR attendance - whilst in hospital it is possible if you really try and registrars have managed to attend a good number even when doing A&E and Medicine”  “Try and sit in on lots of outpatient clinics”  “Get all your DOPs done before finishing hospital posts (much easier getting a reg in A&E watching you do a PR then trying to do it in GP-land)”

What Previous Registrars Say  “In A&E - spend as much times as possible in minors”  “In Paeds - take heart that PAR is really useful for seeing lots of sick kids as you rarely see any in GP-land”  “In Gynae - do lots of clinics and get good at gynae examinations.”

And Finally...  If you haven’t already – become a member of the BMA while in training  Employment issues – holidays, maternity pay etc – can be a minefield so worth having proper representation  Good luck and keep up the good work!