Dr M Feldman
Medical school [ 5 yrs ] Foundation year 1 – typically 6 months surgery, and 6 months medicine Foundation year 2 – 3x 4/12 of ◦ Various specialties ◦ May include a spell in GP
Entry onto training scheme ◦ Knowledge test ◦ Assessment centre Consultation Group work Written test
Scheme consists of 3 yrs ◦ 2 yrs in hosp then one in GP ◦ Increasingly 18 months in hosp then 18 months gp ◦ Selection of specialties A&E Hospice O&G Paeds Care of elderly Medicine Rheumatology +GP ( ITP) Dermatology +GP ( ITP )
Training practices ◦ Specially approved Premises Trainers – one year course now Standards – Notes Library Accommodation Teaching assessed
nMRCGP ◦ Applied Knowledge Test – often taken in 2 nd year ◦ Work Based Assessment Patient satisfaction questionnaire Multisource feedback Consultation observation tool Direct Observation Procedures Case Based Discussion Eportfolio log diary Educational Reviews
nMRGGP ◦ Clinical Skills Analysis 12 Cases like a real surgery – 10 minute consultations
Work in teams Average practice about 5900 patients About 1800 per GP 35% partners are female 60% GP registrars are female
ActivityFull time GP / Week Surgery consults102.3 Phone consults18.8 Home Visits6.4 Care home visits1.9 Clinics1.5
Most British full time GP work either 8 or 9 sessions per week Typical sessions are hours long with 12 – 15 booked patients Average time per consult 11.7 mins Average time per home visit 26 mins
Working from own premises Working from health centres Polyclinics – to come
Most GP self employed – partners We employ ◦ Nurses ◦ Nurse assistants and phlebotomists ◦ Receptionists ◦ Admin staff and practice managers ◦ Occasionally counsellors We rarely employ Midwives (5%) Physiotherapists ( 3%)
Almost all increase in clinical contact due to extra nursing input
Average income GP 2007 about ◦ £ = Euro – partner ◦ £ = Euro 86,800 – salaried gp ◦ Currently dropping due to government clawbacks ◦ Need for GP’s to fund staff increase ◦ Our practice approx Euro staff bill excluding doctors