1. Planning your Registrar Year Louise Willcocks Swindon/Bath GP Registrar DRC March 2007

2. AIMS Starting out Starting out Exams Exams Certification and paperwork Certification and paperwork Top Tips Top Tips

3. Starting out

4. EMIS EMIS A-Z map for home visits. A-Z map for home visits. Doctor’s bag and stuff Doctor’s bag and stuff Remembering everyone’s names. Remembering everyone’s names. Who/what/ how and when to refer? Who/what/ how and when to refer?

5. Half day for study (shopping). Half day for study (shopping). DRC once a week. DRC once a week. No weekends No weekends No nights/evenings No nights/evenings No bleeps No bleeps

6. The Year Goes really fast Goes really fast

7. Exams – Summative Assessment COGPED MCQ COGPED MCQ Video Video Audit Audit Trainer’s report Trainer’s report CPR certificate CPR certificate

8. COGPED MCQ May 2007. May 2007. Free Free Can resit up to 5 times Can resit up to 5 times 3 hrs long 3 hrs long Quite random questions e.g. DVLA/sick certs/fitness to fly/dandruff. Quite random questions e.g. DVLA/sick certs/fitness to fly/dandruff. Don’t read into questions too much. Don’t read into questions too much.

9. COGPED MCQ If you pass the MRCGP MCQ automatically pass the summative. If you pass the MRCGP MCQ automatically pass the summative. Questions are of a different standard in the two exams. Questions are of a different standard in the two exams. Final COGPED MCQ is May 07. If you fail- which you won’t- will do AKT. Final COGPED MCQ is May 07. If you fail- which you won’t- will do AKT.

10. VIDEO Can submit to SA or “single route” for MRCGP. Can submit to SA or “single route” for MRCGP. Criteria for SA and MRCGP different. NOSA and RCGP websites give information on this. Criteria for SA and MRCGP different. NOSA and RCGP websites give information on this. 2 hours long. No consultation longer than 20 mins. 2 hours long. No consultation longer than 20 mins.

11. “Single Route” Video “Single Route” Video Logbook on RCGP website. Logbook on RCGP website. 7 consultations, at least 1 child under 10 yrs and one psychosocial. 7 consultations, at least 1 child under 10 yrs and one psychosocial. 15 mins maximum for each consultation. 15 mins maximum for each consultation. Judged by 14 criteria (10 pass and 4 merit). Need 4/7 for each pass criteria to pass. Judged by 14 criteria (10 pass and 4 merit). Need 4/7 for each pass criteria to pass.

12. Need to send logbook with video Need to send logbook with video Need to keep consent forms and all patients must be consented. Need to keep consent forms and all patients must be consented. COGPED video route not available from August 2007. ?Submit videos Oct 2007. COGPED video route not available from August 2007. ?Submit videos Oct 2007.

13. Tips for video Start early on Start early on The more you do the easier it gets. The more you do the easier it gets. You can have a printout of the MRCGP criteria in front of you as long as not in camera shot. You can have a printout of the MRCGP criteria in front of you as long as not in camera shot. Check sound quality, position of camera, date/time on tape recording. Check sound quality, position of camera, date/time on tape recording. Make sure patients not exposed on camera. Make sure patients not exposed on camera.

14. Audit Keep it simple Keep it simple Start asap Start asap Discuss with Trainer/practice/colleagues for ideas. Discuss with Trainer/practice/colleagues for ideas. Relate to recent guideline changes/QOF/hot topics. Relate to recent guideline changes/QOF/hot topics.

15. Audit Tips on Bath web site. Tips on Bath web site. 8 proforma 8 proforma 3000 words double spaced and anonymised. 3000 words double spaced and anonymised. Send 3 copies and keep one for yourself. Send 3 copies and keep one for yourself.

16. Trainer’s report. Do as you go along Do as you go along Familarise yourself with it. Generally trainer fills it in. Familarise yourself with it. Generally trainer fills it in. Send it into deanery approx 6 weeks before reg year finishes with VTR1. Send it into deanery approx 6 weeks before reg year finishes with VTR1.

17. Exams- MRCGP MCQ MCQ Written paper Written paper Video Video Oral Oral Each module costs ₤340. Closing date for applications 9/2/07.

18. Syllabus available on RCGP website which is invaluable. For MCQ preparation PEP CD’S and onexamination.com are fantastic resources. Courses like hot topics and revision course (Portsmouth or Taunton.)

19. Study Group Essential preparation for written paper. Essential preparation for written paper. Past papers on line RCGP website. Past papers on line RCGP website. Look at past examiners comments. If question done badly topic may come up again. Look at past examiners comments. If question done badly topic may come up again. Good gossip session. Food and wine essential!

20. Exams- nMRCGP From August 2007 single training route and new assessment process. From August 2007 single training route and new assessment process. AKT- applied knowledge test AKT- applied knowledge test CSA- clinical skills assessment CSA- clinical skills assessment Enhanced trainer’s report Enhanced trainer’s report

21. AKT 200 questions 200 questions Machine marked Machine marked Extended matching questions and single best answers. Extended matching questions and single best answers. 3 times a year Feb/May/Oct 3 times a year Feb/May/Oct

22. CSA OSCE format OSCE format Assesses clinical, professional, communication and practical skills. Assesses clinical, professional, communication and practical skills. ? To be held 3 times a year. ? To be held 3 times a year.

23. Enhanced Trainer’s report Similar to current Trainer’s report but more in depth. Similar to current Trainer’s report but more in depth. Requires evidence as proof of reaching a certain standard. Requires evidence as proof of reaching a certain standard.

24. Out of Hours Minimum 72 hours. Minimum 72 hours. Log book to be completed Log book to be completed Should be supervised. Should be supervised. Shifts short 3-5 hrs so start soon. Shifts short 3-5 hrs so start soon. Variety of shifts weekends/evenings, base or visiting. Variety of shifts weekends/evenings, base or visiting.

25. Often good fun Often good fun Might want to do more of it when you finish GPR year. Might want to do more of it when you finish GPR year. Log book doesn’t need to be sent anywhere. Log book doesn’t need to be sent anywhere. Keep a log of interesting patients for PDP. Keep a log of interesting patients for PDP.

26. Certification and paperwork Join RCGP costs ₤350 in order to complete CCT. Join RCGP costs ₤350 in order to complete CCT. Submit your VTR2 forms once you have done this to RCGP certification unit. Make sure all the dates are correct, stamped and filled in correctly. They will get sent back if not. Submit your VTR2 forms once you have done this to RCGP certification unit. Make sure all the dates are correct, stamped and filled in correctly. They will get sent back if not.

27. Do this as soon as possible. Dull but essential and will save lots of hassle later. Do this as soon as possible. Dull but essential and will save lots of hassle later. Then known as an associate member and in theory get BJGP. Then known as an associate member and in theory get BJGP.

28. Before the end of the job need to register with PMETB. Before the end of the job need to register with PMETB. Submit VTR1 form with ₤500 and should then receive CCT. Can’t do this till 6 weeks prior to finishing. Submit VTR1 form with ₤500 and should then receive CCT. Can’t do this till 6 weeks prior to finishing. Look at NOSA website and RCGP for guidelines and application forms. Look at NOSA website and RCGP for guidelines and application forms.

29. Top Tips PDP keep a record of your tutorial topics, list of education meetings, interesting patients, referrals e.t.c. Do as you go along, it’ll be a lot less tedious and easier in the long run. PDP keep a record of your tutorial topics, list of education meetings, interesting patients, referrals e.t.c. Do as you go along, it’ll be a lot less tedious and easier in the long run. Keep electronically or paper. Keep electronically or paper.

30. Journals BMJ BMJ BJGP BJGP Pulse/Doctor/GP Pulse/Doctor/GP BMJ careers BMJ careers Internet up dates e.g. doctors.net Internet up dates e.g. doctors.net

31. Courses Exam related- revision courses Exam related- revision courses Hot Topics Hot Topics Others- DFFP, DRCOG. Minor surgery. Others- DFFP, DRCOG. Minor surgery. No study budget so can get expensive.

32. Contacts Summative assessment Summative assessment –http://www.nosa.org.uk –Moira Linden; 01962 893 813 –moira.lindenl@sevwesdeanery.nhs.uk moira.lindenl@sevwesdeanery.nhs.uk RCGP certification RCGP certification –020 7930 7228 –certification@rcgp.org.uk certification@rcgp.org.uk PMETB PMETB –0871 220 3070 –info@pmetb.org.uk info@pmetb.org.uk –article11@pmetb.org.uk article11@pmetb.org.uk HOT Topics course HOT Topics course –0191 489 0555 –www.nbmedical.co.uk www.nbmedical.co.uk MRCGP course MRCGP course –Carol White; 01264 355 005 –cwhite@rcgp.org.uk

33. Audit criteria 1.Reason for choice of audit Potential for change Relevant to the practice 2.Criterion/Criteria Chosen Relevant to audit subject and justifiable, eg. Current literature 3.Standards set Targets towards a standard with a suitable timescale 4.Preparation and Planning Evidence of teamwork and adequate discussion where appropriate 5.Data Collection (1) Results compared against standard 6.Change(s) to be evaluated Actual example described 7.Data Collection (2) Comparison with Data collection (1) and standard 8.Conclusions Summary of main issues learned

34. Video criteria PC1the doctor is seen to encourage the patient's contribution at appropriate points in the consultation PC2 (M)the doctor is seen to respond to signals (cues) that lead to a deeper understanding of the problem PC3the doctor uses appropriate psychological and social information to place the complaint(s) in context PC4the doctor explores the patient's health understanding PC5the doctor obtains sufficient information to include or exclude likely relevant significant conditions PC6the physical/mental examination chosen is likely to confirm or disprove hypotheses that could reasonably have been formed OR is designed to address a patient's concern PC7the doctor appears to make a clinically appropriate working diagnosis PC8the doctor explains the problem or diagnosis in appropriate language PC9 (M)the doctor's explanation incorporates some or all of the patient's health beliefs PC10 (M)the doctor specifically seeks to confirm the patient's understanding of the diagnosis PC11the management plan (including any prescription) is appropriate for the working diagnosis, reflecting a good understanding of modern accepted medical practice PC12the patient is given the opportunity to be involved in significant management decisions PC13 (M) the doctor takes steps to enhance concordance, by exploring and responding to the patient’s understanding of the treatment PC14the doctor specifies the appropriate conditions and interval for follow-up or review

35. Constructs ClinicalPatient Self-management Agenda Decision Aids Benefits Education Death & Driving Support Groups Ideas, concerns & expectation Transcultural Doctor Risk management Up to date DEN’s Evidence-based Confidentiality/Consent Health promotion Open questions Prejudice Prescribing Empathy Record-keeping/Referrals Practice Protocol Register Audit Change management Training IT Contract/clinics Ease Wider Goldberg & Huxley’s filters to care Rationing Inverse care law Medicilisation Screening Health Inequalities Teamwork EthicalConsultationPrescribing

36. Any Questions?