1. The Problem Trainee

2. Definition One who fails to meet the expectations of the training programme because of a problem with knowledge, skills, attitude or health

3. GMC - Good Medical Practice 16. If you are involved in teaching you must develop the skills, attitudes and practices of a competent teacher. 18. You must be honest and objective when appraising or assessing the performance of colleagues, including locums and students. Patients will be put at risk if you describe as competent someone who has not reached or maintained a satisfactory standard of practice.

4. Areas of difficulty - knowledge Medical knowledge IT Systems Patient pathways

5. Areas of difficulty – skills Time management Data interpretation Problem solving Communication Organisation

6. Areas of difficulty - attitudes Low motivation Poor attitudes to patients Poor attitudes to colleagues Poor self assessment/awareness Strained relationship with supervisor

7. Areas of difficulty – health & social Mental health Physical health Burn out Childcare Relationship difficulties Drug & alcohol issues Criminal

8. How do you know? Gut feeling Case review – including CBD/COT Significant events Complaints Observations by colleagues Absence / poor attendance at HDR etc Audit Lack of preparation for tutorials etc

9. First define the problem What is wrong? Who is it a problem for? Effects of the problem? Is this part of a pattern? Does it need addressed? Does the trainee realise they have a problem? What can we do about it & when?

10. A way forward Discuss with trainee & colleagues Understand from trainees perspective Explain concerns Do they acknowledge concerns? Tactful, empathy, respect Challenge where appropriate Share responsibility for problem solving

11. Educational action Develop learning plan to address concerns Aim to engage & motivate Set targets Review progress

12. Attitudinal issues More difficult to address Is the supervisor part of the problem?? Get support from those who have been there before!

13. Health & social issues Encourage to engage with appropriate services OH support Leave of absence

14. Responsibilities of GPStR Disclose problems early Meet as requested Agree to share educational plan Take responsibility for implementing change Meet targets set

15. Responsibilities of educational supervisor Identify problems early Share concerns with GPStR Liaise with deanery structure Review targets set & take action if not met Document, document, document! Assure due process – fair etc

16. Summary Identify and tackle issues at an early stage Find out facts – 2 sides to every story Seek advice & support early Share responsibility for problem sharing Document, document, document!

17. Resources Good Medical Practice Dealing With Problems That Arise During The GPST. A Booklet for Trainers. BMA Defence Union Occupational Health