Doctors in DifficultySimon Carley

‘Any trainee who has caused concern to his/ her educational

supervisor(s) about the ability to carry out their duties, which has

required unusual measures.

RecogniseReviewReferRehabilitate

Task 2

What would alert you to a DiD?

The disappearing actLow work rate

Ward rageRigidity

Bypass syndromeCareer problems

Insight failureInappropriate attitudes

Lack of engagement (with CS/ES)Lack of initiative/professional engagement

EWS Regulator

EWS Regulator

Warning Signs

EWS Regulator

Warning Signs

REGULATOR

PerformancePunctualityaPPearance

Task 3

What are you going to do about it?

Trigger event

Investigate Decide

Does it matter?

Can they normally do it?

Why are they not doing it

now?

Trigger event

Investigate Decide

Is this health?

Is this performance?

Is this conduct?

Is this environment?

Is this health?

Is this performance?

Is this conduct?

Is this environment?

OccupationalHealth

Clinical assessment

Disciplinary

MedEd team investigates

Is this health?

Is this performance?

Is this conduct?

Is this environment?

OccupationalHealth

Clinical assessment

Disciplinary

MedEd team investigates

OccupationalHealth

Clinical assessment

Disciplinary

MedEd team investigates

PlanDocument

Share

Poor performance is a symptom

not a diagnosis

Documentation and witnesses

http://www.gmc-uk.org/Final_Appendix_5_Trainees_in_Difficulty.pdf_53816759.pdf

Guidance

Meetings

Task 4Exercise

Dr X is an PGY4 & has been with you for 4 months.

He has not participated in any educational assessments to date and finds it very difficult to find time to meet with you. Appointments are made but he often cancels these at short notice. Your initial meeting went well but you have not formally met with him since.

He has phoned in sick again today and your colleague points out that this is his 4th episode of sickness since starting this placement.

You you have had a few minor concerns about his practice but no major clinical concerns. He is slow at seeing patients and the nurses find him frustrating. He has told them that he is doing the best he can, but the patients are complex.

He failed his last set of professional exams.

Dr Y is an PGY2 and you are his educational supervisor for the last 4

months.

You had a good start with this doctor.

He came with good recommendations and have a great

portfolio but their performance on your team has been poor. They are

not engaged, often late and you have had several reported episodes

of them becoming angry with members of the nursing staff and

junior members of the team.

Dr V is a PGY2 doctor. He has been with you for 3 weeks and has just

finished nights in medicine.

You have several complaints about this doctor from nurses and middle grades.

They say he is incompetent and lazy.

Last night he tried treating an SVT on the ward with Adenosine. On review the patient had a sinus tachycardia secondary to a pyrexia (missed by

him).

The middle grade and ward sister tell you that he should not do nights

again.

Dr Z is a new locum doctor

You are contacted by the nurse on duty last night.

She noticed that Dr Z had a large empty syringe of antibiotics in

her pocket. When questioned she said that he had drawn the

morphine up for a patient earlier in the shift but as they did not

need it all he had kept it and used the remainder on another 2

patients.

This is Dr Z’s 1st job in the country.

RecogniseReviewReferRehabilitatewRite it all down