west herts gp specialist training programme
DESCRIPTION
West Herts GP Specialist Training Programme. ST1 Induction Meeting 5 th August 2009. Programme Directors. ST1 Group Paul Heatley & Bruce Covell ST3 Group Pauline & Nick Foreman VTS Administrator Maria Parry-Price Postgraduate Centre Manager Kim Hull. - PowerPoint PPT PresentationTRANSCRIPT
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West Herts GP Specialist Training Programme
ST1 Induction Meeting
5th August 2009
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Programme Directors
• ST1 Group– Paul Heatley & Bruce Covell
• ST3 Group– Pauline & Nick Foreman
• VTS Administrator– Maria Parry-Price
• Postgraduate Centre Manager– Kim Hull
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West Herts VTS – a very brief history
• NW Herts VTS (Hemel/St Albans/Radlett/Kings Langley/Berkhamsted)
• Programme Directors: Paul Heatley & Bruce Covell
• Watford VTS• Programme Directors: Pauline & Nick Foreman
• Merged August 2007
• Trainers workshops remain separate
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VTS Teaching Programme
• ST1 and ST3 groups have a weekly half day meeting at Watford Hospital Postgraduate Centre from 2.15 to 5pm. Broadly follows school terms
• Both groups have a residential course in the summer
• ST2 group have three study days per year but no weekly programme.
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Content of VTS Programme
• Guided by GP Curriculum – See RCGP website www.rcgp-curriculum.org.uk – Condensed curriculum guide
• External speakers• Case discussion• E-portfolio• Journal Club• Preparation for nMRCGP• Your views are important and will be sought
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Plus…..
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Visit to Nice – July 2009
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VTS Rotation(s)
• 18 months in general practice and 18 months in a variety of secondary care posts
• The local trusts have four month posts (some have a six month cycle)
• We have two rotationsA.18 entrants per year established in 2007B. 4 entrants per year established in August
2009
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Rotation A – ST1 year
• 4/12 full time general practice• 4/12 medicine/geriatrics/A&E• 4/12 part-time GP and part-time
GU/Derm/Palliative Care/Community Geriatrics
• Allocation process
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Rotation A – ST2 & ST3
• ST2– 4/12 Paediatrics– 4/12 Obstetrics and Gynaecology– 4/12 Psychiatry
• ST3– 12/12 full time General Practice
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Rotation B
• Part of national drive to increase training capacity
• 18 months secondary care in other Trusts (currently QEII, Welwyn and the Lister, Stevenage). August 2011 posts to be confirmed.
• 18 months in local training practice
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Working week in GP attachments(Deanery Guidelines)
• 40 hours• Ten sessions
– Seven sessions consulting with patients– One session of formal teaching– One session at the VTS– One session of private study
• Plus Out of Hours experience (108 hours over the three years ie 1 session per month)
• Experience of extended hours
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Specimen timetable for full time GP attachment
Monday Tuesday Weds Thurs Fri
Surgery
& visits
Tutorial
& visits
Surgery
& visits
Surgery
& visits
Surgery
& visits
Surgery Surgery Private Study
VTS Surgery
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Relationships
• GP based posts – you will be employed by your trainer
• Secondary care posts - You will be employed by a hospital or community trust
• Educational Supervisor- You will be attached to a trainer or PD for the
duration of the three year course but there is some flexibility.
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If you have a problem…
• Do talk to………..– Other members of the group– Consultant or Trainer– Programme Director– Patch Director (Dr Keith
Cockburn)– Deanery Director of Postgraduate
General Practice (Dr Arthur Hibble)
Don’t…
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Exams!
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nMRCGP
• Applied Knowledge Test (AKT)
• Clinical Skills Assessment (CSA)
• Workplace Based Assessment (WPBA)
• New rule: from August 2010 candidates can attempt the CSA and AKT a maximum of four times.
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Applied Knowledge Test (AKT)
• Can be done at any time in the ST2 or ST3 year• Held at one of 150 Pearson Vue testing centres;
Oct, Jan & April each year• 200 multiple choice questions in 3 hours• 80% clinical medicine, 10% critical appraisal and
EBM, 10% health informatics & administration• Sample questions on rcgp web site• NMRCGP Practice Papers: Applied Knowledge
Test by Rob Daniels (PasTest)
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Things that come up in the AKT• Legal aspects, e.g. DVLA
• Professional regulation, e.g. GMC
• Business aspects, e.g. GP contract
• Prescribing, e.g. Controlled drugs
• Appropriate use of resources, e.g. drugs
• Health & Safety, e.g. needlestick injury
• Ethical, e.g. Mental capacity, consent
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Clinical Skills Assessment - CSA
• Can only be done in the ST3 year• Simulated surgery with actors and trained assessors• 13 patients, 10 minutes each, 2 minute break• The three domains on which you will be marked are:
• DATA-GATHERING, TECHNICAL & ASSESSMENT SKILLS: Gathering & using data for clinical judgement, choice of examination, investigations & their interpretation. Demonstrating proficiency in performing physical examinations & using diagnostic and therapeutic instruments
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• CLINICAL MANAGEMENT SKILLS: Recognition & management of common medical conditions in primary care. Demonstrating a structured & flexible approach to decision-making. Demonstrating the ability to deal with multiple complaints and co-morbidity. Demonstrating the ability to promote a positive approach to health
• INTERPERSONAL SKILLS: Demonstrating the use of recognised communication techniques to gain understanding of the patient's illness experience and develop a shared approach to managing problems. Practising ethically with respect for equality & diversity issues, in line with the accepted codes of professional conduct.
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CSA – III – new scoring• Each domain is marked separately to give an overall
score• In addition the examiner grades each consultation as:
Clear Pass, Marginal Pass, Marginal Fail, Clear Fail• A “cut score” is calculated each day to allow for any
variation in the difficulty of the cases and is used to define the pass mark
• Held at assessment centre in Croydon four times per year (will eventually move to new RCGP in Euston)
• Cases and Concepts for the New MRCGP: CSA and CbD for the NMRCGP by Naidoo, P.
• CSA Courses in Rickmansworth run by CSA examiners
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Workplace Based Assessment (WPBA)
• E-portfolio – starts now and you must register with the RCGP to get access
• Curriculum www.rcgp-curriculum.org.uk
• Case Based Discussions (CBD)
• Consultation Observation Tool (COT)
• Multi-Source Feedback (MSF)
• Patient Satisfaction Questionnaire (PSQ)
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WPBA – Timetable for ST1 Year
• Prior to review at 4 months (November 2010)– CBD x3– COT or mini CEX x3– MSF 5 clinicians– Clinical supervisors report
(secondary care only)– PSQ (primary care only)– DOPS (opportunistic)
• Prior to review at 10 months (May 2011)– CBD x3– COT or mini CEX x3– MSF (5 clinicians)– Clinical supervisors report
(secondary care only)– PSQ (primary care only)– DOPS (opportunistic)
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Educational Supervision - timing
• Your 4 month review will take place in November 2010 – time is tight!
• Your 10 month review will take place in May 2011
• The “Annual Review of Competence Progression” ARCP Panel meets in June and December
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E-portfolio
• Shared Learning Log: regular reflective recording of at least three entries per week– Clinical encounters– Tutorial– VTS
• Personal Development Plan (PDP)– Regular entries and review
• Trainee Self-Rating
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Associate in Training (AiT)Cost
• AiT joining fee £145• AiT annual fee £218 (each April)
• AKT £430 (£478 non-AiT)
• CSA £1445 (£1606 non-AiT)
• CCT (PMetB) £805
• (costs as published on 17.7.10)
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What I wish I’d known when I started…..
• E-portfolio – what to put in and what is meant by reflective learning
• The AiT journal “InnovAit” is excellent
• Make a learning plan at each stage
• Get to know the other members of the group early on – valuable resource
• Learn about consultation models early on
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What I wish I’d known continued..
• What to expect from your trainer– Contract– Learning needs analysis– One to one teaching– Supervision and support
• Inform MPS/MDU when you are in a GP post. Higher cost but you can claim reimbursement
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Useful web sites
• Royal College of General Practitioners– rcgp.org.uk
• East of England Deanery– Easterngp.co.uk
• Bradford VTS– www.bradfordvts.co.uk
• Postgraduate Medical and Education Board (PMeTB)– www.pmetb.co.uk
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Useful Web Sites• RCGP Curriculum
www.rcgp-curriculum.org.uk • www.gpnotebook.co.uk - quick,concise clinical
guidance • www.patient.co.uk - leaflets & support groups• www.doctors.net.uk - e-mail address, discussion
fora and clinical advice• www.bmjlearning.com - excellent learning
modules; £70 if not a BMA member