Hospital Posts on the Bradford Scheme

how to make the most of them

Hospital Posts

You will gain useful clinical knowledge But how else can you make your

experience useful for your future in GP? What could you reflect on and put in

your eportfolio?

Generic Aspects of Hospital Practice Useful for your Future

as a GP Medical teamwork Safe prescribing Multidisciplinary teamwork Communication skills How families behave Significant event analysis Ethical issues The hospital-GP interface

Medical Teamwork

Support for colleagues Allocation of work Effective handover of important

information – essential in hospital shift system, especially useful in GP if you work LTFT

Safe Prescribing

Hospital ‘zero tolerance’ policy for prescribing in allergic patients

Easier in GP when prescribing on computer

Sounds obvious but - look it up if its an unfamiliar drug

Be extra careful when prescribing for children

Multidisciplinary Teamwork

Understand the roles of team members Especially other health professionals Respect their skills and contribution to

patient care Ensure effective communication with

other team members

Communication Skills

With patients With relatives With colleagues With other team member Record keeping

How Families Behave

Many family interactions visible in hospital specialties especially A&E, Paediatrics, Medicine for the Elderly and Palliative Care

In GP family are generally in the background – but in hospital they’re often there for you to observe

Exceptions in GP – patients with dementia, children

Significant Event Analysis

Looking at what’s happened when something went wrong or nearly did so

Looking at the feelings of everyone involved

Reviewing the organisational systems involved

Working out how to prevent a recurrence

Ethical Issues

Capacity to consent Informed consent Confidentiality End of life issues Reproductive health issues (in O&G) Take responsibility – if you have

misgivings about a practice, even if it is well established, talk to your supervisor or TPD advisor

The GP-Secondary Care Interface

Understanding what secondary care has to offer

Communication between GPs and hospital doctors

Understanding referral pathways, and what you’ll be referring patients for, when you’re a GP

What Previous Registrars Say

“It's important to realise, even though you’re doing a hospital rotation, you really need to get out what GP's actually need to know”

“For instance, in Obs and Gynae instead of being in theatres a lot, spend more times in Gynae outpatient clinics - see what GPs refer, learn acute assessments in MAC, learn how to insert a speculum etc"

What Previous Registrars Say

“HDR attendance - whilst in hospital it is possible if you really try and registrars have managed to attend a good number even when doing A&E and Medicine”

“Try and sit in on lots of outpatient clinics”

“Get all your DOPs done before finishing hospital posts (much easier getting a reg in A&E watching you do a PR then trying to do it in GP-land)”

What Previous Registrars Say

“In A&E - spend as much times as possible in minors”

“In Paeds - take heart that PAR is really useful for seeing lots of sick kids as you rarely see any in GP-land”

“In Gynae - do lots of clinics and get good at gynae examinations.”

And Finally . . . If you haven’t already – become a member

of the BMA while in training

Employment issues – holidays, maternity pay etc – can be a minefield so worth having proper representation

Good luck and keep up the good work!