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 e portfolio?

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

Support for colleagues Allocation of work Effective handover of important

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

Hospital ‘zero tolerance’ policy for prescribing in allergic patients

Easier in GP when prescribing on computer

Understanding the roles of team members

Especially other health professionals Respect for their skills and contribution

to patient care Effective communication with other

team members

With patients With relatives With colleagues With other team members

Many family interactions in A/E, Paeds and Medicine for the Elderly

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

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

Capacity to consent Informed consent Confidentiality End of life issues Reproductive health issues (in O&G)

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

Rotations all have 18m of GP GP posts are 12m in ST3; remaining 6m

may be in ST1 or 2, usually in a different practice

Practice is a business contracted to provide primary medical care for the NHS - you are a practice employee

Your trainer› More personal relationship than with consultants› Many roles – teacher, employer, mentor,

assessor, possibly friend Practice staff – be relaxed but respectful Practice manager – a key person to get to know Give-and-take - practices may be more flexible

employers than hospital, if you are seen as helpful and conscientious and flexible

You won’t be thrown in at the deep end – will have an induction period

Appt interval long at start, aim to reduce to 10 mins Timetable - 7 surgeries/wk, educational time with trainer,

HDR, study ½-day Friendly environment but actual work may feel quite

isolated Good personal organisation needed – follow through, not

handover Long days, possibly 8.30 – 6.30 ish Visits by agreement, not to scary places Out of hours – see next slide

You are required (ideally) to do 6 hours per month in GP posts

Rota organised by our administrator Most sessions with Local Care Direct (LCD) seeing

patients at OOH centre or visiting them, with a trainer or other experienced GP supervising you

Also triage session with NHS Direct who handle the phone calls. Induction session with them first

Other kinds of OOH experience may count Record on form from Y&H website, upload to EP

Support during surgeries and OOH sessions, and debriefing afterwards

Teaching with trainer according to your educational needs

Assessments by trainer Possibly teaching and/or assessments by

other practice members Wednesday group tutorials at Ashcroft

Surgery, 1 – 2.30 pm

Transport to get yourself to visits and educational sessions

Reliable attendance at OOH sessions No ‘moonlighting’ without discussion

with your trainer (preferably none at all)

Geographical position Inner

city/urban/semirural Size Demography of

patients Building Number of sites

Doctors’ interests – clinical, medicopolitical, other teaching, non-NHS work

Demography of team Systems, IT Management style Ethos/values/

prioritiesLater today you’ll be asked to give your preferences for GP posts in relation to these variables