The nMRCGP curriculumThe nMRCGP curriculum

A proposal from the Yorkshire A proposal from the Yorkshire Deanery Curriculum GroupDeanery Curriculum Group

Paul Robinson leads from the Paul Robinson leads from the DeaneryDeanery

The GPR 3 year programmeThe GPR 3 year programme

2 years in specialisms: ST1 and ST22 years in specialisms: ST1 and ST2

1 year in general practice ST31 year in general practice ST3

Some schemes will have innovative posts Some schemes will have innovative posts half GP/ half specialismhalf GP/ half specialism

ST1and 2: agendasST1and 2: agendas

Orientate new GPR’s to general practice; Orientate new GPR’s to general practice; keep in touch with GP during these yearskeep in touch with GP during these years

Preparing the GPR to hit the ground running Preparing the GPR to hit the ground running for the GP year to pass the CSAfor the GP year to pass the CSA

Acquiring knowledge and skills relation to the Acquiring knowledge and skills relation to the nMRCGP specialism curriculum to take and nMRCGP specialism curriculum to take and pass AKT at end ST2pass AKT at end ST2

ST1and 2: agendasST1and 2: agendas

Orientate new GPR’s to general practice; Orientate new GPR’s to general practice; keep in touch with GP during these yearskeep in touch with GP during these years

Preparing the GPR to hit the ground running Preparing the GPR to hit the ground running for the GP year to pass the CSAfor the GP year to pass the CSA

Acquiring knowledge and skills relation to the Acquiring knowledge and skills relation to the nMRCGP specialism curriculum to take and nMRCGP specialism curriculum to take and pass AKT at end ST2pass AKT at end ST2

ST1and 2: agendasST1and 2: agendas

Orientate new GPR’s to general practice; Orientate new GPR’s to general practice; keep in touch with GP during these yearskeep in touch with GP during these years

Preparing the GPR to hit the ground running Preparing the GPR to hit the ground running for the GP year to pass the CSAfor the GP year to pass the CSA

Acquiring knowledge and skills relation to the Acquiring knowledge and skills relation to the nMRCGP specialism curriculum to take and nMRCGP specialism curriculum to take and pass AKT at end ST2pass AKT at end ST2

ST1and 2: agendasST1and 2: agendas

Provide educational supervisionProvide educational supervision

Predominantly service commitmentPredominantly service commitment

Covering the curriculum for the jobs GPR’s Covering the curriculum for the jobs GPR’s will not have in their rotationswill not have in their rotations

AssessmentAssessment

ST1and 2: agendasST1and 2: agendas

Provide educational supervisionProvide educational supervision

Predominantly service commitmentPredominantly service commitment

Covering the curriculum for the jobs GPR’s Covering the curriculum for the jobs GPR’s will not have in their rotationswill not have in their rotations

AssessmentAssessment

ST1and 2: agendasST1and 2: agendas

Provide educational supervisionProvide educational supervision

Predominantly service commitmentPredominantly service commitment

Covering the curriculum for the jobs GPR’s Covering the curriculum for the jobs GPR’s will not have in their rotationswill not have in their rotations

AssessmentAssessment

ST1and 2: agendasST1and 2: agendas

Provide educational supervisionProvide educational supervision

Predominantly service commitmentPredominantly service commitment

Covering the curriculum for the jobs GPR’s Covering the curriculum for the jobs GPR’s will not have in their rotationswill not have in their rotations

AssessmentAssessment

ST1 and 2 : proposed ST1 and 2 : proposed solutionssolutions

Abandon HDR for ST1 and 2 Abandon HDR for ST1 and 2

Have study blocks written into GPR’s Have study blocks written into GPR’s contracts: a block every 6 months.contracts: a block every 6 months.

Range of educational events to cover the Range of educational events to cover the nMRCGP specialisms curriculum: deanery nMRCGP specialisms curriculum: deanery level organisation, resources from VTS’slevel organisation, resources from VTS’s

ST1 and 2 : proposed ST1 and 2 : proposed solutionssolutions

Abandon HDR for ST1 and 2Abandon HDR for ST1 and 2

Have study blocks written into GPR’s Have study blocks written into GPR’s contracts: a block every 6 months.contracts: a block every 6 months.

Range of educational events to cover the Range of educational events to cover the nMRCGP specialisms curriculum: deanery nMRCGP specialisms curriculum: deanery level organisation, resources from VTS’slevel organisation, resources from VTS’s

ST1 and 2 : proposed ST1 and 2 : proposed solutionssolutions

Abandon HDR for ST1 and 2 Abandon HDR for ST1 and 2

Have study blocks written into GPR’s Have study blocks written into GPR’s contracts: a block every 6 months.contracts: a block every 6 months.

Range of educational events to cover the Range of educational events to cover the nMRCGP specialisms curriculum: deanery nMRCGP specialisms curriculum: deanery level organisation, resources from VTS’slevel organisation, resources from VTS’s

ST1 and 2 : proposed ST1 and 2 : proposed solutionssolutions

One compulsory block on consultations skills One compulsory block on consultations skills to prepare for ST3to prepare for ST3

4-6 weekly facilitated peer group sessions 4-6 weekly facilitated peer group sessions

Each GPR will have an educational Each GPR will have an educational supervisor for the 3 years- their trainer in supervisor for the 3 years- their trainer in ST3?ST3?

ST1 and 2 : proposed ST1 and 2 : proposed solutionssolutions

One compulsory block on consultations skills One compulsory block on consultations skills to prepare for ST3to prepare for ST3

4-6 weekly facilitated peer group sessions 4-6 weekly facilitated peer group sessions

Each GPR will have an educational Each GPR will have an educational supervisor for the 3 years- their trainer in supervisor for the 3 years- their trainer in ST3?ST3?

ST1 and 2 : proposed ST1 and 2 : proposed solutionssolutions

One compulsory block on consultations skills One compulsory block on consultations skills to prepare for ST3to prepare for ST3

4-6 weekly facilitated peer group sessions4-6 weekly facilitated peer group sessions

Each GPR will have an educational Each GPR will have an educational supervisor for the 3 years- their trainer in supervisor for the 3 years- their trainer in ST3?ST3?

ST1 and 2: assessmentST1 and 2: assessment

GPR is responsible for getting their GPR is responsible for getting their assessments completedassessments completed

There will be an electronic portfolioThere will be an electronic portfolio

RITA will occur at end 6 mnth posts and RITA will occur at end 6 mnth posts and completed by hospital specialist supervisorcompleted by hospital specialist supervisor

There should be formal assessment of There should be formal assessment of each piece of learning included in the each piece of learning included in the portfolioportfolio

ST1 and 2: assessmentST1 and 2: assessment

GPR is responsible for getting their GPR is responsible for getting their assessments completedassessments completed

There will be an electronic portfolioThere will be an electronic portfolio

RITA will occur at end 6 mnth posts and RITA will occur at end 6 mnth posts and completed by hospital specialist supervisorcompleted by hospital specialist supervisor

There should be formal assessment of There should be formal assessment of each piece of learning included in the each piece of learning included in the portfolioportfolio

ST1 and 2: assessmentST1 and 2: assessment

GPR is responsible for getting their GPR is responsible for getting their assessments completedassessments completed

There will be an electronic portfolioThere will be an electronic portfolio

RITA will occur at end 6 mnth posts and RITA will occur at end 6 mnth posts and completed by hospital specialist supervisorcompleted by hospital specialist supervisor

There should be formal assessment of There should be formal assessment of each piece of learning included in the each piece of learning included in the portfolioportfolio

ST1 and 2: assessmentST1 and 2: assessment

GPR is responsible for getting their GPR is responsible for getting their assessments completedassessments completed

There will be an electronic portfolioThere will be an electronic portfolio

RITA will occur at end 6 mnth posts and RITA will occur at end 6 mnth posts and completed by hospital specialist supervisorcompleted by hospital specialist supervisor

There should be formal assessment of There should be formal assessment of each piece of learning included in the each piece of learning included in the portfolioportfolio

ST3 agendaST3 agenda

Passing CSAPassing CSA

Completing the WPBACompleting the WPBA

Obtaining a satisfactory trainers reportObtaining a satisfactory trainers report

Preparation for independent practicePreparation for independent practice

ST3 essential attributes to be a ST3 essential attributes to be a GP: integrationGP: integration

Contextual: person, family, community, Contextual: person, family, community, culture and beliefsculture and beliefs

Attitudes: values and ethicsAttitudes: values and ethics

Scientific approach: critical and research Scientific approach: critical and research based approach, continuing learning and based approach, continuing learning and quality improvementquality improvement

ST3 possible solutionsST3 possible solutions

Weekly HDR in small stable facilitated groupsWeekly HDR in small stable facilitated groups

Emphasis on communication and problem Emphasis on communication and problem solving skills, attitudes, values and ethics, critical solving skills, attitudes, values and ethics, critical thinking- they will have passed the AKT!thinking- they will have passed the AKT!

Educational supervision; the electronic portfolioEducational supervision; the electronic portfolio

3 monthly review in WPBA process3 monthly review in WPBA process

The big changesThe big changes

GPR will be responsible for their learning and GPR will be responsible for their learning and completing their assessments to a clear completing their assessments to a clear timetable. No AKT/WPBA/CSA/TR = no job. timetable. No AKT/WPBA/CSA/TR = no job. More will fail.More will fail.The electronic portfolio means we will know what The electronic portfolio means we will know what happened in other postshappened in other postsThey will arrive in practice with a higher They will arrive in practice with a higher knowledge baseknowledge baseThe practice year will be about integration of The practice year will be about integration of knowledge, skills and attitudes to be a GPknowledge, skills and attitudes to be a GP

The big changesThe big changes

VTS’s through Deaneries could combine VTS’s through Deaneries could combine to deliver learning opportunities in ST1 to deliver learning opportunities in ST1 and 2and 2VTS’s could deliver learning opportunities VTS’s could deliver learning opportunities in a HDR release format in ST3 by in a HDR release format in ST3 by organising stable facilitated groups.organising stable facilitated groups.Trainers could take on the role of Trainers could take on the role of educational supervisors for GPR’s not yet educational supervisors for GPR’s not yet in their practicesin their practices

The big changesThe big changes

The assessment role will increaseThe assessment role will increase

The teaching role may change: the HDR/ The teaching role may change: the HDR/ practice teaching roles and responsibilities will practice teaching roles and responsibilities will have to be more clearly described and allocatedhave to be more clearly described and allocated

We will have to acquire the skills to manage the We will have to acquire the skills to manage the tensions of the formative/ summative tensions of the formative/ summative assessment interface in a creative way to enrich assessment interface in a creative way to enrich out roles as trainers rather than rip out our out roles as trainers rather than rip out our enthusiasmenthusiasm

Issues for trainersIssues for trainers

Weekly tutorials: what will they be for? What will Weekly tutorials: what will they be for? What will the practice contribute vs the HDR e.g. the practice contribute vs the HDR e.g. consultations skills consultations skills Clinical skills emphasis in CSA- are we good Clinical skills emphasis in CSA- are we good enough to teach them?enough to teach them?Trainers as assessors: can we do it?- quality Trainers as assessors: can we do it?- quality assuranceassuranceTrainers as assessors vs trainer as teacher/ Trainers as assessors vs trainer as teacher/ coach/mentor/educational supervisor.coach/mentor/educational supervisor.