WHAT

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SOCIAL MEDIA

The local trust suspends an ST2 whilst investigating an ‘unprofessional’ entry on her Facebook page. It was a comment about the behaviour of colleagues (who work at a neighbouring) trust at a party. You cannot access the comments.

How would you handle this? As her TPD, or her trainer?

PROBITY

An ST1 obtained leave from his hospital consultant to attend HDR.

She did not attend HDR and did not send apologies. Her attendance at HDR was poor.

On being challenged by the TPD, the trainee stated that there had been a family ‘emergency’ as she was setting out for HDR. This was a domestic issue in London relating to a lost key. When asked by the consultant about it her story was changed. She subsequently complained because the failure to attend HDR was written as ‘unauthorised absence’ in her Educators Notes.

How would you deal with this? What issues does it raise?

Please turn over

Subsequent to this, you discover that the trainee had actually been doing a locum shift on that afternoon at a nearby trust.

Does this make a difference to your actions?

PROBITY 2

A trainee in general practice records a detailed examination of a patient, and confirms their findings during debrief.

The patient subsequently consults you and tells you they were disappointed with the previous consultation as they had not been examined at all.

What would you do?

What if the trainee is adamant that they did the examination and that the patient must have forgotten?

Would it be different if this was not the first occasion that a patient had disputed a recorded examination by this trainee?

VAGUE CONCERNS

You are preparing an ESR for an ST1 after 6 months in hospital posts. He has failed to arrange a meeting at the correct time, so this is 2 months late.

You read his CSR for O&G and Gen Med and see some concerns about his interaction with nursing staff, and his punctuality which is poor. He has completed the minimum required assessments, but all at the last minute, and you do not recognise the names of all the assessors, one of whom is identified as ‘ST’. His MSF score is rather low, but there are very few comments to suggest why.

There are not many log entries (18) and none have been read or validated. His curriculum coverage is low as a result. He has recorded no significant events, nor professional conversations.

At the ESR he is pleasant and listens to your concerns, saying he has talked to his CS about them, and that he will try to improve.

What ESR outcome would you give him? Would you record your concerns? If so, where and how? Would you talk to the TPDs to find out more? What tools can you use to identify concerns more precisely, and quantify them?

EDUCATIONAL PRESCRIPTIONS

A trainee has failed the CSA and been awarded an extension for 4 months. The ARCP panel has advised shared surgeries, video review amongst their list of educational interventions.

The only place you can find for him is a partner down (long term illness) and has only one trainer. The trainee seems to expect at least one whole shared surgery per week. The trainer feels unable to do this, as it limits his patient’s access in a difficult time.

What would you advise?

TRAINEES ON EXTENSIONS

You are a TPD trying to place a trainee who has failed the CSA three times, and has a 3 month full time extension for his final attempt. His scores so far suggest he is unlikely to pass the next time without a lot of input. You do not have a place in any of your experienced training practices. The only place available is in a practice with a trainer who started only 6 months ago, and has had one ST1.

What might you do to support this trainer?

Is there an alternative to placing the trainee here?

SICKNESS ABSENCE

A trainee (ST1) has frequent short sickness absences – often centred around weekends.

Over the first year, they have had 49 days in total. Reasons given have included ‘viral diarrhoea, headaches, migraine, ‘flu, gastritis, back pain’.

What issues do you need to consider?

What would you do about it?

TRAINEE NOT ENGAGING

An ST1 is allocated to you for Educational Supervision. You fail to make contact with him for his first ESR despite many attempts, by email, phone and educators note. At the time for the second ESR he fails to respond again. AT this point he has made 9 log entries, done no assessments at all, and is obviously not engaging with his portfolio in any meaningful way, nor with you.

What should you do?

Can you do an ESR with a trainee who won’t engage and do their bit?

‘REFER TO PANEL’

You have just completed a mid year ESR on your trainee.

You have concluded that they are not making satisfactory progress and you press the ‘refer to panel’ button on the ESR.

What else should you do?

SHARED TUTORIALS

You are in a practice with more than one trainer and trainee.

You learners are often at different stages of their training and vary in their background.

What steps could you take to ensure shared tutorials are appropriate and useful?

A TRAINEE APPROACHES YOU!

A trainee who thrived with you for their 4 months in ST1 is now at another practice and struggling after 6 months of their ST3 year.

The trainee approaches you and knowing you have spare capacity asks if they can change to your practice.

How would you handle this situation?

SHARING THE LOAD

Your learner needs to know more about the management of childhood asthma. You have a nurse who is particularly strong in this area.

You plan to put the learner in to one of her clinics.

What are the key considerations?

LEGAL – TRAINEE ERROR

You have received a formal complaint from the mother of a 12 yr old child your trainee saw last week.

The mother states that the trainee was ‘very rough’ when examining the child’s ears and throat, and made the child cry.

By coincidence this was videoed, and having watched the consultation you would agree with the mother.

What are the implications for you and the practice?

LEGAL – EMPLOYMENT

Your learner’s behaviour is not satisfactory. They are continually late for work, and disappear in the middle of the day, often leaving paperwork, results and prescriptions outstanding. They have not responded to feedback from you as their trainee, and the practice manager.

Whose job is it to sort this out?

EQUAL OPPS

You are due to take your first GPST1 in 3 weeks. At an informal meeting they tell you that they have had problems with anxiety and miss their family (Inverness). They have applied for 80% less than full time training, and are requesting Fridays off.

How do you handle this?

EQUAL OPPS – RELIGIOUS MATTERS

You have a trainee who has asked for a quiet place to pray during lunch time and in the early evening. There is a room he can use (broom cupboard) but this affects his ability to attend practice education meetings twice a week.

Options?

What would you really do?

LEGAL

You discover that your trainee has not got indemnity cover, despite having been reimbursed for this. He has been seeing patients in the practice for almost 3 months.

What do you do?