Sunday, February 21, 2010

Training at Leatside



Increasingly at the surgery we have Clinical Staff at various levels of training.
Being a training practice is thought generally to indicate a practice with a high standard of clinical care and generally high quality.
These qualities are assessed regularly by those in charge of medical training regionally in order to ensure that their trainees or students aren't going to be short-changed.

Dr Frankland and Dr Watkins are approved trainers for GP Registrars. Dr Loverock, Dr Grant, Dr Martinus and Dr Morris are our trainers for Medical Students.

For a long time we have had Hospital Doctors training to be GPs.
These days these are called GP Registrars.
They can have a varied clinical background. Anything from having come straight out of house jobs to having worked around the world for many years.
They are nowadays attached to the Surgery for 2 stints- one of 6 months and one of 12 months. The training is actually 3 years overall, so the other 18 months is spent at Torbay doing Hospital posts appropriate to General Practice like A&E, Gynaecology or Psychiatry.
These are well qualified Doctors, so when they are at the Surgery they work relatively independently. The level of supervision they get depends on their level of expertise. They are strongly encouraged to discuss any cases where they feel at all uncertain. Cases are reviewed routinely on a weekly basis and each week they share a Surgery with their trainer. Sometimes their Surgeries are videos to be reviewed later together with their trainer. These days we use HD webcams to record the consultations.
At the end of their time training they will have sat a number of quite expensive exams from the Royal College of General Practitioners and if they pass can then work independently as GPs. All of our recent Registars have gone on to get partnerships locally.

Some practices have Doctors in their early work years. What used to be called house jobs are now called Foundation training posts. These take two years and in the second year (as an F2) they can work in General Practice.
They necessarily require a greater degree of supervision and training. This takes more time on the trainers part to do this and can take them further away from their own patient lists. As yet we have not had an F2 but are looking at the possible benefits of this. Anyone who has ever been a teacher or perhaps had an apprentice perhaps will know that often the benefit of a trainee is not going to be so much in terms of a lighter workload, because the supervision pretty much cancels that out - more it is the fresh or different view on things. Students often challenge their teachers in many ways and for the practice or the trainer that is enormously valuable in their own development. There is a super little essay here on burnout in the medical prevention and how it may be prevented. Training others is one of the key approaches to keeping your own practice vital.

Thirdly is the role of medical students. We have had these intermittently at the Surgery for many years. In the old days they used to visit from London and stay for a week or two with one of the GPs. These days they come solely from the Peninsula Medical School and come on a day by day basis. Again, they can vary widely in their level of expertise, so if you are asked to consult with a Medical Student, be reassured that your case will always be thoroughly reviewed by one of the GP partners.

What we have always not managed to accommodate are School-based work-experience students. It is not thought possible to allow them routinely into clinical scenarios due to stringent patient confidentiality. The rest of the non-patient work we do is frankly too boring to be of interest to a student.
It is a shame really, as a keen student planning to apply to medical school would probably really like to have a spell at the Surgery. We feel this certainly shouldn't happen within the confines of the town in which they study. So if you have a son or daughter in that situation we would suggest approaching General Practices in nearby towns instead.

We do occasionally have trainee nurses as well. More often these are attached to the District Nursing or Health Visitors teams.

0 comments: