Your GP Posts

Your GP Posts

4 things to do as soon as you join a scheme…

1. Register with the RCGP

– To register online, click here

– There is an enquiry line for AiTs (email ait@rcgp.org.uk or telephone 020 7344 3078) for any registration queries.

2. Make contact with the Practice Manager and your GP Trainer

Ask them what is required of you before you start. Also tell them of any holiday dates that you need to take early.

3. We recommend getting extra protection from a medical defense organisation

In GP and Hospital posts, you are to some extent covered by the Indemnity offered by the NHS. However, you may end up doing (without realising it) other professional activities which may not be covered by the NHS Indemnity. So, if you want peace of mind, we strongly recommend additional cover through membership of a recognised medical defense organisation or insurer for these purposes. 

4. Note the dates of the GP Training Scheme’s induction & book the leave

If you don’t know when your GP scheme’s induction is – email your GP scheme administrator. When you have got your dates for your GP TRAINING SCHEME’S induction, don’t forget to  book that time as study leave with your first post. PLEASE TELL THEM AND BOOK IT IN AS SOON AS POSSIBLE – they will not automatically know.  

What equipment do I need?

You just need to bring your stethoscope. Everything else will be provided by your GP training practice. Hopefully, they will give you a doctors bag containing things like a BP machine, sats monitor, thermometer, Eye/Ear diagnostic set, and emergency drugs.

How will my timetable look?

You won’t work more than 40 hours a week. So, look at your timetable and double check. There will be a session devoted to attending the weekly Half-Day Release teaching programme run by your TPDs. There will be a session or two (if split) for tutorials with your GP trainer. And then you will one half day for study and getting your administrative work done. Please note, this is for study and getting your admin work done and should not be seen as “half a day off”.

If you have any concerns voice them with your Practice Manager and GP Trainer early.

Understanding Debriefs

When you start doing surgeries – you will receive debriefs from one of the qualified doctors at the surgery to double check that what you have done is okay and that the patient has received good appropriate clinical care and that the consultation has not left them vulnerable or unsafe. This is the primary purpose of debriefs. The great thing about debriefs is that often, the person debriefing you will also teaching you things along the way. If you want to get the most out of debriefs, you need to be open and honest and not cover up things you failed to do.

In your first GP post (in ST1 or ST2) – you should be debriefed after EVERY SINGLE SURGERY. Further more, EVERY SINGLE PATIENT should be reviewed (not just the difficult ones). If this is not happening, please raise it with both your GP trainer and your Practice Manager because it is unsafe and puts both you and the practice at medico-legal risk! It’s not fair on the patient either.

In your final GP post (in ST3), you will still receive debriefs after EVERY SINGLE SURGERY until you finish. However, the difference is that not every single patient will be reviewed. Initially, they will be but as you become more ready for independent practice, the doctor will end up selecting a few random patients to review to ensure all is okay. Again, make sure your debriefs are happening and if they are not – raise your concern with the Practice Manager AND your GP Trainer.

A note about Urgent Unscheduled Care (UUC) & Out of Hours (OOH)

In General Practice, you will need to engage in Urgent, Unscheduled Care (UUC). This includes being the on-call duty doctor for the surgery (during in hours service) or with a local Out of Hours service provide (OOH). In ST1/2 – if you are in a GP post, you wont be doing much of these. Instead, you’ll probably be sitting in and observing or seeing the odd patient under direct supervision. However, in ST3, you’ll be doing lots more, initially supervised and later more independently.

Don’t forget, if you do any shifts at a local Out of Hours centre – this needs to come off the 40 hours maximum working time per week. Your practice will not know when you are doing Out of Hours. So, when you have your dates, please tell your Practice Manager / Rota coordinator early so that he or she can tweak your rota to ensure your average week working time remains 40 hours and no more. Telling them in advance helps them to do this without disrupting the service provision to patients from their practice.

Teaching

You will receive 4 hours teaching per week from the training practice. Some practices do this in one go. Others split it into two 2h tutorials. During these tutorials, you and your trainer will do things like

  • Communication Skills training
  • COTs
  • CBDs
  • Clinical topics
  • Discuss patients you are having difficulty with
  • QIA project work

My friend’s GP training post is much easier than mine. And I think my GP trainer is harder.

All GP practices are different.  There are no two practices that are the same.  They differ in so many ways, for example, one may be urban, the other semi-rural or even rural. The types of patients will differ. Some will provide distinctive extra services. IT systems may be different as may the management style.

So, it is unsurprising that when comparing notes, two practices may well differ, and that includes the experience and training you receive compared to others. However, this should not matter because we are preparing you for the real world. When you qualify, and you are looking for a job, no two practices will be the same.

And the one thing we can say is with certainty is that your GP trainer has gone through rigorous training process in order to become a GP teacher. So, even if you perceive one as being tougher than another, please remember the quality and level of teaching you will be receiving will probably be high. All our GP trainers are re-approved every 5 years and for that, they have to attend courses, show videos of them teaching and engage in teaching activities to show how good they are.

Get into the mindset of embracing differences and the possibility that if you feel your trainer is a bit harder than others, you might actually be getting a higher level of teaching experience.

Sometimes there might even be different approaches for trainees in same practice which will usually be due to specific personal / educational needs of the particular trainee. Please be mindful practices cannot discuss this with you about another trainee.

Non-urgent advice: Some tips from GP trainees

—   In your first GP post, spend 80% of your time developing your consultation model. This will help you with the CSA / RCA later on in ST3.

—   Don’t put too much pressure on yourself in terms of AKT; you need a good chunk of time in GP before sitting this. It helps if you can take this in ST2 year otherwise think about taking it in early ST3 instead. Ensure spending reasonable time preparing for your AKT using self study and AKT package on FourteenFish platform.

—   Try and get the Quality Improvement Activity project out of the way in your first GP post.

—   Getting on well with your trainer is key and makes everything easier.

—   Try and choose a few hospital clinics to sit in (good ones are memory clinic, syncope clinic, ENT etc.)

—   Keep a list of your referrals and then check back to read clinic letters to learn from them.