Things to do before you start your GP Post
Read the email that we send out about your post.
Make contact with the Practice Manager and GP Trainer.
Consider whether you need extra medical defence cover, most people do this.
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?
Your timetable should be for 40 hours a week. So, look at your timetable and double check. There will be a session devoted to attending the GP teaching programme on a Wednesday afternoon. 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. (protected learning time) 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 talk to your Practice Manager and GP Trainer.
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 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. EVERY SINGLE PATIENT should be reviewed (not just the difficult ones). If this is not happening, please raise it with both your GP trainer 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 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 early so that he or she can amend your rota to ensure your average weekly 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 the practice.
The RCGP advice for what trainees have to do to prove competency in this area has changed recently. Trainees used to have to complete 18 sessions of OOH care for CCT. You still need to complete OOH sessions as this is in your contract, but it’s your ability to demonstrate you can manage patients in an UUC setting that is important. There is more information about this under the MRCGP section.
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
- Consultations Skills training
- COTs and CATs
- Clinical topics
- Random case analysis
- Joint surgeries
- CSA Practice
- Discussing ethical issues that arise in the consultation
- 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.
In York we give you three different practices for 6 months each, one in ST1 or 2 and two in ST3. This means you have a broader experience of training. We do our best to ensure you have experience of an urban and rural practice, a small and large practice
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 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. Think about taking it in early ST3 instead.
– 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.