TYPES OF DIFFICULTY EXPERIENCED BY TRAINERS AND THEIR TRAINEES

 

 

 

 

1. A PERSONALITY CLASH

These situations should be faced sooner rather than later. Share your concerns with your trainee/trainer and the programme director(s). Trainers might wish to consult their trainers' group but please bear in mind the issue of confidentiality.

 

Where to Get Help

Involve the programme directors EARLY. They should clarify issues and arbitrate if this is feasible. Every effort should be made to solve this problem quickly at scheme level.

If the problem seems complicated Associate/Deputy Directors are available to advise and guide you and your programme director(s)

 

It is vital that trainers document their concerns and also share these concerns with the involved trainee. Together, with the informed trainee, one can make alternative more suitable arrangements for all parties involved. The outcome of external arbitration may be to move the trainee to another practice. It is important that neither of the involved people see this as failure. The GP training scheme will have a responsibility to keep in contact with those involved over the following few months to deal with any developments.

 

Special Points

Do not think that the answer is to “sack” the trainee Do not think the Deanery will sort this out ‘sometime'

 

 

 

2. HEALTH PROBLEMS IN THE TRAINEE

The trainee should have a personal GP who is not based within the training practice. If not, the trainee should register with one. Trainers should not assume the role of being the trainee's personal doctor or counsellor. Trainers should document any concerns.

 

Where to Get Help

The trainee's own GP (always involve them)

Programme directorss and associate/deputy directors (Deanery)

Occupational health services are available for trainees and should be referred via the scheme for an assessment. It may be necessary for the trainee to take sick leave from work to allow this process to happen.

Occupational Health Department, St Luke’s Hospital, Little Horton Lane, BRADFORD, BD5 ONA, Telephone: 01274 734744

Counselling Services - at the local hospital (through Occupational Health) or Leeds University Counselling Services,19 Clarendon Place, Leeds, LS2 9JY, Telephone: 0113 343 4107, http://www.leeds.ac.uk/uscs/

National Help Services for Doctors - click on "Where to Get Help" in the sub-menu above.

 

Special Points

Where trainees lose a period of training due to illness there are now easy mechanisms for ensuring extended training is provided. In a small number of cases the health problem will be such that it raises doubt about the safety of the doctor to practice. If a trainer has concerns of this magnitude, (s)he should share them urgently with the programme directors and with the Deanery.

 

The Deanery has clear mechanisms for referral to the General Medical Council. Documentation of concerns is vital in these situations as a written report for the General Medical Council may be requested.

 

 

 

3. UNEXPLAINED ABSENCE FROM WORK

Any unexplained absence from work should trigger an attempt to contact the involved trainee. "Case Law" usually suggests that there is an underlying problem that has overwhelmed the involved doctor. So be supportive!

 

If you are unable to contact the doctor or unable to uncover a significant problem communicate with your VT Scheme who may involve the Deanery. Do not “sack” a trainee without discussing this with your VT Scheme first.

 

Special Points

Please remember, doctors who are frequently absent or late for work should not be automatically judged as being lazy or having a "poor work ethic". Most are hardworking but unfortunately are overwhelmed by other issues occuring at the same time. This could be heavy workload from other areas (eg MRCGP, other studies, doing work elsewhere), health issues (eg depression) or stressful life events (eg a partner who is ill, young new mothers).

 

 

 

4. UNEXPLAINED ABSENCE FROM HALF DAY RELEASE

Trainees vary in their attendance at half-day release. It may well be that they have identified a more effective personal method for education. They should however have discussed this with you and obtained your and the programme director’s agreement.

 

Sometimes, unexplained absence from HDR may be due to similar issues as stated in "unexplained absence from work" above. Such issues will need deeper exploration with the trainee. What is not acceptable is absence because they don’t feel like attending. If they are not spending the time when they are not at half-day release working in the surgery they are in fact acting fraudulently (because they are being paid to attend) and action will have to be taken.

 

 

 

5. A TRAINEE WHO IS FAILING ACADEMICALLY

Usually it is the trainer who recognises an academically failing trainee; trainees may have some insight. The key words again come into play; such concerns must be shared between the trainer and trainee. Sometimes, the underlying cause might be family or other life issues that are interfering with training. They may be suffering from anxiety or depression or some other illness. There may be language barriers that may be interfering with understaning or they might not be making effective use of learning time or study skills.

 

Involve the programme directors EARLY; they may have to involve the Deanery. Trainers should document all concerns. Trainers: If you believe it will be difficult for you to make the decision relating to signing off the e-portfolio you should share this concern both with your VT Scheme and with the relevant Deputy/Associate Director. If necessary the Deanery can take over the responsibility of not signing off an e-portfolio if this is the correct path to follow. DO NOT FALL INTO THE TRAP OF SIGNING OFF THE E-PORTFOLIO IN THE HOPE AND BELIEF THAT THE DOCTOR INVOLVED IS CERTAIN TO IMPROVE IN FUTURE POSTS.

 

Where to Get Help

Programme Directors/Deanery

Counselling Services - Failing can be a particular problem for doctors (especially overseas graduates) most of whom have always succeeded in what they do. The trainee is a person and quite often they have some insight into their failing progress. This often causes immense emotional upset and loss of self confidence/esteem. The use of counselling services at Bradford Infirmary and Leeds University may need to be enlisted.

Counselling Services: Bradford Hospitals Trust Counselling Service, Ext 5565, Run by clinical health psychology dept. Self referral or occupational health or line manager. Free to employees;

Leeds University Counselling Services,19 Clarendon Place, Leeds, LS2 9JY, Telephone: 0113 343 4107, http://www.leeds.ac.uk/uscs/

May Need to Consider a Study Skills Course - how to learn more effectively and efficiently; discuss with local programme directors.

 

 

 

6. A TRAINEE WHO HAS ENGAGED IN CRIMINAL ACTIVITY

Again, an honest discussion should take place between trainer and trainee. Programme directors should be involved early. Further action depends on the nature of the event. For instance, abuse of a practice's controlled drugs has issues related to the criminal activity and issues related to the health of the doctor and his/her fitness to practise.

 

 

 

7. A SPECIAL NOTE ABOUT TRAINEES WHO HAVE QUALIFIED OVERSEAS

New VTS applicants are invited to a Deanery run seminar on “orientation to UK general practice”, but this doesn’t help with cultural acclimatisation problems. Overseas trainees sometimes seek their own peer support groups with similar others on other Yorkshire schemes. We would encourage overseas trainees to do this.

 

Some overseas qualified trainees still have a problem with their English language, despite having passed the PLAB test. They might like to seek further help from: English Night School held at local schools and colleges.

 

The Language Centre, University of Leeds, LEEDS LS2 9JT, UK tel: (44) (0)113 343 3251; fax: (44) (0)113 343 3252; email: langc@leeds.ac.uk

Leeds English Language School, 115 Victoria Road, Leeds UK, LS6 1DR , TEL : 44 113 275 1964 email: info@leedsenglish.com

http://www.leedsenglish.com/