The universal GP Training website for everyone, not just Bradford.   Created in 2002 by Dr Ramesh Mehay

Teaching Consultation Skills

Joint Consulting

Is Joint Consulting Worth Doing?

Absolutely!  It makes a massive difference to trainees.   Sit and Swap surgeries is where the GP Trainer and trainee take it in turns to see patients.  It is one of the best ways of helping trainees acquire communication skills.   The GP trainer demonstrates and role models consultation behaviour.   Then the trainee has a go at some of the skills.  The trainer fine tunes, and the GP trainee continues to “have another go”.

 When done in addition to tutorials on the consultation, it helps by

  1. allowing you to demonstrate to the trainee how to do some of the microskills in practice that you have been thus far only talking about.
  2. allow the trainee to practice and demonstrate they can do certain consultation microskills
  3. help you to give feedback and help trainees refine their skills and take them to the next level in real time.

We like to call joint surgeries “Sit and Swap” surgeries because we believe the key to success is not only watching the trainee, but you swapping with them and demonstrating some of the consultation microskills.  You can’t just be watching and advising.   You have to demonstrate.  You have to get them to practise again and again, until they get it.

How often should I be doing Sit and Swap surgeries with my trainee?

  • Minimum – once a month, preferably two per month. 
  • But the more the better.  It is such a powerful and effective consultation/communication skills learning method and can help a trainee who you are struggling with pass the CSA. 
  • Do lots more with trainees who did not graduate from the UK (once a week?)

Tips for the Practice Manager - how to organise Sit and Swap Surgeries

  •  The Practice Manager needs to schedule regular Sit and Swap surgeries – at least one per month THROUGHOUT THE ENTIRE TRAINING PERIOD.   The preferred is 2 per month.  
  • Patients need to be booked in at 20 minute intervals. 
  • Just book them into one surgery – perhaps under the trainee’s name – otherwise the patient will expect to be consulted by the GP trainer.  And then let the Trainer and trainee decide how they want to split seeing them.
  • Sit and Swap surgeries should be provided for trainees at all stages, not just ST1s.   ST3s have consultation learning needs too – no matter how good they are.
  • Trainer – remember that some COTs can be carried out on directly observed consultations (no more than one in any one surgery).

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Bradford VTS was created by Dr. Ramesh Mehay, a Programme Director for Bradford GP Training Scheme back in 2001. Over the years, it has seen many permutations.  At the time, there were very few resources for GP trainees and their trainers so Bradford decided to create one FOR EVERYONE. 

So, we see Bradford VTS as  the INDEPENDENT vocational training scheme website providing a wealth of free medical resources for GP trainees, their trainers and TPDs everywhere and anywhere.  We also welcome other health professionals – as we know the site is used by both those qualified and in training – such as Associate Physicians, ANPs, Medical & Nursing Students. 

Our fundamental belief is to openly and freely share knowledge to help learn and develop with each other.  Feel free to use the information – as long as it is not for a commercial purpose.   

We have a wealth of downloadable resources and we also welcome copyright-free educational material from all our users to help build our rich resource (send to

Our sections on (medical) COMMUNICATION SKILLS and (medical) TEACHING & LEARNING are perhaps the best and most comprehensive on the world wide web (see white-on-black menu header section on the homepage).