Your GP Training Scheme Induction
understanding more about your GP Training Scheme
- RCGP registration/AIT pages
- RCGP website
- RCGP AIT committee
- RCGP MRCGP pages
- Bradford VTS MRCGP intro pages
- Half Day Release (BVTS)
- Moonlighting – can I do other jobs on the side?
- European Working Time Directive (EWTD) by BMA
An intro to all the different types of induction...
You will have several induction programmes when you join a GP training scheme. You will have an induction in EACH of the jobs on your rotation. In addition to these, at the start, you will have a SCHEME INDUCTION. You may be wondering – why all these inductions? Are they really necessary? Are they even important?
- It usually lasts 2 days and often done in a nice venue or the hospital post-graduate department.
- It usually lasts a day.
- It usually lasts 2 weeks.
Both types of induction are important. The specialty post inductions are essential for helping you smoothly integrate into that particular post. The GP Scheme’s induction is essential for helping you smoothly integrate into the whole 3 year programme. The specialty post inductions provide a landscape from the ground floor level whilst the scheme’s induction provides a bird’s eye perspective. So – back to the original questions – are they all necessary? Are they both important? Answer – absolutely YES.
Why do I have to be on a GP Training Scheme/Programme?
Okay, let’s start. Firstly: welcome to you GP Training Scheme and congratulations on being successful!
Hospital consultants have to go through a rigourous experiential training programme (and pass certain exams) before they can qualify as independent qualified consultants. The same goes for GPs. This rigorous GP Specialty Training Programme (STP) is organised and delivered through out the country by GP Training Schemes. It’s usually a 3 year programme (longer if you go part-time) and will usually consists of 6 posts – 3 of which will be in hospital specialties and 3 in GP land.
Hospital consultants are specialists of their particular secondary care world. Likewise, GPs are specialists of their primary care world. An ordinary GP could not do they job of (say) a cardiologist – because the knowledge and skill sets are different with a small amount of overlap. Likewise, a specialty consultant would not be able to simply quit their job and become a GP. And that is why we have the MRCGP – a specialist exam which tells the world (like the FRCS does for surgeons, MRCP for medics) that you have attained a good level of proficiency for your chosen career.
How does it all work? The structure of Training in the UK?
There are many GP training schemes throughout the UK. So how are they regulated to make sure their programmes are good enough and reach a minimum standard?
This is where the HEE Deaneries come in. Your GP training scheme will belong to a particular HEE School or Deanery. The UK is split into regions. Each region has a HEE School or Deanery that looks after several GP training schemes. Here’s a list of all the Deaneries in the UK > click here. The deaneries make sure that their training schemes deliver effective education and training programmes.
Your training scheme's educational philosophy
All schemes see General Practice Training as a partnership between you, the enthusiastic doctor, willing to learn and wanting to be a high quality General Practitioner and us, the educators.
Throughout your training, you will meet so many people that will teach and change you in so many ways. We all stand on the shoulders of giants who have gone before us. Those educational giants are obvious and sometimes not so obvious.
The obvious ones include the Training Programme Directors who seek to provide a training scheme that is flexible and centred around your needs. Then there are the GP Trainers who pride themselves on their commitment to training and to giving you a wide range of experience in their practices. And finally, there are the hospital consultants in specialities who wish to prepare you to face the breadth of clinical situations that General Practice will give you. All of us want to facilitate the development of doctors who are reflective practitioners, hoping that by the end of training you will have a sound practical knowledge of clinical medicine, understand the basic principles of health and health care for populations, have a broad understanding of medical ethics and positively embrace diversity.
The not so obvious educators are as important as the obvious ones. These include all the people you work with. If you are willing to remove the “doctor’s ring fence” you have around you and truly interact with people like admin staff, hospital porters, nurses, pharmacists and staff from other disciplines, you will be surprised at the unintended things that you learn – some of which will be life changing! And of course, the biggest group that have not been mentioned so far is our patients. Be genuinely interested in patient’s, their experience of illness and their lives. Doing this will teach you a lot about life, it’s natural complexities and how to live your own.
As doctors, we really are in a wonderful profession where we discover so many wonderful things about others, and ourselves.
To have good communication skills
To practice patient-centred medicine
To value diversity
To practice evidence-based medicine
To practise preventative medicine
To use time effectively
To tolerate uncertainty
To organise an efficient and caring practice
To work effectively in multidisciplinary teams
To adapt to change throughout one’s career
To regularly audit one’s own performance
To plan one’s own continuing education and professional development
To look after our colleagues
To look after ourselves (balancing the demands of personal and professional life)
What is a TPD and the Programme Administrator?
So, the GP Training Scheme you belong to is organised and run by Training Programme Directors (TPDs for short). There are usually several of them. They are experienced and qualified GPs who have a passion for education. Most will have a formal qualification in medical education. You can’t just one day decide to become a TPD – you have to go through a teaching training programme and they are reapproved every 5 years to make sure they are good enough.
You will find that different TPDs have different roles. One or two may be responsible for the Half Day Release Programme. Others will have a responsibility for things like Educational Supervision, allocating your post rotations, training up the trainers, the pastoral care of trainees and so on. Hopefully at the scheme induction programme, you will get a rough idea of who does what.
Each scheme will also have a GP Scheme or Programme Administrator. This person, although not a doctor, is absolutely one of the most crucial persons there is. If you compare a GP training scheme to a mechanical clock, they’re the person who makes sure all the cogs are regularly oiled and are turning. It is disappointing to hear that some trainees are slightly demanding and treat Programme Administrators in not so nice a way – simply because they are not qualified doctors. Please don’t do this – be respectful; we are all human and therefore we are all equal. Besides, the Programme Administrator has a wealth of knowledge. They do all the administrative work that is needed to make the GP training scheme programme work. They can make your life ten times easier. So – be super nice and get to know them well.
What learning opportunities will the scheme provide?
During your time on the training scheme, you will be involved in a variety of teaching sessions and your educators will use a variety of techniques to maximise your learning potential.
What will my rotation look like?
- Generally a GP training scheme rotation is for 3 years. It becomes longer if you go part-time (pro-rata).
- 6 posts within that rotation.
- 3 in hospital specialties. 3 in General Practice.
Most schemes get you to do one GP posts in ST1 or 2. You will rotate around various specialties throughout the first 2 years. The final ST3 year is reserved purely for GP. You will normally do two posts but in the same GP practice. This continuity gives you and your trainer a good foundation for helping you prepare for exams like the CSA whilst building up the final core GP skills necessary for independent practice.
Tell me a quick thing or two about Half Day Release (HDR)
This is your weekly educational programme put on for ALL GP trainees on the scheme. You get to meet and mix with other trainees on the scheme. It’s a great place and usually emits a great vibe. Most are held in a hospital teaching facility (in Bradford for example, it is at Field House Postgraduate Teaching Centre at Bradford Royal Infirmary). .
HDR covers a whole range of areas, not just the clinical. In particular, it’s the place where you will get to explore skills and attitudes in some significant detail because these things change very little with time and are difficult to find in books (compared with clinical knowledge – which becomes out of date pretty soon and is always available online). HDR sessions will vary from one to the next – using a mixture of educational methods to suit different learning styles. In this way, HDR also maximises opportunties for group learning and support. Half-Day Release is a good place for developing your teaching skills and you may want to contact your TPD to ask if you can help out.
An important note about HDR attendance… please read
- All GP trainees are expected to attend at least 70% of them (hospital and GP). Hospital consultants will be aware are aware of how important it is for you to attend. You are expected to attend every week UNLESS you are on approved leave. Your attendance is mandatory, because you are PAID TO COME!!! The lowest paid ST1 GP gets about £90 for attending a HDR session – many of you will get a lot more!
- It is therefore unethical for you not to come – because you are being funded to come – it is built into your wage packet – and that money comes from the public purse! A low paid worked would take 14 hours (nearly 2 days) to earn that. Your wage is paid from their taxes. How would your low paid person feel if they knew you were laissez faire about your attendance at HDR?
- However, if you want to do another educational activity instead of coming to HDR, please discuss it with your TPD. But if you have booked an appointment with the dentist or plumber for this time – cancel it and rearrange it to fit into your personal time, not publicly paid time!
- Remember, you are not a student in a ‘placement’. You are an employee doing a job!
We are sorry to have to write in these terms but there are many trainees who take HDR for granted and bunk off – this is not on.
Tell me a quick thing or two about Clinical Supervision and Educational Supervision.
During your training, you will have an Educational Supervisor and a Clinical Supervisor – and you will have mandatory meetings with both. Trainees often get confused between the two. So let’s try and clear this up for you.
Clinical Supervision (CS)
- A Clinical Supervisor is usually the senior doctor that you are working for – this will be the consultant in a hospital job and a GP Trainer for a GP post. Their role is to support you during that job, help you get some knowledge and skills, and then carry out the necessary training assessments on you. Therefore your Clinical Supervisor will change every time you change your post. There job is to make sure that you are performing well in the particular post you are in and getting good enough educational experience from just that particular post.
Educational Supervision (ES)
- An Educational Supervisor is a senior doctor (in Bradford, usually a GP Trainer) who looks after you for the entire 3 year GP training programme. They will help you keep on track for GP training (especially during your hospital posts) – after all it is a GP that you are trying to become! There job is to make sure that you are performing well OVERALL throughout your whole GP training programme so that you are on the right track to becoming a good GP (the ultimate goal).
- You will have one ES meeting in every post (except ST1 where you have an extra initial handshake ES meeting at the start too). These meetings are important and mandatory. And they require quite a lot of preparation on your part before the meeting ensues. So – please regard them with the utmost of respect and importance.
- Please don’t be scared of these meetings. Their purpose is to help you along your training journey in order to make it as smooth as possible. For that to happen though, there has to be a good relationship between you and your Clinical & Educational Supervisors – one which is based on honesty, integrity, respect and trust.
And ARCPs? What's that all about then?
- ARCP is short for Annual Review of Competency Progression. In other words, these panels assess each trainee before they move from one ST training year to the next – to make sure they’re progressing at a good enough rate before allowing them to move on.
- Hence, they are usually held a month before you are due to change an ST year. You basically get an ARCP every year (hence the word “annual”).
- They assess you through your ePortfolio and what is written in it, as well as other things like the Educational Supervisor’s Report, the Clinical Supervisor’s Report, performance in CBDs, COTs, CExs, PSQs, MSFs and so on.
- If any of this looks very bad, they can stop you moving up an ST year and they can make you repeat a post if they consider you unsatisfactory. They even have the power to remove you from the scheme for repeated failures.
- That is why you need to make sure that your Educational Supervision meetings happen (at around month 4 of your post) and that you do the necessary preparation for them as well as making regular use of your ePortfolio and keeping it up to date.
What's this ePortfolio thing and is it important?
It’s incredibly important.
The ePorfolio is the online tool/storage space/book that holds all your evidence together. It’s where you keep a record of your learning and clinical encounters. Where you record significant events. Where your assessments like CBDs, COTs, CEXs, MSFs, PSQs – are all uploaded. It is where your Clinical and Educational Supervisors write reports about you. It is where your Out of Hour sessions are recorded including the learning from them. And where your AKT and CSA results will be posted. In summary, it is a structured online book where everything related to your GP training is stored and collated and organised year by year.
And therefore, it is this ‘online book’ that represents YOU. Your ARCP panels will ultimately judge you through this rather than a face-to-face consultation with you! I hope this makes it clear why you must show it a lot of respect and pay careful attention to it. Don’t treat the ePortfolio as a crappy little notebook that no one bothers with. Pay a lot of care to how you write in it – because it is through the ePortfolio that you are ultimately judged! And remember – meaningful entries are more important than lengthy waffly unstructured ones! We expect a lot more than what you may have experience with the ePortfolio you engaged with in your Foundation Years.
It’s simple really. You are on a 3 year programme. So, if you’re in the first year, you are called ST1. If in the second year – ST2 and so on. The ST bit stands for Specialty Trainee – which is what you are. Simple!
- You are entitled to 25 days’ annual leave in hospital, increasing to 30 days after Incremental Point 3 of the salary scale.
- In GP, the practice contract almost always gives the same entitlement as in hospital.
- Study leave is 30 days per year (this includes Half Day Release while in GP).
- If you take over 2 weeks’ other leave in a year (maternity, paternity, sick or compassionate leave), means you have to extend your training at the end, by the same amount of time.
- You must record all leave on your ePortfolio (eg through ‘The ES Workbook’ – found under the Educational Supervision pages on this website)
- Maternity leave entitlement treats you as in continuous NHS employment even if you have changed employer
Yes, you can take a break. But you have to apply for it WELL IN ADVANCE. Look up “Out of Programme Experience”. The most important thing is to let your TPD and Consultant/GP Trainer know as early as possible. Telling them early means they have more time to help make your plans go smoothly and ensure your return is easy too.
Of course, if you are pregnant then you’ll need to take a break for your maternity and paternity leave. And likewise – if you are ill or have an operation planned.
The most important thing is to let your TPD and Consultant/GP Trainer know as early as possible. Telling them early means they have more time to help make your plans go smoothly and ensure your return is easy too.
A quick thing on... Responsibility
The Royal College of General Practitioners say that it is the trainee’s responsibility to ensure all assessments are done in a timely way. That includes CBDs, COTs, MiniCEXs, Educational Supervisor meetings, Clinical Supervisor meetings and so on. Please do not expect Educational and Clinical Supervisors to be chasing after you. You will need to chase them. And chase them well in advance – supervisors have lives too and may be on holiday at a time when you want to meet them.
What if I run into problems?
If you find yourself in difficulty, please talk to us sooner rather than later. Remember that there are a number of people who will be available to you…
- Your hospital consultant if you are in a hospital post
- Your GP Trainer if you are in a GP post
- Your Educational Supervisor
- Your TPD. Some schemes, like Bradford, have each trainee assigned to one of the TPDs (and referred to as their TPD advisor).
- Join the BMA now – they can help with employment problems. https://www.bma.org.uk/
- There is a confidential counselling service free for trainees:
- For health, alcohol and drug issues – http://gphealth.nhs.uk
- For financial difficulty/debt – bradfordvts help pages on debt
Please join the BMA...
We strongly urge you to become a member of the BMA. They’re amazing at supporting you when things go wrong. And often, the people who need the BMA are often the people who think it’s not important. If you’re an IMG, we STRONGLY suggest you become a BMA member. You’ll regret it if things go wrong – because they will not help you with an issue if you were not a BMA member at the time. In the big court cases in the UK, the BMA have been absolutely amazing. You may be thinking that you dont feel you get much for your subscription costs – but nothing could be further from the truth. They supply the BMJ, lots of wonderful educational modules online and they if you ever need their counsel – be it for sickness in yourself or litigation – they are simply amazing. Trust us – join them!
Got any suggestions or advice or comments?
Got any advice? Anything we’ve missed? Anything that you think is inaccurate? Any ideas of how we can improve this page? Then leave a message below. Got a resource to share: contact [email protected].
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