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The Trainer's Toolkit | Bradford VTS
Bradford VTS — Educators & Teaching

The Trainer's Toolkit

Because nobody handed you a manual when they made you a GP trainer. Until now.

For Trainees, Trainers & TPDs High-impact learning in minutes Web Resources & Quick Summary Induction Toolkit — ST1/ST2 & ST3 Appointment Titration Guide Monthly Journey Map End of Post Checklist Common Pitfalls & Trainer Pearls Trainee Voices & Wellbeing IMG Support & Struggling Trainees Teaching Tips & Take-Home Points

A one-stop guide for GP Trainers and Practice Managers — mapping out the entire trainee journey, month by month, so nothing vital gets missed. Whether your trainee starts tomorrow or finishes next week, this page has you covered.

Last updated: April 2026

🌐 Web Resources

A hand-picked mix of official and practical GP training resources. Because sometimes the best pearls are not hiding in the official documents.

📌 Core Bradford VTS Pages

📚 Assessment & ePortfolio

🎓 Teaching & Consultation Skills

🌍 External & Official

⚡ Quick Summary — If You Only Read One Thing

2–4w

Before they arrive: contact them, send a welcome letter, send pre-reading, set up their timetable

Day 1

Orientation day: practice tour, meet the team, educational philosophy, key checks & educational contract

Wks 1–2

Sit in, don't rush: observe different consulting styles, 'sitting with Nellie', computer training, learning needs assessment

Wk 3

Own surgeries begin: start at 30-minute slots, debrief after every surgery, named Clinical Supervisor each day

Month 2

Consultation skills focus: COTs begin, CbDs begin, ePortfolio training, consultation theory book starts

Month 3+

Regular reviews: WPBA check, learning needs review, mid-post review, QI project launch

Month 6

End of post: Clinical Supervisor's Report, evaluation of your own teaching, a proper leaving do

Always

If concerned: contact TPDs early. Don't wait. The sooner a concern is shared, the sooner it can be helped

💡 Why This Matters in GP Training

The Reality

Most GP trainers are fantastic clinicians — but nobody actually trains them how to run a training post from scratch. The induction gets done (mostly), but important things still slip through the cracks. The trainee starts too many surgeries too fast. The debrief time disappears. The ePortfolio gets forgotten until month 4. And then month 6 arrives like a surprise.

This page fixes that. It is a chronological, step-by-step checklist — one for the GP Trainer and one for the Practice Manager — covering every month of a 6-month GP post.

The Impact

💛
For the Trainee

A well-organised training post feels supportive and intentional. Trainees who are properly inducted, properly supervised and properly debriefed learn faster, feel more confident and make fewer mistakes.

🌿
For the Trainer

A structured approach reduces the anxiety of "have I forgotten anything?" and makes you a far more effective teacher without spending more time on it.

📋
For Patient Safety

Proper supervision, timely debriefs, and clear Clinical Supervisor allocation every day are not just good practice — they are patient safety essentials.

⚠️
Concerns? Don't Wait

If you have any concern about a trainee — clinical, professional, or personal — contact your TPD (Training Programme Director) early. This is not a sign of failure on anyone's part. Early involvement almost always leads to a better outcome for everyone.

Weeks 1–2
Orientation & Settling In
  • Sitting-in sessions
  • Computer training
  • Learning Needs Assessment
  • Educational contract
Week 3 → Month 1
Own Surgeries Start
  • 30-min appointment slots
  • Daily debrief × 30 min
  • Named Clinical Supervisor
  • COT consent process set up
Month 2
Assessments Begin
  • COTs & CbDs start
  • ePortfolio & log entries
  • Consultation theory book
  • Video surgeries weekly
Months 3–4
Review & Develop
  • Mid-post review (month 3)
  • WPBA numbers check
  • Consultation skills focus
  • QI project underway
Month 5
Consolidate
  • 20-min appointment slots
  • Telephone/video consulting
  • Ongoing WPBA & portfolio
  • Training evaluation
Month 6
End of Post
  • Clinical Supervisor's Report
  • QI project presented
  • Evaluate your own teaching
  • Leaving card, gift & leaving do
🔁
The Monthly Review Loop — Always Running in the Background
  • Read and validate ePortfolio log entries
  • Check WPBA numbers against the Training Map
  • Review Learning Needs document — anything to add, change or action?
  • Ask how things are going (genuinely — not as a box to tick)
  • Any concerns? Contact TPDs early. Every time.
📌
About this toolkit

All blue-underlined text links to further resources. Most are also available from the GP Post – Induction pages. This toolkit covers the full 24-week ST1/ST2 GP post.

Making contact before arrival makes the trainee feel valued, enables pre-reading to be shared, and frees up precious induction time for deeper learning.

🏢 Practice Manager

  • PM checklist — before trainee joins.doc
  • 5 tasks before you start with us.docx
  • Registering with the RCGP as an AiT.docx
  • Foundation year trainees — induction to GP.doc (for FY docs in GP)
  • Glossary for GP training.doc
  • Send a welcome & introductory email — practice demographics, surgery address & leaflet, induction timetable
  • Also send an induction pack — timetable, educational contract, learning needs questionnaire, personality/learning questionnaires if using
  • Ask about any workplace adjustments needed and known holidays
  • Check work contracts (usually held by hospitals — confirm for your area)
  • Contact previous practice manager (if trainee was in GP) to identify early concerns
  • Set up systems: (i) timetable — no own surgeries, no on-call, no prescription signing, no telephone consultations, no visits in week 1; (ii) tutorial sessions including 1-1 getting-to-know-you, PM tour session, computer training; (iii) surgeries — week 1 observe, week 2 'sitting with Nellie', week 3 own surgeries; (iv) 3h tutorials/week split as 2 × 1.5h; (v) video surgeries from month 2, 20-min slots; (vi) Sit and Swap — minimum 1/month from month 1, 20-min slots
  • Set up medical system logins and smart cards
  • When trainer is away: delegate to a named Clinical Supervisor

👨‍⚕️ GP Trainer

🏢 Practice Manager

  • Full practice tour: sign in/out, toilets, kitchen/common room, emergency equipment, fire exits & assembly point
  • Discuss local geography and patient demographics
  • Discuss personal safety: items in rooms, on visits, in the car, in higher-risk areas
  • Introduce to the whole practice team as you walk around
  • PM checklist — during induction.doc

👨‍⚕️ GP Trainer

  • Work through the BVTS GP Induction Booklet as the basis for induction tutorials. Have it printed professionally — it makes trainees feel special and costs very little
  • Use Getting-to-know-each-other tools
  • Discuss your educational philosophy: why you train, why the practice values training
  • Checks: Registered with RCGP? On the Supplementary List? Defence union? BMA membership (optional but strongly recommended)? Booked onto scheme induction?
  • Exchange mobile phone numbers
  • Share key websites: bradfordvts.co.uk, RCGP training, your practice website, your GP training scheme & Deanery/GP School websites
  • Lunch together?

The first month is the busiest. Give the trainee time to settle. Month 2 onwards is generally much easier.

🏢 Practice Manager

  • PM checklist — during induction.doc
  • No own surgeries — book trainee to observe different doctors (week 1); 'sitting with Nellie' sessions (week 2): pharmacist, practice nurse, district nurse, health visitor, reception, waiting room
  • Ensure clinical system logins and smart cards are set up
  • Book 2–4 computer training sessions on the medical system (Systm1 / EMIS / ARDENS). Cover: navigating the record, adding consultations, vital signs, prescribing (acute/repeat/ETP), ordering tests, referrals/fast-tracks/Choose & Book, internal email, hospital letters, lab results, SNOMED codes, Telephone Directory & Referral Repository. Use a dummy patient to practise. Weak keyboard skills? Try Mavis Beacon Teaches Typing
  • Sign work contract and Information Governance & Confidentiality agreement

👨‍⚕️ GP Trainer

🏢 Practice Manager

  • Surgeries start now. See the Appointment Titration Guide for slot lengths. Always discuss with GP Trainer before changing intervals; never change unilaterally.
  • Nominate a named Clinical Supervisor for each working day — must be a GP partner or regular salaried GP (not a locum). Must be on-site. Identifiable from the timetable.
  • Ensure debriefs are protected time: 30 minutes after every 2-hour surgery
  • Continue or complete clinical system training (2–3 sessions on Systm1/EMIS/ARDENS — see Weeks 1–2 for topics)

👨‍⚕️ GP Trainer

  • Introduce Desktop Consultation Dashboard
  • Show the trainee their consulting room: equipment check (thermometer, sphyg, auroscope, ophthalmoscope, tendon hammer, tuning fork, PEFR meter, urinalysis sticks, Snellen chart, flourescein, weighing scales, height measure, vaginal specula), panic button use, sharps bin safety, waste bins, locking the room, removing smart card when away
  • Ensure debrief after every surgery (30 mins per 2h). Purpose: patient safety AND education. Will involve different doctors. "Use the whole practice — not just the GP trainer"
  • Clinical system training — specifically how to: interpret & file blood tests; action/file scanned letters; order tests; dictate; do referrals (electronic & dictation); do fast-tracks; admit a patient (visit vs surgery); use Bradford VTS Desktop Consultation Dashboard
  • Discuss Home Visits: what did they learn from the first 2 weeks of accompanying doctors? Review Home Visit Reflection Form
  • Discuss daily routine: in-tray, letters, blood results, email, visits, clear-desk policy
  • Discuss study leave: HDR attendance eats most of it. Practices may offer additional leave for trainees with additional needs — at practice discretion, not an automatic right

🏢 Practice Manager

👨‍⚕️ GP Trainer

🏢 Practice Manager

  • Surgeries for ST1/ST2: 20-min appointments continue until week 17. Always check with trainer and inform trainee before any change.

👨‍⚕️ GP Trainer

🏢 Practice Manager

  • Surgeries: continue 20-min appointments until week 17. Double-check with GP Trainer. Acknowledge any apprehension about future changes — it is normal.

👨‍⚕️ GP Trainer

  • Communication Skills Training: continue consultation skills tutorials (something like Neighbour). ~45 min per week exploring a particular aspect. Consultation Models · Consultation Micro-skills
  • Introduce alternative consultation modes: telephone, e-consultation, video
  • Review: QI Project progress; ePortfolio entries; WPBA numbers; Learning Needs document; mid-post review at ~month 3
  • Any major concerns — talk to TPDs early
  • Periodically ask the trainee to evaluate your training — reflect on how to improve it next time

🏢 Practice Manager

  • Surgeries: continue at 20-min appointments. Double-check with GP Trainer and inform trainee.

👨‍⚕️ GP Trainer

  • Introduce alternative consulting modes if not already done: telephone, e-consultation, video
  • Review: QI Project; ePortfolio entries; WPBA numbers; Learning Needs document
  • Mid-post review at ~month 3 (if not already done)
  • Any major concerns — talk to TPDs early
  • Ask trainee to evaluate your teaching and training — reflect and improve

🏢 Practice Manager

  • Surgeries: continue 20-min appointments to end of post
  • Organise leaving card — get the whole team to sign, ask each person to write one thing they valued about the trainee
  • Organise in-house leaving presentation — at least 30 minutes of a practice learning time meeting, not a rushed lunch. Bring food.
  • Leaving do — combine with welcoming the new trainee. £5–10 per head contribution works well. Invite the whole practice team.

👨‍⚕️ GP Trainer

📌
About the ST3-1 Toolkit

ST3-1 is the first 6 months of the final year. The structure mirrors ST1/ST2 closely. The key difference: never assume an ST3 has already experienced everything — always ask about previous GP placements and sitting-in sessions.

🏢 Practice Manager

  • PM checklist — before trainee joins.doc
  • Welcome & introductory email with practice demographics, address, leaflet, timetable & induction pack
  • Ask about workplace adjustments and known holidays
  • Confirm work contract arrangements; contact previous PM if trainee was in GP before
  • Set up: timetable (week 1 = sitting-in only); tutorial sessions; computer logins & smart cards
  • 3h tutorials per week — split as 2 × 1.5h. Video surgeries from month 2. Sit and Swap minimum 1/month from month 1.
  • When trainer is away: delegate to a named Clinical Supervisor

👨‍⚕️ GP Trainer

🏢 Practice Manager

  • Full practice tour: sign in/out, toilets, kitchen, emergency equipment, fire exits & assembly point
  • Discuss local geography and demographics
  • Discuss personal safety
  • Introduce to the whole practice team
  • PM checklist — during induction.doc

👨‍⚕️ GP Trainer

💡
The ST3 Sitting-In Opportunity

ST3 trainees may not have had proper sitting-in sessions during ST1/ST2. Always ask. If they haven't, give them this experience — it is the only time in their career this protected observation space is available in general practice.

🏢 Practice Manager

  • Timetable: no own surgeries in weeks 1–2. Observe different doctors (week 1); 'Sitting with Nellie' if never done in ST1/ST2 — ask them (week 2)
  • Set up medical system logins and smart cards
  • Book 2–4 computer training sessions. Sign work contract and IG/Confidentiality agreement.

👨‍⚕️ GP Trainer

  • Learning & Personality Styles
  • Learning Needs: review CV and previous posts; use LNA tools including EmAQ; devise a learning plan
  • Discuss: Attitudinal Grid, What makes a good GP, Differences from hospital, 13 Professional Capabilities, NFD grading (expected — not failure), ePortfolio & WPBA responsibilities, Educational Contract
  • Sitting-in task sheets with all relevant staff; home visits with different doctors
  • Show protocols & policies; GP Trainer discussion checklists (clinical, educational, specific items, surgery protocols)

🏢 Practice Manager

  • Surgeries start — see Appointment Titration Guide for ST3-1 slot lengths
  • Named Clinical Supervisor for each day (GP partner or regular salaried — not a locum; on-site at all times)
  • Protected debrief time: 30 minutes after every 2-hour surgery
  • Continue computer system training (2–3 sessions)

👨‍⚕️ GP Trainer

  • Introduce Desktop Consultation Dashboard
  • Show consulting room: equipment check, panic button, sharps bin, room security, smart card
  • Debrief after every surgery (30 min per 2h) — patient safety AND educational
  • Clinical system specifics: blood test interpretation & filing, scanning, referrals, fast-tracks, admissions, Patient Information Leaflets
  • Discuss daily routine, home visits, study leave

🏢 Practice Manager

  • Surgeries: move to 20-min appointments. Check with trainer and inform trainee. Acknowledge any apprehension.
  • Video surgeries start — one per week, 20-min slots, max 2.5h. COT resources as per ST1/ST2 tab above.
  • Sit and Swap surgeries — minimum 1 per month, 20-min slots

👨‍⚕️ GP Trainer

  • Priority starter tutorials: EmAQ, Spotting the sick child, High-risk medications, 10 tips for safer prescribing
  • Discuss COTs: process, IG, video concerns, first video (consider showing your own first), COT criteria, grading
  • Introduce Consultation Theory Book. For ST3-1: Skills for Communicating with Patients or The Naked Consultation
  • First CbD: process, criteria, grading, NFD normalisation
  • ePortfolio training: reflection, log entries, Ram's easy method (live session)
  • GP Consultation Things: midwife, crisis team, counselling, physio, GPSI clinics
  • Ask how things are going

🏢 Practice Manager

  • Surgeries: continue at 20-min appointments until week 9

👨‍⚕️ GP Trainer

  • Regular review against The GP Training Map: ePortfolio entries, WPBA numbers, Learning Needs document
  • Discuss equality & diversity: TOPs, LGBTQ+ patients, homeless, drug/alcohol misusers, asylum seekers, traveller communities
  • Remind about UUC/OOH engagement requirements
  • Ask how things are going. Any concerns? TPDs early.

🏢 Practice Manager

  • Surgeries: switch to 15-min appointments for the next 12 weeks (weeks 9–20). Double-check with GP Trainer. Acknowledge apprehension — step back if needed.

👨‍⚕️ GP Trainer

  • Introduce alternative consulting modes: telephone, e-consultation, video
  • Review: ePortfolio entries, WPBA, Learning Needs, mid-post review at ~month 3
  • Any major concerns — contact TPDs early
  • Periodically ask trainee to evaluate your training

🏢 Practice Manager

  • Surgeries: continue at 15-min appointments until week 21

👨‍⚕️ GP Trainer

  • Alternative consulting modes (if not already done): telephone, e-consult, video
  • Review: ePortfolio entries, WPBA, Learning Needs. Any concerns — TPDs early.
  • Evaluate your training periodically

🏢 Practice Manager

  • Surgeries: move to 20-min appointments (leave at 15 if trainee is struggling — ask GP Trainer first and inform trainee)

👨‍⚕️ GP Trainer

  • Review ePortfolio entries — engaging well?
  • Review WPBA — how are the numbers?
  • Write Clinical Supervisor's Report
  • Any concerns? Talk to TPDs and to the next GP Trainer.
  • Evaluate your own teaching. See evaluation documents above.
📌
About the ST3-2 Toolkit

ST3-2 is months 7–12 — the final 6 months of GP training. The focus shifts towards consolidation, on-call experience, and preparation for CCT. If this trainee is transferring from another practice, follow the ST3-1 schedule for the first 4 weeks before moving to this schedule from month 2.

🏢 Practice Manager

  • Surgeries — continuing from ST3-1: 15-min appointments from now until they finish. If still struggling, consider 20 min for month 7 but move to 15 min by month 8 at the latest.
  • Surgeries — transfer from another practice: Week 1 no surgeries (sitting-in); Next 1w 20-min; Next 4w 15-min; Final 18w 15-min
  • If transfer: follow PM checklist — during induction.doc
  • Nominated Clinical Supervisor for every day — GP partner or regular salaried GP (not locum); on-site at all times; identifiable from timetable
  • Debriefs (30 min) after every surgery — clearly labelled who they are with
  • Tutorials: 3h/week (best as 1.5h × 2)
  • Video surgeries: one per week, 20-min slots
  • Sit and Swap: minimum 1/month, 20-min slots

👨‍⚕️ GP Trainer

  • If transfer from another practice: for the first 4 weeks follow the ST3-1 schedule, then return to this ST3-2 schedule from month 2 onwards
  • Learning Needs: review ST3-1 learning needs document — how well are they doing? Any amendments needed? New document needed?
  • Devise or revise learning plan: Learning Needs Tools
  • Quickly revisit (slow down where difficulties found): interpreting/filing blood tests; actioning scanned letters; doing reports; ordering tests (balance of too little vs too much); referral letters/fast-tracks; admitting a patient; home visits (take me through your process from start to finish)
  • Discuss daily routine, admin habits, clear-desk system, study leave
  • Quickly revisit protocols & policies — especially Child Protection, Adult Protection, Information Governance, Chaperones, Equality & Diversity
  • Bradford VTS Desktop Consultation Dashboard (if not already familiar)

🏢 Practice Manager

  • Normal surgeries: should be on 15-min appointments. At the very latest must be on 15 min by month 9.
  • On-call surgeries must start — one per week. Initially 3–4 sessions with GP Trainer or salaried/partner GP; then gradually move to doing them independently.
  • Sit and Swap surgeries — minimum 1/month (ideally 2)

👨‍⚕️ GP Trainer

  • Community Placement — has the trainee had any thoughts? How to progress?
  • Leadership Project — has the trainee had any thoughts? How to progress?
  • On-call surgeries — 4-session graduated approach: (1) trainee sits in with you, sees odd patient; (2) trainee does half your on-call, you see each patient before they leave; (3) trainee handles half independently with debrief after; (4) trainee does all the on-call, you help only if they get stuck. See UUC/OOH resources
  • Sit and Swap surgeries — are they happening?
  • Continue COTs: COT criteria · marking sheet
  • Do some CATs: other consultation tools · random case analysis · prescribing review · review of investigations · referrals analysis · debriefs
  • Continue Consultation Theory tutorials: Consultation Micro-skills. Strong recommendation: The Naked Consultation or Skills for Communicating with Patients
  • Continue CbDs: template, question maker, competency descriptors, hot tips
  • Review: ePortfolio quality, OOH/UUC engagement, Training Map progress
  • Ask how things are going in general. Any concerns — contact TPD.
  • Evaluate your training periodically

🏢 Practice Manager

  • Normal surgeries: 15-min appointments. Must be on 15 min by month 9 at the latest.
  • On-call surgeries — one per week, must be in place
  • Sit and Swap surgeries — continue until end of post

👨‍⚕️ GP Trainer

  • Community Placement — finalising?
  • Leadership Project — finalising? Presented to practice?
  • On-call surgeries — check they are happening. UUC/OOH resources
  • Continue COTs, CATs and CbDs (same resources as months 8–10)
  • Continue Consultation Theory tutorials
  • Review: ePortfolio entries, WPBA numbers, OOH/UUC engagement, Training Map
  • Ask how things are going in general. Any concerns — contact TPD.
  • Evaluate your training

🏢 Practice Manager

  • Normal surgeries: continue at 15-min appointments
  • On-call surgeries — must be happening
  • Sit and Swap surgeries — continue to end
  • Organise leaving card from the whole team (ask everyone to write one thing they valued)
  • Organise in-house leaving presentation — 30 min at a practice learning meeting. Bring food. Let admin and nursing staff speak too.
  • Leaving do — invite the whole practice team; combine with welcoming the new trainee. £5–10 per head contribution works well.

👨‍⚕️ GP Trainer

This model exists because hospital medicine and general practice run at completely different speeds. A junior doctor who has spent an hour taking a history on the ward needs time to adapt to shorter GP consultations — and that's completely normal. The key rule: always discuss with the GP Trainer and inform the trainee before changing the appointment interval. Never change it unilaterally.

Trainee Type Phase 1 Phase 2 Phase 3 Phase 4 Phase 5
ST1/ST2
No previous FY in GP
Wks 1–2
No surgeries
Next 4w
30 min
Next 10w
20 min
Final 8w
20 min
ST1/ST2
With previous FY in GP
Wks 1–2
No surgeries
Next 2w
30 min
Next 12w
20 min
Final 8w
20 min
ST3-1
First 6 months
Wks 1–2
No surgeries
Next 1w
30 min
Next 5w
20 min
Final 16w
20 min
ST3-2
Continuing from ST3-1
All 6 months: 15 min
ST3-2
Transferring from another practice
Wk 1
No surgeries
Next 1w
20 min
Next 4w
15 min
Final 18w
15 min
💛
When the Trainee Feels Apprehensive About Shortening

It is completely normal for trainees to feel anxious when appointment times are shortened. Acknowledge this openly. Normalise it. Let them know that almost every trainee feels this way — and that if they need more time, you can always step back temporarily. The goal is to progress at their pace, not to hit an arbitrary number.

⚠️
The Struggling Trainee Needs a Slower Transition

These titration regimes apply to an average trainee who is progressing well. A trainee who is struggling needs a slower pace and more support — not the same timeline applied rigidly. Always be guided by clinical progress and patient safety, not the calendar.

Visual: The ST1/ST2 Appointment Journey

Wks 1–2 Sit-in Next 4w 30 min Next 10w 20 min Final 8w 20 min 20 min goal

GP Trainer — Final Month Checklist

🪞
Reflect on Your Own Teaching

At end of post, ask yourself (and ideally your trainee):

  • What worked really well that I want to keep doing?
  • What didn't work so well that I want to change?
  • Are there practice-level training improvements worth making?

Reflection documents: End of post reflection.doc · Trainee evaluation of GP post.doc · 4 fundamental questions.doc · Tynedale evaluation.doc

🎉 Sending Them Off Well

This part matters more than most trainers think. A trainee who leaves feeling genuinely valued carries that memory forward — and it shapes how they think about training, and general practice itself. Don't rush it.

🎂 Leaving Card & Gift

Get a card signed by everyone — not just the doctors. Ask contributors to write one thing they valued about the trainee (a wonderful way of delivering positive feedback they will remember). A small universal gift — a nice pen or notebook — works well. Consider enclosing:

🏆 In-House Leaving Presentation

Set aside at least 30 minutes — not a quick lunch thing. Use a practice learning time slot. Bring food. Let admin and nursing staff speak too. They often have things to say that genuinely move the trainee.

A quick 5-minute acknowledgement at a corridor coffee break does not have impact. 30 minutes with the whole team does.

🍽️ Leaving Do

At Ashcroft Surgery, we ask the outgoing trainee to organise it — and we combine it with the welcoming meal for the new trainee. The whole practice team is invited. A per-head contribution of £5–10 makes it affordable, and it can be recorded as a tax expense.

It does double duty: a social for the team, a farewell for the leaver, and a welcome for the new arrival. One event, triple value.

🚫
Skipping the Pre-Arrival Contact

Not making contact 2–4 weeks before the trainee arrives is a missed opportunity. The induction period is always busier than expected. Pre-arrival communication frees time and builds rapport before they even walk through the door.

Rushing Into Own Surgeries

Two full weeks of sitting-in feels like a lot. It isn't. Trainees who observe different consulting styles before they start their own surgeries develop far more flexibility and confidence in their own approach.

🔕
Letting Debriefs Disappear

Debrief time is the first thing to get eaten by a busy practice day. It must be scheduled and protected. 30 minutes after every 2-hour surgery is not optional — it is a patient safety and educational requirement.

📋
Forgetting the Clinical Supervisor Allocation

The trainee must know who their Clinical Supervisor is every single day — a named GP partner or regular salaried GP, identifiable from the timetable. A locum does not count. Someone must always be on site and reachable.

📅
Assuming an ST3 Has Seen Everything

ST3 trainees often arrive with gaps in their induction experience that their previous practice never addressed. Always ask. If they haven't had proper sitting-in sessions, give them that opportunity — it's the last time in their career they'll have it.

🚨
Waiting Too Long to Contact the TPD

If something concerns you about a trainee — clinically, professionally, or personally — contact the TPD early. Waiting to see if it improves is understandable but usually makes things harder. Early intervention leads to better outcomes every time.

📉
Ignoring the ePortfolio Until Month 4

The 14Fish ePortfolio is not a paperwork exercise — it is a core educational and professional record. If trainees don't engage with it from month 1, they end up scrambling at ARCP time. Review it monthly.

🎯
Forgetting to Evaluate Your Own Teaching

Most trainers ask their trainees to fill in a feedback form at the end of the post — and then don't look at it. The evaluation is only useful if you actually read it and reflect on it. What worked? What didn't? What will you do differently next time?

💎 Insider Pearls — Wisdom From the Trainers

Things that experienced GP trainers wish someone had told them earlier in their training career.

🌱
Rapport Built Before Day 1 Is Worth Its Weight in Gold

Trainers who make personal contact before the trainee starts consistently report smoother inductions, more open trainees, and faster development of the educational relationship. The effort costs minutes. The return lasts months.

📖
A Consultation Theory Book Transforms Teaching

Introducing a consultation theory text in month 2 and working through it chapter by chapter over 10–12 weeks gives both trainer and trainee a shared framework, a shared language, and a focus for weekly tutorials that goes far beyond ad hoc case discussion.

🤝
The Whole Practice Is a Teaching Resource

The GP trainer is not the only educator in a training practice. The practice nurse, pharmacist, receptionist, and district nurse all teach things that the GP trainer cannot. Protect and structure the sitting-in sessions — don't let them become passive shadowing.

💬
NFD Is Not a Failure Grade

Needs Further Development is the expected grade for a trainee who is progressing normally. Many trainees arrive believing that anything below Competent is a warning sign. Correct this on Day 1 and reinforce it regularly — otherwise trainees will avoid difficult cases or underprepare for assessments out of fear of the grade.

📸
The Professionally Printed Booklet Works

Getting the BVTS Induction Handbook printed and bound costs very little. But trainees consistently describe it as the most professional thing any practice has ever given them. First impressions matter in education just as much as in clinical practice.

🎓
The Best Trainers Reflect Too

The trainers who develop most over their careers are those who treat every trainee as an opportunity to improve their own teaching — not just an opportunity to assess someone else's performance. Seeking feedback from your trainee is a mark of confidence, not weakness.

The checklist tells you what to do. This section tells you why it matters — from the perspective of the people being trained. These insights come from published UK research, national surveys, and the collected wisdom of GP educators. No single source is named, but every point reflects a real, recurring pattern across UK GP training.

📊 What the Research Shows

The Top 3 Trainee Concerns About Qualifying (UK Survey Data)

Intensity of the working day 82%
Volume of administrative work 75%
Work-related stress and burnout 65%

Source: King's Fund GP Trainee Survey 2023 (n=340 trainees across UK)

💡
What this means for trainers

Trainees are watching how qualified GPs work — and they are worried about their own futures. When your training post shows a manageable, well-supported working life, it does more than teach medicine. It helps shape how the next generation sees the profession. That is no small thing.

🤝 The Relationship Is Everything

UK research consistently finds one thing above all others: the quality of the trainer–trainee relationship is the single most important factor in a trainee's training experience. Not the clinical workload. Not the exam prep. Not even the tutorials.

When the relationship works…

  • The trainee learns faster and more deeply
  • They bring better cases to tutorials
  • They ask for help before things go wrong
  • They feel psychologically safe enough to make mistakes
  • They leave with a positive view of general practice

When the relationship breaks down…

  • The trainee stops bringing real concerns
  • Stress and anxiety increase significantly
  • Exam performance often suffers
  • The trainee may start to question their career choice
  • It can leave lasting damage that follows them beyond training
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What published research says about good supervisor relationships

GP trainees describe their best training experiences as "world-class" — built around one-to-one supervision, regular self-directed teaching, close clinical support, and guidance before high-stakes assessments. That description comes directly from trainees who had it. Your job is to make it true for your trainee.

💬 What Trainees Wish Their Trainers Knew

These themes recur across UK trainee surveys, qualitative research, and professional discussions — rewritten here in plain, honest language.

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💡 Insider Tip — From Trainee Experience

"The first few weeks are overwhelming in a way that is hard to explain. Everything is new — the building, the system, the patients, the paperwork, the culture. Feeling lost is not the same as being incompetent. A trainer who says 'this is normal — it gets easier' on day one is worth more than all the checklists in the world."

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💡 Insider Tip — From Trainee Experience

"NFD does not mean failure. We know this in theory. But in our heads, every NFD still feels like a quiet judgment. It helps enormously when trainers actively reinforce that NFD is expected, not exceptional — especially on the very first CbD or COT."

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💡 Insider Tip — From Trainee Experience

"We notice when trainers ask 'how are you doing?' but do not actually wait for the answer. A real check-in — one that pauses and listens — is rarer than you might think. And when it happens, it makes a significant difference to how safe we feel in the post."

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💡 Insider Tip — From Trainee Experience

"When I asked for help mid-surgery and the GP I called was irritated, I stopped asking for help. That was not the right outcome for me or for patients. The easiest way to teach good clinical judgement is to make asking for help feel completely normal."

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💡 Insider Tip — From Trainee Experience

"The debrief after surgery was the best part of the post. Not just for the clinical questions — for the chance to decompress. When it was cut short or skipped, the day felt harder. That 30 minutes is worth more than any tutorial."

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💡 Insider Tip — From Trainee Experience

"IMGs in particular: we come from systems where asking your supervisor a question can feel like admitting weakness. British training culture is different — but nobody tells us that explicitly. The best trainers explain this directly, on Day 1."

The Numbers Are Real

75% of trainees report burnout symptoms

Source: BMA GP Trainees Survey (652 trainees, UK)

75% of UK GP trainees report experiencing symptoms of burnout, stress, depression or anxiety during training. This is not a rare edge case. It is the majority. And it is happening during training, before the full pressures of qualified practice begin.

What the Trainer Can Do

You are not a counsellor. You are not responsible for fixing a trainee's mental health. But you are in a unique position — you see them every day. Small things make an enormous difference.

  • Ask genuinely how they are — and actually wait for the answer
  • Normalise the struggle. Say clearly: "What you're feeling is very common. You're not alone in this."
  • Make asking for help feel safe — react to clinical questions with curiosity, not irritation
  • Protect their study time — don't let service needs routinely eat into it
  • Protect the debrief — it is pastoral as much as clinical
  • Notice changes in behaviour: withdrawal, increased errors, tearfulness, hypervigilance
  • Know your referral routes: NHS Practitioner Health, BMA Wellbeing Support, Occupational Health, TPD
  • If you are worried about a trainee's wellbeing — contact the TPD. That is not a failure. It is good training.

🔀 When to Escalate — A Simple Decision Guide

This covers both clinical concerns and wellbeing concerns. The principle is the same: early is always better than late.

Something concerns you about your trainee Is it a patient safety concern right now? YES Stop the surgery. Act immediately. NO Have you noticed it more than once? YES Contact your TPD. Early is always better. NO Note it. Watch. Keep a brief record. Speak to the trainee directly if appropriate.
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The Danger of Waiting

Research on trainees who struggled in training consistently shows one finding: by the time a formal concern was raised, the problem had been visible for months. The trainee knew it. The trainer often sensed it. But the conversation was delayed. Early contact with your TPD is never a mistake. Late contact almost always makes things harder.

A growing proportion of GP trainees in the UK qualified outside the UK — in South Asia, Africa, the Middle East, or elsewhere. This is not a problem. It is a richness. But it does mean there are specific adjustments that the trainer and practice need to make. An IMG who is well supported becomes an excellent GP. An IMG who is unsupported becomes a struggling trainee — and often an unfair one at that, because the struggle is about system adjustment, not clinical ability.

Key Differences in Healthcare Culture to Discuss Explicitly

Area What Trainees From Abroad Often Expect What UK General Practice Actually Looks Like
Asking for help Asking for help can signal weakness or incompetence Asking for help is expected, valued, and mandatory for patient safety
The patient's role The doctor decides and the patient follows Shared decision-making — the patient's views actively shape the plan
Uncertainty Expressing uncertainty may be seen as incompetence Acknowledging uncertainty openly is a core GP skill and an RCGP expectation
Hierarchy Senior doctors are addressed formally; challenge is rare The trainer–trainee relationship is collaborative; challenge and debate are welcome
Feedback Feedback from a senior is often a reprimand Feedback in UK training is developmental and expected to be two-way
The 10-minute consultation Comprehensive history-taking takes 30–60 minutes (hospital model) 10 minutes is the norm in established practice — this takes genuine adjustment time
Prescribing expectations Patients may expect a prescription at every visit Safety-netting, watchful waiting, and non-prescription management are first-line approaches
Mental health Mental health problems may carry significant stigma Mental health is a major part of GP work and is discussed openly with patients
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What Helps IMGs Most
  • Explicit, early conversation about cultural differences — not assumed
  • Knowing it is safe to ask questions, including "basic" ones
  • Being told clearly that NFD is the expected grade
  • A trainer who asks about their previous training experience with genuine curiosity
  • Being introduced to the whole team warmly on Day 1 — not just handed a badge
  • Explanation of NHS-specific systems: referral pathways, QOF, summary care records, repeat prescriptions
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💡 Insider Tip — IMG Perspective

"Nobody told me that in the UK, it is completely normal to say 'I don't know — let me look that up.' In my previous training, that would have been embarrassing. Here, it is expected. My trainer telling me this on week one changed how I practised for the rest of the post."

"The referral system, the computerised records, the prescription workflow — these things look simple but each one has nuances I had never seen before. My trainer walked me through them in real time, not just in theory. That made a huge difference."

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A Note on WPBA and IMGs

Published UK research shows that IMGs — particularly those from outside the EEA — are often more positive about WPBA than UK graduates, once they understand the system. The problem is usually the understanding, not the ability. Spend extra time on WPBA orientation for IMG trainees, particularly the grading system and the purpose of each tool. And always remember: a trainee who has come from the other side of the world to train in UK general practice has already demonstrated extraordinary resilience. Start from that premise.

Every trainer will, at some point, have a trainee who is not progressing as expected. This does not reflect failure on your part — or theirs. What matters is how you respond. The key principle: early recognition + early support + early escalation leads to better outcomes than watching and hoping.

The Spectrum of Struggle

Not all difficulty is the same. Understanding what type of struggle you are seeing helps you respond in the right way.

NORMAL ADJUSTMENT Slow start, anxiety, settles by month 2 PERFORMANCE GAP Specific skills lag behind; targeted tutorials help PERSISTENT DIFFICULTY Same issues despite support; TPD involvement needed PATIENT SAFETY Act immediately; do not delay

The Trainer's Response — Step by Step

1
Name it
Speak to the trainee directly and kindly. Name what you have observed — without judgment.
2
Understand it
Ask about their perspective. Is there a health concern, a personal issue, or a misunderstanding about expectations?
3
Support it
Targeted tutorials, extra Sit-and-Swap surgeries, slower appointment titration. Document what you do.
4
Escalate it
If the same issues persist after targeted support — contact your TPD. Do not carry this alone.
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Document Everything — Kindly but Clearly

When a trainee is struggling, write brief Educator's Notes in the 14Fish ePortfolio as you go — even positive notes showing what you tried and what helped. If the situation escalates to ARCP level, a clear, contemporaneous record protects the trainee, protects you, and helps the panel make a fair decision. "Good" documentation is not about building a case against someone. It is about showing that they were supported.

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What Research Tells Us About Failure to Progress

Published UK qualitative research on trainees who failed to progress in training consistently identifies the same theme: a lack of sufficient social and emotional support, combined with delayed escalation, made things harder than they needed to be. The trainer's role is not simply academic supervision — it includes being a human point of contact in a high-pressure environment. Trainees who had strong trainer support navigated difficulties better, even when the difficulty itself was not resolved quickly.

These insights come from the collective wisdom of UK GP educators — synthesised from teaching principles, experienced trainer advice, and what trainees themselves say makes the biggest difference. None of this replaces official RCGP or deanery guidance. It complements it.

What Makes a Great Post-Surgery Debrief?

The debrief is not a tick-box exercise. Done well, it is the most powerful teaching activity in a GP training post. Here is what experienced trainers do differently.

Start with "How did that feel?"

Not "Tell me about your most complex case." Opening with the trainee's emotional experience — before the clinical one — creates psychological safety. A trainee who feels heard learns more from what follows.

Let them bring the agenda

Ask "Which case would you like to think through?" rather than choosing for them. Trainees learn more deeply from cases they feel ownership of. The case you think is interesting may not be the one they need.

Use the "What / So What / Now What" structure

What happened? Why does it matter? What would you do differently? This simple framework turns a clinical discussion into a reflective learning opportunity — and directly maps to ePortfolio log entries.

End with a positive

However challenging the surgery, find something the trainee did well and name it explicitly. Trainees remember criticism easily and forget praise. A specific positive comment — not vague reassurance — stays with them.

The Good Tutorial — A Quick Framework

1. CONNECT Check in. How are they? Set the tone. 2. AGENDA Negotiate the topic. Trainee-led where possible. 3. EXPLORE What do they already know? Build from there. 4. TEACH Add new knowledge. Make it active, not passive. 5. APPLY & CLOSE How will this change practice? One action point. Adapted from established GP educational principles — suitable for 1:1 tutorials of any length

Quick Tips That Experienced Trainers Swear By

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Use the Whole Practice

Training is a practice activity, not just a trainer activity. Other GPs, nurses, the pharmacist, and reception staff can all contribute meaningfully to a trainee's learning — and it takes the load off you. Brief them, involve them, and thank them.

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The Consultation Book Changes Things

Introducing a consultation theory text (Neighbour, Tate, or similar) and working through it chapter by chapter over 10–12 weeks gives both trainer and trainee a shared framework and language. It transforms tutorials from ad hoc case discussions into a coherent learning journey.

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Show Them One of Your Own Videos First

Before a trainee does their first video surgery, watch and discuss one of your own recordings together. This normalises the process, shows that even experienced GPs do things imperfectly, and builds psychological safety around the whole COT process.

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Home Visits Are Under-Used as Teaching Moments

The home visit is a rich and unique educational opportunity that exists nowhere else in medical training. Ensure a structured debrief follows every visit. Use the Home Visit Reflection Form. Ask trainees to reflect on what they could only have learned in that patient's home.

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Learning Styles — What the Evidence Actually Says

The idea that people have fixed "learning styles" (visual, auditory, kinaesthetic) is not supported by current research. Do not waste time trying to identify your trainee's "style." Instead, use varied teaching methods — discussion, observation, practice, written reflection — because variety itself is what helps learning stick.

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Feedback Is a Two-Way Street

The most effective trainers ask for feedback on their own teaching — regularly, genuinely, and without defensiveness. A trainee who sees their trainer welcome feedback is far more likely to welcome it themselves. It models exactly the reflective behaviour you are trying to develop.

🏆 What "World-Class" GP Training Looks Like — In Practice

GP trainees who describe their training posts as "world-class" consistently name the same four things. These are not extraordinary. They are simply the basics done consistently well.

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One-to-one supervision
Time that belongs to the trainee, not shared with service delivery
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Self-directed teaching
Tutorials built around what the trainee needs, not what is easiest to teach
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Close clinical support
Always someone available, always feel safe to ask, mid-surgery help is normal
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Guidance before exams
Proactive preparation for WPBA assessments and MRCGP — not left to chance
  1. Start before they start. Contact the trainee 2–4 weeks in advance. Send a personal welcome, pre-reading, and the BVTS Induction Booklet. The induction period is much smoother when trainees arrive prepared.

  2. Protect the sitting-in period. Two full weeks of observation is not indulgent — it is foundational. Trainees who observe multiple consulting styles are more adaptable and develop their own style faster.

  3. Debrief every surgery, every time. 30 minutes per 2-hour surgery. This is both a patient safety measure and the single most impactful educational activity in a GP training post.

  4. Name a Clinical Supervisor for every day. The trainee must know who this is before the day starts. It cannot be a locum. They must be on-site.

  5. Use the appointment titration model — but don't rush it. The 30 → 20 minute progression is a guide, not a race. A struggling trainee needs more time, not less.

  6. Engage with the 14Fish ePortfolio from month 1. Review log entries regularly. Check WPBA numbers against the Training Map every month. Don't leave the ePortfolio until it's urgent.

  7. Contact TPDs early if you have any concerns. Every time. There are no prizes for waiting and hoping. Early involvement leads to better outcomes.

  8. End the post properly. A Clinical Supervisor's Report, a genuine leaving card from the whole team, a real leaving event, and honest reflection on your own teaching. The ending of a post shapes how the trainee remembers everything that came before it.

  9. Evaluate and reflect on your own teaching. Every trainee teaches the trainer something. Make sure you capture that learning — in your own ePortfolio, in your appraisal, and in how you do things next time.

  10. This page is your checklist — not a one-time read. Come back to it at the start of each new post, at the end of each month, and whenever you feel like something might have been missed.

path: DECISION MAKING

page link here…

path: MEDICAL WISDOM (PHRONESIS)

path: DISCUSSION CHECKLISTS

path: EDUCATIONAL CONTRACT

path: GETTING TO KNOW EACH OTHER

path: SURVIVAL GUIDES (for trainees)

path: TIMETABLE

path: TASKS TO DO TOGETHER

path: SITTING IN TASK SHEETS

page link here…

path: LEARNING NEEDS – attitudes

path: LEARNING NEEDS – clinical knowledge

path: LEARNING NEEDS – communication skills

path: LEARNING NEEDS – from emergencies, admissions, referrals & OOH

path: LEARNING NEEDS – from real surgeries

path: LEARNING NEEDS – skills

LEARNING NEEDS – miscellaneous

page link here…

path: TUTORIAL SUGGESTIONS

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