The Trainer's Toolkit

A one-stop page of resources to help the Trainer & their Practice Manager

This page provides some guidance for both GP Trainers and their Practice Managers about what to consider doing with your trainee and when.  Mapping out the  journey will (we hope) help make your organisational life easier, and ensure that nothing vital is missed.   Please remember to revisit this page regularly to reassure yourself that you’re on track or to re-jig your memory.  

Download and adapt this handbook for your own use.  In fact, please read this induction handbook – there’s information in it that you will find helpful.  At our practice, we get this induction handbook printed off by one of the online printing services and get it professionally bound (details on the right).  New trainees tell us that they have never had something so professional looking from other practices and that it makes them feel like they are “special”.   We get them to bring it to every day of induction so we can follow it through like a workbook.   It works well – trainees love it and it keeps us (the trainers) effortlessly on track.    Try it. 

  • Online printers we use: https://doxzoo.com/documents/book-printing
  • Cost: £20 per copy if you order more than 1 copy
  • Order Details as follows…..
  • Orientation: portrait     Paper size: A4     Printed sides: double-sided     Print in: colour     Paper colour: white     Paper finish: silk     Paper weight: 130g    Binding position: left long edge   
  • Cover design: cover design is included (recommended)     Front cover included: move page 1     Back cover included: copy last page     Spine design: design a spine     Print covers in: colour     Cover lamination: Gloss laminated

INDUCTION TOOLKIT - the new trainee - ST1/ST2

All texts in blue are links to more information and resources.   Most of these resources are also available from the  GP Post – Induction pages

There are several reasons why you should make contact with your trainee before they start with you.    First of all, it serves as a handshake and makes them feel valued and wanted if you say how much you are looking forward to them starting with you.    It also provides a opportunity for you to communicate what you would like them to do before they start and to give them some introductory material to read.    Doing this releases time for you to cover more ground during the induction period.  And for the trainee, it gives them the opportunity to prepare themselves with some basic information before they start.

Practice Manager

  • 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
  • practice manager checklist BEFORE trainee joins.doc
  • Send an Welcome & Introductory letter – via email – welcoming them and introducing them to the practice.  Provide details of the practice’s demographic.   Include the practice leaflet & surgery address.
  • Also provide timetable of induction and surgeries
  • Also send them an induction pack for your practice.   Liaise with the trainer about what needs sending.   Usually a timetable, educational contract and perhaps a learning needs questionnaire.  Some like to include personality and learning questionnaires.    
  • Ask them if there are any work place changes that need to be made to accomodate any specific needs.
  • Also ask about any holidays that are known so that you can try your best to give them the time off. 
  • Most work contracts are now with hospitals – but check for your area.
  • Speak to the Practice Manager of their previous post (if the trainee was in GP) to identify any concerns early.
  • Ensure practice systems are in place such as their
    • i) timetable
        • Do not book GP trainee in for their own surgeries
        • No daytime on-call duties
        • No signing of prescriptions
        • No telephone consultations
        • No visits (until start of week 2/3) – during week 1, the trainee should shadow visits with other doctors
    • (ii) Specific Tutorial sessions
        • GP Trainer Tutorial:  1-1 “getting to know you session” with the new trainee
        • Session with the Practice Manager: tour of practice, protocols/policies, regulations, emergency equipment (as above)
        • Book in for computer training on the medical system
    • (iii) Surgeries:
        • Week 1: Book them in to observe a variety of consulting styles with different doctors
        • Week 2: Book ‘sitting with Nellie’ sessions with pharmacist, practice nurse, district nurse, health visitor, reception and the waiting room
        • Week 3: own surgeries start
        • Make sure you have set up medical system log on codes and smart cards
    • (iv) Tutorials in general:
        • 3h per week per full-timer. 
        • Ask GP Trainer how they wish to have this.  1 x 3h is not ideal..  No one can concentrate for that length of time. 
        • Suggest 2 x 1.5h per week.  
    • (v) Video surgeries
        • Start at month 2
        • Slot in one surgery per week that will be a video surgery
        • Patients always booked at 20 mins slots.  Not any less.
        • Discuss process with trainee when the time is right… Admin process for collecting consent.
    • (vi) Sit and Swap Surgeries
        • GP Trainer to sit in on whole of GP Trainee surgery
        • MINIMUM 1 per month (preferably 2 per month) – starting from month 1
        • book at 20 min slots
  • If any concerns, please communicate to your GP trainer.  In fact, include the GP trainer in all of the above emails so that they can see what has been sent and the subsequent dialogue.
  • IMPORTANT NOTE: When the trainer is unavailable (e.g. annual/sick/study leave), responsibility for the GP trainee should be delegated to an alternative named GP as a Clinical Supervisor.

GP Trainer

For the following, liaise with your Practice Manager.  They will be sending an email anyway.  Do you wish to send this with the things the PM will be sending?  Or are you like me – send it separately because you want to establish a personal initial link?

  • Try not to book leave during the first 2 weeks of the GP trainee starting.  It’s twice as hard to build that rapport and bond if you do.
  • Welcome letter or email (- let them know who you are,  how excited or keen you are to meeting and working with them.    Point the trainee to the following pages.  Tell them to bring the handbook if you are giving it to them early.  
  • The New GP Trainee page: point trainees to this starter’s page to GP Training as a whole (and refresh yourself too).
  • GP Post – Induction page: details specific useful starter information for their GP post.
  • Learning Needs Tools: perhaps give them one of the assessments to do at home before they start?   
    Click here for Theory behind Learning Needs and more tools.
  • BVTS GP Induction Booklet: “Please bring this with you on day 1 and for the whole of the induction period.  We will be using this as the basis for our tutorials.”
  • Evening meal with the practice?  (combine with leaving do of exiting GP trainees).

Practice Manager

  • Show around the practice
      • Signing in/out, loo, tea/coffee/common room
      • Esp emergency equipment, fire door, fire gathering point
  • Discuss: local geography, demography
  • Discuss personal safety – personal items in surgery rooms or the car, on home visits, particular areas
  • Introduce to members of the practice as you go around.
  • Practice Manager’s checklist DURING induction.doc

GP Trainer

The first month is the busiest month. There is lots to do and get organised. However, take reassurance in the fact that things get generally easier from month 2 onwards. To make the first month a bit easier to understand, we have divided it into two sections: a) what you need to do in the first 2 weeks and b) what you need to do the the last 2 weeks.  You need to make sure that the trainee has a period of time to ‘settle in’. They’ll need to get to know the whole practice team, get familiar with important policies and procedures and be aware of their personal responsibilities.

Practice Manager

Remember: Ensure practice systems are in place such as their 

  • Practice Manager’s checklist DURING induction.doc
  • i) timetable for first 2 weeks
      • Do not book GP trainee in for their own surgeries
      • No daytime on-call duties
      • No signing of prescriptions
      • No telephone consultations
      • No visits (until start of week 2/3) – during week 1, the trainee should shadow visits with other doctors
  • (ii) Surgeries during the first 2 weeks
      • DOCTORS: Book them in to observe a variety of consulting styles with different doctors.   If this is the first time the trainee is experiencing general practice, arrange for them to sit in with several different doctors during the first week and second weeks in order to expose them to a variety of consulting styles and demonstrate that there is no such thing as the ‘one and only’ consulting style. It will also help them discover their own personal style and start working on developing it.
      • OTHER STAFF: Book ‘sitting with Nellie’ sessions with pharmacist, practice nurse, district nurse, health visitor, reception and the waiting room.   If the trainee is an ST3, do not assume they have previously had sitting in sessions with doctors and various other staff.  Ask them.  If they haven’t, given them this opportunity – because it is the only one they will ever get in their career that is General Practice.
      • Make sure you have set up medical system log on codes and smart cards
  • (iii) Tutorial session

    (iv) Contracts

        • Sign The Work Contract
        • Information Governance & Confidentiality agreement

GP Trainer

Practice Manager

  • Surgeries should be starting now.  Provided below are suggested appointment titration regimes for the average GOOD GP trainee.
      • Please always discuss with GP trainer before changing the appointment times to ensure GP Trainer is happy for you to do so.  
      • The struggling GP trainee will need a slower transition. 
      • Always be guided by the GP Trainer.  Once agreed, then inform the GP trainee.    Never change the appointments times without discussion with GP Trainer and Trainee.
      • The following is based on a full-timer GP trainee (who will be with you for 6 months [=24 weeks])
          • ST1 or ST2 no previous FY placement in GP
              • First 2w: no surgeries – sitting in
              • Next 4w: 30 min appointment per patient  
              • Next 10w: 20 min appointment per patient 
              • Final 8w: 15 min appointment per patient  
          • ST1 or ST2 WITH previous FY placement in GP
              • First 2w: no surgeries – sitting in
              • Next 2w: 30 min appointment per patient 
              • Next 12w: 20 min appointment per patient  
              • Final 8w: 15 min appointment per patient  
          • ST3-1
              • First 2w: no surgeries – sitting in
              • Next 1w: 30 min appointment per patient  
              • Next 5w: 20 min appointment per patient
              • Next 12w: 15 min appointment per patient  
              • Final 4w: 10 min appointment per patient 
          • ST3-2 continuing from ST3-1
              • For the last 6 months : 10 min appointment per patient 
          • ST3-2 transfer from another practice
              • First 1w: no surgeries – sitting in
              • Next 1w: 20 min appointment per patient
              • Next 4w: 15 min appointment per patient  
              • Final 18w: 10 min appointment per patient  
      • This 30-20-15 minute model allows the trainee to gradually adapt from hospital medicine (where they’ve usually spent an hour or so taking a history and examination) to the general practice model of 10 minutes.  It also gives them time to get used to the new computer medical system.  Some move steadily at the usual rate but others will need more time.   
      • Before shortening the interval, PLEASE consult both the trainee and trainer to ensure it is an appropriate time to move forwards. Trainees often feel apprehensive about the shortening of the interval and it is important to acknowledge this and empathise.   Provide reassurance  and tell them that this is a common feeling among GP trainees – and that they are not alone and that we can always move back a step if needs be.
  • Ensure nominated Clinical Supervisor for each day and that the trainee is aware who they are.
      • GP trainees must be supervised at all times.  In other words, someone has to be available for giving advice (and be available on site).   
      • It has to be a GP partner or regular salaried GP.    This cannot be a locum GP. 
      • The Clinical Supervisor should be easily identifiable from the GP trainee’s weekly timetable.
      • Someone should be available even when a trainee engages in baby clinic or child immunisations with the practice nurse.
  • Also ensure debriefs are in place after every surgery  (30 mins for every 2h surgery) – ensure this is protected time for the GP trainer.
  • Training on the Clinical System.   Arrange 2-3 sessions on the following (if not already done so)
      • For example: Systm1/EMIS/ARDENS/ASSIST
      • See task sheets back of BVTS GP Induction Booklet
          • Overview of navigating around the medical record
          • How to add consultations
          • Adding vital signs/examination findingd (e.g. BP, pulse, temp, sats)
          • How to prescribe – acute and repeats, ETP
          • How to order tests
          • How to do referrals, Fast-tracks and Choose & Book, Letters
          • How to use the internal email system
          • How to deal with medical letters (e.g. from the hospital)
          • How to deal with lab results – looking at bloods
          • SNOWMED codes, The Telephone Directory & The Referral Repository
      • Play around with a dummy patient.Computer training on the medical system: Book 2-3 sessions if not already done so.  As a minimum, you should cover:
      • Keyboard skills – if bad, refer to Mavis Beacon Teaches Typing (amazing resource, learn to touch type within 2 weeks!  Yes, it is that good)
GP Trainer
  • Introduce to Desktop Consultation Dashboard 
  • Show GP Trainee their room
      • Check equipment available (thermometer, sphyg, tongue depressors, unrinalysis sticks, auroscope, ophthalmoscope, tendon hammer, tuning fork, flourosceine, Snellen chart, PEFR meter, weighing scales, height measure, vaginal specula).
      • Show panic button (and the right way of using it – i.e. try and calm patient down first).
      • “make this room your own; make it a place you like coming to because you will be here a lot; bring own pics etc)
      • Discarding waste into correct bins.
      • Sharps bin – fill only to 2/3rds full, then close and keep out of the reach of children at all times.  Should never be on the floor.
      • Keep desks tidy and clean – free of clinical specimens esp tongue depressors – should be thrown away straight after use.
      • Lock the room even if you’re out for a few minutes
      • Remove your smart card, even if your out for a few minutes.
  • Ensure debrief after EVERY surgery (30 mins per 2h)
      • Purpose: patient safety and educational
      • Will be with different doctors
      • “If you have clinical questions/need clinical help – using the whole practice not just the GP trainer (i.e. other docs and nurses)”
  • Training on the Clinical System.   Arrange 2-3 sessions on the following (if not already done so)
      • For example: Systm1/EMIS/ARDENS/ASSIST
      • See task sheets back of BVTS GP Induction Booklet
          • Overview of navigating around the medical record
          • How to add consultations
          • Adding vital signs/examination findingd (e.g. BP, pulse, temp, sats)
          • How to prescribe – acute and repeats, ETP
          • How to order tests
          • How to do referrals, Fast-tracks and Choose & Book, Letters
          • How to use the internal email system
          • How to deal with medical letters (e.g. from the hospital)
          • How to deal with lab results – looking at bloods
          • SNOWMED codes, The Telephone Directory & The Referral Repository
      • Play around with a dummy patient.Computer training on the medical system: Book 2-3 sessions if not already done so.  As a minimum, you should cover:
      • Keyboard skills – if bad, refer to Mavis Beacon Teaches Typing (amazing resource, learn to touch type within 2 weeks!  Yes, it is that good)Should be a Systm1/EMIS/ARDENS/ASSIST training system.
  • Specifically, how to….
      • (Stress importance of doing all the following in a timely way)
      • Interpreting and filing blood tests 
      • Read, Action/File Scanned Letters 
      • How to order tests
      • How to dictate
      • How to do a referral – electronic & dictation
      • How to do fast tracks
      • How to admit a patient (on a visit vs from the surgery)
      • Good Patient Information Leaflets
      • The Bradford VTS Desktop Consultation Dashboard
  • Discuss Home Visits:  what do they remember from the first 2 weeks of accompanying doctors on their visits?  Home Visit Reflection Form – 
  • Discuss daily routine – paper in-tray, letters, blood results & other test results, email, visits  & clear desk system when leaving surgery (plus closing windows, doors, not getting locked in).
  • Discuss leave – When trainer is away, tutorials will STILL be provided.   Study leave – most is eaten by HDR.  Study leave policy – attendance at HDR eats most of the study leave and many GP trainee schemes additional leave granted for taking exams.  Practices may wish to give additional study leave to those trainees in difficulty who have additional needs, but this is at the discretion of the practice and not an automatic right.   If the practice provides it, the trainee should show gratitude in return. 

Practice Manager

GP Trainer

Practice Manager

  • Surgeries for ST1 or ST2 : 20 min appt per patient until week 17.   Check with trainer and inform trainee.  Trainees often feel apprehensive about the shortening of the interval and it is important to acknowledge this and empathise.   Provide reassurance  and tell them that this is a common feeling among GP trainees – and that they are not alone and that we can always move back a step if needs be, but most find that they don’t need to. 

GP Trainer

Practice Manager

  • Surgeries : continue 20 min appointment per patient until week 17.  Remember to double check with GP trainer and inform trainee.  Trainees often feel apprehensive about the shortening of the interval and it is important to acknowledge this and empathise.   Provide reassurance  and tell them that this is a common feeling among GP trainees – and that they are not alone and that we can always move back a step if needs be, but most find that they don’t need to. 

GP Trainer

  • Communication Skills Training
  • Introduce alternative ways of  consulting
      • Telephone Consultations (caution re: leaving messages on someone’s answer phone)
      • e-consultations
      • video consultations
  • Review the following
      • Quality Improvement Project – How is it going?  Start doing if not already done so.
      • Read and validate ePortfolio log entries – how are they doing?   
      • Does the skill of reflection still need working on?  If so, review Ram’s easy way to write a log entry and go back to doing hands on “writing a reflective log entry” tutorial sessions until they get it.     
      • Review ePortfolio WPBA – how is it going?  On track?   Check Numbers.
      • Review Learning Needs document – does anything need changing, adding or doing?  
      • Mid Term Review at around month 3 (12 weeks in): and ask how things are going in general.
      • Any major concerns – talk to TPDs early!
  • Evaluate your teaching & training periodically: It’s important to ask your trainee to evaluate the training being provided by you and your practice.   Review and reflect on the training you are providing: how can you make it better the next time round?

Practice Manager

  • Surgeries : 15 min appointment per patient until trainee finishes (leave on 20 if GP trainee struggling)..  Remember to double check with GP trainer and inform trainee. 

GP Trainer

  • Introduce alternative ways of  consulting  (if not already done so)
      • Telephone Consultations (caution re: leaving messages on someone’s answer phone)
      • e-consultations
      • video consultations
  • Review the following 
      • Quality Improvement Project – How is it going?  Start doing if not already done so.
      • Read and validate ePortfolio log entries – how are they doing?   
      • Does the skill of reflection still need working on?  If so, review Ram’s easy way to write a log entry and go back to doing hands on “writing a reflective log entry” tutorial sessions until they get it.     
      • Review ePortfolio WPBA – how is it going?  On track?   Check Numbers.
      • Review Learning Needs document – does anything need changing, adding or doing?  
      • Mid Term Review at around month 3 (12 weeks in): and ask how things are going in general.
      • Any major concerns – talk to TPDs early!
  • Evaluate your teaching & training periodically: It’s important to ask your trainee to evaluate the training being provided by you and your practice.   Review and reflect on the training you are providing: how can you make it better the next time round.

Practice Manager

  • Surgeries : continue 15 min appointment per patient  (leave on 20 if GP trainee struggling).

GP Trainer

  • Quality Improvement Project – Finalise and present to practice.
  • Review ePortfolio log entries – engaging?
  • Review WPBA – engaging well?  How are the numbers?
  • Write a Clinical Supervisor’s Report
  • Any major concerns? – talk to TPDs and next GP Trainer.
  • Evaluate your own Teaching & Training
  • Leaving Card & Gift
      • We have a system in our practice where we always get the trainee a card and little gift.  The gift need not be expensive and can be something universal (so you can buy in bulk) like a nice pen or notebook.  Actually, it’s in our surgery’s Outlook Calendar and one of the admin team organises it all. The difficult bit is getting everyone to sign it (not just the doctors) – again, sorted by our admin person.   It’s good practice to ask contributors to write down one thing they liked or will miss about the trainee (often a good way of feeding back on positive behaviour that the trainee will be encouraged to maintain).    
      • You might want to consider printing the following document and enclosing it with the leaving card (it’s something my trainer gave me and I have found it helpful ever since): 10 golden rules for general practice.docx
      • Include your phone number – if they need a bit of advice (and only if you mean it).
  • In-house Leaving Presentation
      • Please make protected time for your team to acknowledge the trainee and show their gratitude. 
      • Don’t do a quick 5 minute thing over lunch which fails to have impact.   How about 30 minutes of the next “practice learning time” meeting.  And bring in a bit of food too.   You can present the card and gift.
      • In that way other group members (like the admin and nursing staff) can say things they might want to say,   They may have bought the trainee their own card and personal gift.  
  • Leaving Do
      • At our practice, we delegate this to the trainee in question (and combine it with the next trainee’s “welcoming meal”).
      • The whole practice team should be invited to this to say their goodbyes.
      • Of course, this could prove expensive for the practice if they decide to pay for the meal. But it needn’t be that way: the practice might consider a £5-10 contribution per head a more affordable way of doing it.  And it can always be put as a tax expense. 
      • At our practice, the leaving do also forms the basis of a ‘social’ for the practice team to help them strengthen bonds again, and as a welcoming do for the new trainee.   Ask the leaving trainee to invite everyone including the next new trainee(s).

INDUCTION TOOLKIT - final year ST3-1

All texts in blue are links to more information and resources.   Most of these resources are also available from the  GP Post – Induction pages

Remember to make contact with your trainee before they start with you.    First of all, it serves as a handshake and makes them feel valued and wanted if you say how much you are looking forward to them starting with you.    It also provides a opportunity for you to communicate what you would like them to do before they start and to give them some introductory material to read.    Doing this releases time for you to cover more ground during the induction period.  And for the trainee, it gives them the opportunity to prepare themselves with some basic information before they start.

Practice Manager

  • practice manager checklist BEFORE trainee joins.doc
  • Send an Welcome & Introductory letter – via email – welcoming them and introducing them to the practice.  Provide details of the practice’s demographic.   Include the practice leaflet & surgery address.
  • Also provide timetable of induction and surgeries
  • Also send them an induction pack for your practice.   Liaise with the trainer about what needs sending.   Usually a timetable, educational contract and perhaps a learning needs questionnaire.  Some like to include personality and learning questionnaires.    
  • Ask them if there are any work place changes that need to be made to accomodate any specific needs.
  • Also ask about any holidays that are known so that you can try your best to give them the time off. 
  • Most work contracts are now with hospitals – but check for your area.
  • Speak to the Practice Manager of their previous post (if the trainee was in GP) to identify any concerns early.
  • Ensure practice systems are in place such as their
    • i) timetable
        • Do not book GP trainee in for their own surgeries
        • No daytime on-call duties
        • No signing of prescriptions
        • No telephone consultations
        • No visits (until start of week 2 or 3) – during week 1, the trainee should shadow visits with other doctors
    • (ii) Specific Tutorial sessions
        • GP Trainer Tutorial:  1-1 “getting to know you session” with the new trainee
        • Session with the Practice Manager: tour of practice, protocols/policies, regulations, emergency equipment (as above)
        • Book in for computer training on the medical system
    • (iii) Surgeries:
        • Week 1: Book them in to observe a variety of consulting styles with different doctors 
        • Week 2: Book ‘sitting with Nellie’ sessions with pharmacist, practice nurse, district nurse, health visitor, reception and the waiting room  (only if never experienced in ST1/ST2 – ask them!)
        • Week 3: own surgeries start
        • Make sure you have set up medical system log on codes and smart cards
    • (iv) Tutorials in general:
        • 3h per week per full-timer. 
        • Ask GP Trainer how they wish to have this.  1 x 3h is not ideal..  No one can concentrate for that length of time. 
        • Suggest 2 x 1.5h per week.  
    • (v) Video surgeries
        • Start at month 2
        • Slot in one surgery per week that will be a video surgery
        • Patients always booked at 20 mins slots.  Not any less.
        • Discuss process with trainee when the time is right… Admin process for collecting consent.
    • (vi) Sit and Swap Surgeries
        • GP Trainer to sit in on whole of GP Trainee surgery
        • MINIMUM 1 per month (preferably 2 per month) – starting from month 1
        • book at 20 min slots
  • If any concerns, please communicate to your GP trainer.  In fact, include the GP trainer in all of the above emails so that they can see what has been sent and the subsequent dialogue.
  • IMPORTANT NOTE: When the trainer is unavailable (e.g. annual/sick/study leave), responsibility for the GP trainee should be delegated to an alternative named GP as a Clinical Supervisor.

GP Trainer

For the following, liaise with your Practice Manager.  They will be sending an email anyway.  Do you wish to send this with the things the PM will be sending?  Or are you like me – send it separately because you want to establish a personal initial link?

  • Try not to book leave during the first 2 weeks of the GP trainee starting.  It’s twice as hard to build that rapport and bond if you do.
  • Welcome letter or email (- let them know who you are,  how excited or keen you are to meeting and working with them.    Point the trainee to the following pages.  Tell them to bring the handbook if you are giving it to them early.  
  • The New GP Trainee page: point trainees to this starter’s page to GP Training as a whole (and refresh yourself too).
  • GP Post – Induction page: details specific useful starter information for their GP post.
  • Learning Needs Tools: perhaps give them one of the assessments to do at home before they start?   
    Click here for Theory behind Learning Needs and more tools.
  • BVTS GP Induction Booklet: “Please bring this with you on day 1 and for the whole of the induction period.  We will be using this as the basis for our tutorials.”
  • Lunch or Evening meal with the practice?  (combine with leaving do of exiting GP trainees).

Practice Manager

  • Show around the practice
      • Signing in/out, loo, tea/coffee/common room
      • Esp emergency equipment, fire door, fire gathering point
  • Discuss: local geography, demography
  • Discuss personal safety – personal items in surgery rooms or the car, on home visits, particular areas
  • Introduce to members of the practice as you go around.
  • Practice Manager’s checklist DURING induction.doc

GP Trainer

The first month is the busiest month. There is lots to do and get organised. However, take reassurance in the fact that things get generally easier from month 2 onwards. To make the first month a bit easier to understand, we have divided it into two sections: a) what you need to do in the first 2 weeks and b) what you need to do the the last 2 weeks.  You need to make sure that the trainee has a period of time to ‘settle in’. They’ll need to get to know the whole practice team, get familiar with important policies and procedures and be aware of their personal responsibilities.

Practice Manager

Remember: Ensure practice systems are in place such as their 

  • Practice Manager’s checklist DURING induction.doc
  • i) timetable for first 2 weeks
      • Do not book GP trainee in for their own surgeries
      • No daytime on-call duties
      • No signing of prescriptions
      • No telephone consultations
      • No visits (until start of week 2/3) – during week 1, the trainee should shadow visits with other doctors
  • (ii) Surgeries during the first 1-2 weeks (only needs to be done if never experienced during their GP placement in ST1 – ask them!)
      • DOCTORS: Book them in to observe a variety of consulting styles with different doctors.   If this is the first time the trainee is experiencing general practice, arrange for them to sit in with several different doctors during the first week and second weeks in order to expose them to a variety of consulting styles and demonstrate that there is no such thing as the ‘one and only’ consulting style. It will also help them discover their own personal style and start working on developing it.
      • OTHER STAFF: Book ‘sitting with Nellie’ sessions with pharmacist, practice nurse, district nurse, health visitor, reception and the waiting room.   If the trainee is an ST3, do not assume they have previously had sitting in sessions with doctors and various other staff.  Ask them.  If they haven’t, given them this opportunity – because it is the only one they will ever get in their career that is General Practice.
      • Make sure you have set up medical system log on codes and smart cards
  • (iii) Tutorial session

    (iv) Contracts

        • Sign The Work Contract
        • Information Governance & Confidentiality agreement

GP Trainer

Practice Manager

  • Surgeries should be starting now.  Provided below are suggested appointment titration regimes for the average GOOD GP trainee.
      • Please always discuss with GP trainer before changing the appointment times to ensure GP Trainer is happy for you to do so.  
      • The struggling GP trainee will need a slower transition. 
      • Always be guided by the GP Trainer.  Once agreed, then inform the GP trainee.    Never change the appointments times without discussion with GP Trainer and Trainee.
      • The following is based on a full-timer GP trainee (who will be with you for 6 months [=24 weeks])
          •  
          • ST3-1
              • First 2w: no surgeries – sitting in
              • Next 1w: 30 min appointment per patient  
              • Next 5w: 20 min appointment per patient
              • Next 12w: 15 min appointment per patient  
              • Final 4w: 10 min appointment per patient 
          • ST3-2 continuing from ST3-1
              • For the last 6 months : 10 min appointment per patient 
          • ST3-2 transfer from another practice
              • First 1w: no surgeries – sitting in
              • Next 1w: 20 min appointment per patient
              • Next 4w: 15 min appointment per patient  
              • Final 18w: 10 min appointment per patient  
      • This 30-20-15 minute model allows the trainee to gradually adapt from hospital medicine (where they’ve usually spent an hour or so taking a history and examination) to the general practice model of 10 minutes.  It also gives them time to get used to the new computer medical system.  Some move steadily at the usual rate but others will need more time.   
      • Before shortening the interval, PLEASE consult both the trainee and trainer to ensure it is an appropriate time to move forwards. Trainees often feel apprehensive about the shortening of the interval and it is important to acknowledge this and empathise.   Provide reassurance  and tell them that this is a common feeling among GP trainees – and that they are not alone and that we can always move back a step if needs be.
  • Ensure nominated Clinical Supervisor for each day and that the trainee is aware who they are.
      • GP trainees must be supervised at all times.  In other words, someone has to be available for giving advice (and be available on site).   
      • It has to be a GP partner or regular salaried GP.    This cannot be a locum GP. 
      • The Clinical Supervisor should be easily identifiable from the GP trainee’s weekly timetable.
      • Someone should be available even when a trainee engages in baby clinic or child immunisations with the practice nurse.
  • Also ensure debriefs are in place after every surgery  (30 mins for every 2h surgery) – ensure this is protected time for the GP trainer.
  • Training on the Clinical System.   Arrange 2-3 sessions on the following (if not already done so)
      • For example: Systm1/EMIS/ARDENS/ASSIST
      • See task sheets back of BVTS GP Induction Booklet
          • Overview of navigating around the medical record
          • How to add consultations
          • Adding vital signs/examination findingd (e.g. BP, pulse, temp, sats)
          • How to prescribe – acute and repeats, ETP
          • How to order tests
          • How to do referrals, Fast-tracks and Choose & Book, Letters
          • How to use the internal email system
          • How to deal with medical letters (e.g. from the hospital)
          • How to deal with lab results – looking at bloods
          • SNOWMED codes, The Telephone Directory & The Referral Repository
      • Play around with a dummy patient.Computer training on the medical system: Book 2-3 sessions if not already done so.  As a minimum, you should cover:
      • Keyboard skills – if bad, refer to Mavis Beacon Teaches Typing (amazing resource, learn to touch type within 2 weeks!  Yes, it is that good)
GP Trainer
  • Introduce to Desktop Consultation Dashboard 
  • Show GP Trainee their room
      • Check equipment available (thermometer, sphyg, tongue depressors, unrinalysis sticks, auroscope, ophthalmoscope, tendon hammer, tuning fork, flourosceine, Snellen chart, PEFR meter, weighing scales, height measure, vaginal specula).
      • Show panic button (and the right way of using it – i.e. try and calm patient down first).
      • “make this room your own; make it a place you like coming to because you will be here a lot; bring own pics etc)
      • Discarding waste into correct bins.
      • Sharps bin – fill only to 2/3rds full, then close and keep out of the reach of children at all times.  Should never be on the floor.
      • Keep desks tidy and clean – free of clinical specimens esp tongue depressors – should be thrown away straight after use.
      • Lock the room even if you’re out for a few minutes
      • Remove your smart card, even if your out for a few minutes.
  • Ensure debrief after EVERY surgery (30 mins per 2h)
      • Purpose: patient safety and educational
      • Will be with different doctors
      • “If you have clinical questions/need clinical help – using the whole practice not just the GP trainer (i.e. other docs and nurses)”
  • Training on the Clinical System.   Arrange 2-3 sessions on the following (if not already done so)
      • For example: Systm1/EMIS/ARDENS/ASSIST
      • See task sheets back of BVTS GP Induction Booklet
          • Overview of navigating around the medical record
          • How to add consultations
          • Adding vital signs/examination findingd (e.g. BP, pulse, temp, sats)
          • How to prescribe – acute and repeats, ETP
          • How to order tests
          • How to do referrals, Fast-tracks and Choose & Book, Letters
          • How to use the internal email system
          • How to deal with medical letters (e.g. from the hospital)
          • How to deal with lab results – looking at bloods
          • SNOWMED codes, The Telephone Directory & The Referral Repository
      • Play around with a dummy patient.Computer training on the medical system: Book 2-3 sessions if not already done so.  As a minimum, you should cover:
      • Keyboard skills – if bad, refer to Mavis Beacon Teaches Typing (amazing resource, learn to touch type within 2 weeks!  Yes, it is that good)Should be a Systm1/EMIS/ARDENS/ASSIST training system.
  • Specifically, how to….
      • (Stress importance of doing all the following in a timely way)
      • Interpreting and filing blood tests 
      • Read, Action/File Scanned Letters 
      • How to order tests
      • How to dictate
      • How to do a referral – electronic & dictation
      • How to do fast tracks
      • How to admit a patient (on a visit vs from the surgery)
      • Good Patient Information Leaflets
      • The Bradford VTS Desktop Consultation Dashboard
  • Discuss Home Visits:  what do they remember from the first 2 weeks of accompanying doctors on their visits?  Home Visit Reflection Form – 
  • Discuss daily routine – paper in-tray, letters, blood results & other test results, email, visits  & clear desk system when leaving surgery (plus closing windows, doors, not getting locked in).
  • Discuss leave – When trainer is away, tutorials will STILL be provided.   Study leave – most is eaten by HDR.  Study leave policy – attendance at HDR eats most of the study leave and many GP trainee schemes additional leave granted for taking exams.  Practices may wish to give additional study leave to those trainees in difficulty who have additional needs, but this is at the discretion of the practice and not an automatic right.   If the practice provides it, the trainee should show gratitude in return. 

Practice Manager

GP Trainer

Practice Manager

  • Surgeries : continue at 20 min appt per patient until week 9.   

GP Trainer

  • Review the following in relation to The GP Training Map
      • Read and validate ePortfolio log entries – how are they doing?   
      • Does the skill of reflection still need working on?  If so, review Ram’s easy way to write a log entry and go back to doing hands on “writing a reflective log entry” tutorial sessions until they get it.     
      • Review ePortfolio WPBA – how is it going?  On track?   Check Numbers.
      • Review Learning Needs document – does anything need changing, adding or doing?  
      • Ask how things are going
      • Any major concerns – talk to TPDs early!
  • GP trainee’s attitude to
      • TOPs and emergency contraception, LGBTQ+ patients, Homeless, Drug & Alcohol misusers, Asylum seekers, the Traveller communities etc.   
      • Discuss Equality & Diversity – and show them your protocol if not already done so.
  • Remind trainees the need to engage with Urgent Uscheduled Care (UUC) including Out of Hours (OOH) 

Practice Manager

  • Surgeries : switch surgeries to 15 min appointment per patient for next 12 weeks (until week 21 = start of month 6).  Remember to double check with GP trainer and inform trainee.  Trainees often feel apprehensive about the shortening of the interval and it is important to acknowledge this and empathise.   Provide reassurance  and tell them that this is a common feeling among GP trainees – and that they are not alone and that we can always move back a step if needs be, but most find that they don’t need to. 

GP Trainer

  • Introduce alternative ways of  consulting
      • Telephone Consultations (caution re: leaving messages on someone’s answer phone)
      • e-consultations
      • video consultations
  • Review the following
      • Read and validate ePortfolio log entries – how are they doing?   
      • Does the skill of reflection still need working on?  If so, review Ram’s easy way to write a log entry and go back to doing hands on “writing a reflective log entry” tutorial sessions until they get it.     
      • Review ePortfolio WPBA – how is it going?  On track?   Check Numbers.
      • Review Learning Needs document – does anything need changing, adding or doing?  
      • Mid Term Review at around month 3 (12 weeks in): and ask how things are going in general.
      • Any major concerns – talk to TPDs early!
  • Evaluate your teaching & training periodically: It’s important to ask your trainee to evaluate the training being provided by you and your practice.   Review and reflect on the training you are providing: how can you make it better the next time round?

Practice Manager

  • Surgeries : continue at 15 min appointment per patient until week 21 (start of month 6).  

GP Trainer

  • Introduce alternative ways of  consulting  (if not already done so)
      • Telephone Consultations (caution re: leaving messages on someone’s answer phone)
      • e-consultations
      • video consultations
  • Review the following
      • Read and validate ePortfolio log entries – how are they doing?   
      • Does the skill of reflection still need working on?  If so, review Ram’s easy way to write a log entry and go back to doing hands on “writing a reflective log entry” tutorial sessions until they get it.     
      • Review ePortfolio WPBA – how is it going?  On track?   Check Numbers.
      • Review Learning Needs document – does anything need changing, adding or doing?  
      • Mid Term Review at around month 3 (12 weeks in): and ask how things are going in general.
      • Any major concerns – talk to TPDs early!
  • Evaluate your teaching & training periodically: It’s important to ask your trainee to evaluate the training being provided by you and your practice.   Review and reflect on the training you are providing: how can you make it better the next time round.

Practice Manager

  • Surgeries : move to 10 min appointment per patient  (leave on 15 if GP trainee struggling).   Remember to ask GP Trainer first and to inform GP trainee.  Again, settle any fears and concerns the trainee may have.

GP Trainer

INDUCTION TOOLKIT - final year ST3-2

All texts in blue are links to more information and resources.   Most of these resources are also available from the  GP Post – Induction pages

Practice Manager

Ensure practice systems are in place such as their 

  • (i) Surgeries 
      • FOR AN ST3-2 CONTINUING FROM ST3-1
          • should be at 10 mins per patient from now until they finish.   If trainee is struggling still, consider 15min per patient for month 7 but move to 10 min by month 8 or month 9 at the latest.
      • FOR AN ST3-2 TRANSFER FROM ANOTHER PRACTICE
          • First 1w:no surgeries – sitting in
          • Next 1w: 20 min appointment per patient
          • Next 4w: 15 min appointment per patient  
          • Final 18w:10 min appointment per patient  
          • If the ST3 is a transfer from another practice
              • In other words, they did not do ST3-1 with you but are doing ST3-2 with you for whatever reason (e.g. sick or retired trainer)
              • Then, as they are new to you, for the first 4 weeks, follow the same schedule as for ST3-1 and then come back to this schedule for ST3-2 from month 2 onwards.
              • If they are new, don’t forget: Practice Manager’s checklist DURING induction.doc
      • For all surgeries ensure
      • There is a nominated Clinical Supervisor (CS) for every day on the timetable.  It has to be a GP partner or regular salaried GP.    This cannot be a locum GP.   Someone should be available even when a trainee engages in baby clinic or child immunisations with the practice nurse.
      • There are debriefs (30 min) after every GP trainee’s surgery.  It should be clearly labelled who that debrief is with.  
  • (ii) Tutorial session
      • 3h per week total
      • best 1.5h twice a week
  • (iii) Video surgeries
      • One surgery per week, 20 min slots.  
  • (iv) Sit and Swap Surgeries
      • MINIMUM 1 per month, book at 20 min slots
  • If any concerns, please communicate to your GP trainer.  
  • IMPORTANT NOTE: When the trainer is unavailable (e.g. annual/sick/study leave), responsibility for the GP trainee should be delegated to an alternative named GP as a Clinical Supervisor.

GP Trainer

  • If the ST3 is a transfer from another practice
      • In other words, they did not do ST3-1 with you but are doing ST3-2 with you for whatever reason
      • Then, as they are new to you, for the first 4 weeks, follow the same schedule as for ST3-1 and then come back to this schedule for ST3-2 from month 2 onwards.
  • Learning Needs:
      • GP Trainer – Review the learning needs document in ST3-1:  how well are you doing?  Any amendments?   Do you need a new fresh Learning Needs document to work from?
      • Devise a learning plan: how the various learning needs identified are going to be met?
      • Learning Needs Tools
      • Theory behind Learning Needs & more tools.
  • Quickly revisit the following and slow down and explore where difficulties identified
      • Interpreting and filing blood tests 
      • Read, Action/File Scanned Letters 
      • Doing reports
      • Ordering tests -how to order, the balance (doing too little vs too much)
      • Dictating/Typing Referral letters/Doing Fast-tracks
      • Admitting a patient (on a visit vs from the surgery)
      • Discuss Home Visits: any difficulties, how long does an average home visit take?   “Take me through the process of what you do on a home visit from the moment you take the home visit summary sheet with you”
      • Discuss daily routine – doing your admin in a timely way e.g. paper in-tray, letters, blood results & other test results, email, visits.   Clear desk system when leaving surgery (plus closing windows, doors, not getting locked in).
      • Discuss leave – When trainer is away, tutorials will STILL be provided.   Study leave – most is eaten by HDR.  Study leave policy – attendance at HDR eats most of the study leave and many GP trainee schemes additional leave granted for taking exams.  Practices may wish to give additional study leave to those trainees in difficulty who have additional needs, but this is at the discretion of the practice and not an automatic right.   If the practice provides it, the trainee should show gratitude in return. 
      • The Bradford VTS Desktop Consultation Dashboard (if not already familiar)
  • Quickly revisit protocols & policies

Practice Manager

  • Normal Surgeries: Is the trainee on 10 minute appointments yet?   At the very latest must be on 10 mins by month 9.
  • On-call surgeries must start. 
      • Have you booked them in?   One per week.   
      • Initially 3-4 sessions with GP Trainer or Salaried/Partner GP to train them up
      • After that, can gradually move to doing them on their own.  
  • Sit and Swap surgeries – have you plugged these in?  One per month MINIMUM, preferably 2.  

GP Trainer

Practice Manager

  • Normal Surgeries: Is the trainee on 10 minute appointments yet?   At the very latest must be on 10 mins by month 9.
  • On-call surgeries must be in place . 
      • One per week.  
  • Sit and Swap surgeries – need to continue until the end.

GP Trainer

Practice Manager

  • Normal Surgeries: continue at 10 min appts.
  • On-call surgeries must be happening.
  • Sit and Swap surgeries – continue.

GP Trainer

TUTORIAL SUGGESTIONS

Most of these tutorials are suitable for trainees at any stage of their GP journey.  If you have any others, let me have them!   [email protected]

EDUCATIONAL SKILLS BUILDER

QUICK ACCESS TO TRAINING TOOLS

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

Please leave a comment if you have a tip, spot an error, spot something missing or have a suggestion for a web resource.
And of course, if you have developed a resource of your own, please email it to me to share with others.

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