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Training Roadmap for ST1s & ST2s in a Hosp Post

things to achieve before the end of each 6 month hospital placement

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The ST1/ST2 training map (Hosp post)

Remember, mini-CEXs are done in hospital posts only.  In a GP post, do COTs instead.   So, if your ST2 year is made up of 6 months of GP and 6 months of a hospital post, then by the end of that year, you will need to have done 4 x CBDs, 2 x COTs, 2 x mini-CEXs.    If the whole of ST2 is hospital posts, then it is 4 x CBDs and 4 x mini-CEXs.

Broad things to achieve by end of each hospital post

Use this to help formulate your Placement Planning Meeting...

Everything we do as doctors and every part of our job  (whether in hospital or GP) can be group into three areas which are all underpinned by PROFESSIONALISM.   Those three areas are RELATIONSHIPS (which includes communication skills), DECISION-MAKING (which includes decisions on all sorts of things, including diagnosis-making) and MANAGEMENT (by management – we do not mean clinical management – we mean management in the broad sense – how we manage our work, ourselves, our sanity, our health, our personal systems, our work-personal life balance).   The latter is important because happy and well-grounded doctors generally make good decisions and less mistakes.   For your Placement Planning Meeting, it can be helpful to think what the trainee might want to develop in their new post in terms of these 4 areas.   Click to open the items below for further clarification on each of these.

What:  At the end of this placement, the trainee will

  • have developed good rapport with most patients.  The trainee will be gradually developing specific communication/consultation skills – like breaking bad news, calming angry patients/relatives, handling other difficult conversations.
  • have developed and shown good working relationships with a wide variety of staff, not just the doctors.  
  • have developed good patient presentation skills – concise, structured, logical flow.
  • have developed good hand-over skills.

How

  • Consider reading a communication skills book – The Doctor’s Communication Handbook by Peter Tate.
  • Breaking Bad News: a 10 step approach by Peter Kaye
  • Through face-to-face consultations with patients.   
  • Observe senior colleagues consult.  Observe seniors break bad news.
  • Engage in tutorials and professional conversations with  colleagues about consulting, breaking bad news, managing difficult patients.
  • Relationship with colleagues: through day-to-day interaction with them.   Showing genuine interest in other people.  Demonstration in informal and formal conversations.   Helping colleagues when you see they are struggling.  

Output Measure:

  • Face-to-Face Consultations
      • Able to explore a patient’s ideas, concerns and expectations.
      • Able to explore a patient’s background and the effect of the symptoms/disease on his or her life (i.e. the illness = the psycho-social-occupational impact of the symptoms/disease)
      • Able to break bad news.
      • Able to manage difficult or angry patients/relatives.
  • Departmental Meetings
      • Contributes to team meetings rather than just sitting back and listening.
      • Demonstrates a respect for other differing opinions.
      • Does not think  he or she is always right.
  • Clinical Supervisor’s Report (CSR):
      • Comments on good consulting skills, breaking bad news, handling difficult patients
      • Comments on good handover/presentation skills
      • Comments on good teamworking and respect for colleagues
  •  Mini-CEX:
      • Achieving (i) Communication and Consultation Skills for the level that the trainee is at. 
      • The trainee should be reaching the level that is expected for his or her peers at the same stage – and not against that expected of a newly qualified GP.
  • CBDs:
      • Achieving (i) Working with Colleagues and in Teams.  
      • Progressing in (ii) Practising Holistically and (iii) Fitness to Practise.
  • MSF
      • MSF positive comments about good relationships 
      • MSF positive comments about good teamworking
      • MSF positive comments about working with clinical, non-clinical staff and patients.
  • ePortfolio
      • Log entries demonstrate thinking and reflection on specific communication micro-skills, like ICE, PSO, Signposting, Screening., Setting Agendas, Summarising, Explanations, Breaking Bad News, Handling Angry Patients/Relatives, Handling Difficult People and so on.
      • Log entries show good levels of reflection on feelings – of self and others. 
      • Log entries show an appreciation for others.

NOTE:
Achieving means trainee is achieving competence or near competence.
Progressing means although trainee might not be competent, they are progressively developing well in this area.

What:  At the end of this placement, the trainee will

  • be able to deal with (i.e. make decisions on) most patient presentations adequately.   They might still seek advice quite often, but not as much as in the beginning.
  • generally make good working diagnoses for the specialty they are working in.   Other times will be reliant on the experienced clinical supervisor to advise them.
  • be good at thinking about differential diagnoses for the specialty they are working in.
  • know where to look for information when they don’t know it.
  • mostly develop reasonable clinical management plans.   
  • know their own limits – clinically.
  • know their own limits – when they are too unwell to practise safely.

How: 

  • Through face-to-face clerk-ins: ward admissions, on-call sessions and through clinics
  • Learns & follows the specialty department’s algorithms for common presentations
  • Develops their own “flow diagram” for “less clear” things.

Output Measure:  

  • Clinical Supervisor’s Report (CSR) & MSF
      • Gradually increasing confidence in the trainees data gathering, diagnostic, prescribing and management behaviour. 
      • Less dependency on seniors (still seeks advice when needs to, but not as much as the beginning).
      • Feedback from colleagues says clinical acumen is good. 
      • Comments about clinical management being sound.   Follows protocols.
      • Knows when to call for help.
  • Other clinical practice activities
      • Attending to patients: is able to prioritise between patients based on clinical urgency and need.
      • Knows what bloods and tests to order for common presentations to the specialty department.
  • Mini-CEX
      • Achieving (i) Clinical Assessment and Judgement (ii) Clinical Management (for that clinical specialty)
  • CBDs
      • Achieving (i) Data Gathering & Interpretation, (ii) Making diagnosis & decisions, (iii) Clinical Mx. 
      • Progressing in (iv) An Ethical Approach and (v) Fitness to Practice.
  • ePortfolio
      • Log entries show good decision making skills.     
      • Links learning logs appropriately to Clinical Experience Groups e.g. “infants, children and young people.”   
      • Entries demonstrate clear evidence of learning.

NOTE:
Achieving means trainee is achieving competence or near competence.
Progressing means although trainee might not be competent, they are progressively developing well in this area.

What:  At the end of this placement, the trainee will

  • understand the different clinical and non-clinical systems in the specialty department they are working in.
  • be able to prioritise own daily workload (both clinical and educational).
  • do their admin work on time (prescriptions, referrals, discharge letters, test results, contact patient’s GP).
  • be engaged in their own learning and development.
  • be able to show a progression in problem-solving skills for both clinical and non-clinical problems.   
  • be able to recognise when they are stressed too unwell to perform.   

How: 

  • Engages with different systems like others do in the specialty department (clinical, non-clinical, including IT).
  • Develops their own system for their daily routine work – ensuring things like test results, letters, prescriptions are done in a timely way.  
  • Dialogue with colleagues about systems, safety, personal management systems and resilience.  Learns from experience of colleagues.
  • Discussions at HDR and other workshops – on practice systems, safety, personal management systems, resilience.
  • Attendance at mandatory course – BLS, ALS, Defibrillator Training, Child Safeguarding, Adult Safeguarding

Output Measure: 

  • Observed in hospital practice
      • Does clerk-ins in a timely way.   
      • Attending to patients: is able to prioritise between patients based on clinical urgency and need.
      • Documents updates from ward rounds in a timely way
      • Uses the hospital computer effectively.
      • Uses other IT systems (e.g. ICE, pathlinks,  interdepartmental referral mechanisms) 
      • Prepares appropriately for ward rounds and grand rounds.
  • MSF
      • No concerns over paperwork, managing tasks etc.   
      • Others say committed learner. 
      • No negative comments like shirking responsibilities.
  • Educational Activities
      • Prepares adequately for tutorials, MDT meetings, departmental teachings and presentations.
      • Prepares for HDR, esp when running a session.
      • Engages in Audit or other Quality Improvement project.
  • Mini-CEX
      • Achieving in (i) Organisation & Efficiency
  •  CBDs
      • Achieving in (i) Working with Colleagues (e.g. delegation, teamwork)
      • Progressing in (i) OML, (ii) Managing Medical Complexity, and (iii) Fitness to Practise.
  • WPBA
      • Does not leave assessments until the last minute.
  • ePortfolio
      • Good engagement.   
      • Log entries entered in a timely way (not last minute). 
      • Log entries demonstrate evidence of learning.   
      • Log entries: periodically reflects on work and life to maintain a good balance.
      • Most PDP items achieved.
  • No concerns over sick leave taken
      • Not too much and not too little. 
      • [Note: both too little or too much can indicate self-management problems.]

NOTE:
Achieving means trainee is achieving competence or near competence.
Progressing means although trainee might not be competent, they are progressively developing well in this area.

What:  At the end of this placement, the trainee will

  • demonstrate a genuine respect for other people
  • demonstrate a genuine respect for their contractual responsibilities

How

  • Through everyday interactions with other people – both patients and colleagues
  • Engaging with both the ePortfolio and WPBA
  • Commitment to professional duties demonstrated at work.

Output Measure:

  • Respect for patients
      • Attends to patients in distress and discomfort.
      • Nice comments from patients made to hospital consultant and others.   This might be document in the MSF and CSR.  Also, trainee may get thank you cards from patients for the respect and kindness they have shown.
      • Shows respect for patients as individual fellow beings –  directly observed on ward roungs, clerk-ins, on-call.
  • Respect for work colleagues
      • MSF – positive comments about the trainee’s professionalism (attitude to work, turning up on time, not shirking responsibilities, going the extra mile for patients and colleagues). 
      • Helps colleagues/team/department during times of struggle.
      • Trainee responds constructively to negative feedback from MSFs, colleagues and elsewhere.
  • Shows respect for Learning Activities by planning for them.
      • Prepares adequately for tutorials.
      • Engages with prep for other learning activities e.g. at HDR, departmental teachings and presentations
  • Shows respect for GP Training Requirements
      • Does not belittle the ePortfolio or WPBA. 
      • Engages well with ePortfolio. 
      • Gets WPBA done and treats them with respect.
      • Log entries written in a way to show evidence of learning (as opposed to non-focussed ‘waffle’ just to ‘tick a box’)
  • Shows respect for the Computerised Medical Record
      • by recording adequate amounts of information rather than one-liners!   Good clerk-ins.
      • clerk-ins done in a timely way.
      • does not falsely alter records.
      • [Note to trainees: all medical systems -both hospital and GP- have an audit trail.   They can tell if you have altered a medical record word by word and the exact timing!   They can tell exactly what you have changed and when.   So do not alter records retrospectively.  Instead, add an additional note in a timely way.]
  • MiniCEX:
      • Achieving in (i) Professionalism.
  • CBDs
      • CBD prep sheet prepared with care (as opposed to last minute quick rough-and-ready write ups).  Preparation shows a respect for the assessment.
      • Achieving (i) Working with Colleagues and in Teams. 
      • Progressing in (ii) An Ethical Approach and (iii) Fitness to Practise.
  • Understands the need to ration care and protect the NHS.
      • Progressively developing in this area – i.e. not ordering every investigation under the sun!
      • Starting to consider costs and effectiveness, of tests and medication, although might not be very well polished at this stage. 
NOTE:
Achieving means trainee is achieving competence or near competence.
Progressing means although trainee might not be competent, they are progressively developing well in this area.

Within the first 4 weeks

Understand the Professional Capabilities

The Professional Capabilities (previously called competences) are basically a set of areas YOU ARE MEASURED AGAINST. Nearly everything you do in GP Training is mapped to these 13 PCs. So, getting a real good understanding of them is crucial to you achieving them!

Click here for more on Professional Competencies

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Understand what Log Entries are all about​

One of the big things that ARCP panels and Educational Supervisors assess are your Learning Log Entries (LLEs). 

You might think you know what log entries are about but trust us, it is unlikely that you truly have a grasp of what they are about or the ‘spirit’ behind them.    So, rather than jumping in and writing a whole load of log entries with meaningless reams of text, slow down and try and understand the educational purpose of why we are so keen for you to do them.   

These LLEs must show evidence of performance as well as learning.  In other words, we want you to write log entries in a way that not only “shows us” evidence of the 13 Professional Capabilities” but also shows us that you value writing them up because of the learning revelations they reveal “for you”.  Pausing for a moment, slowing down and reflecting on your clinical encounters will help you become a better doctor.  The good doctor is one who continuously pauses, slows down and reflects on their behaviour and actions.

Click here to understand the basics behind Learning Log Entries

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Understand the theory behind Reflection

Your log entries must show evidence of learning – in other words, that you find new revelations for yourself which then helps you to become an even better doctor.

But learning cannot happen without reflection. Therefore, understanding Reflection is a key thing to writing good learning log entries.  Again, rather than jumping in to write any sort of log entry, why not learn about reflection first to help you write log entries that do “hit the mark” both educationally for you and educationally for others (like Educational Supervisors and ARCP panels).

Click here for our pages on Learning Logs & Reflection

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Read Ram’s Easy Peasy Guide to Writing Learning Logs​

The biggest thing that we as educators come across in GP trainees is the vast number who write up log entries so poorly.   Often there is just a mere description of what happened with little analysis/intelligence behind the write up.    Remember, the educators assessing your ePortfolio and log entries at ARCP time may not even know you.  So you are judged according to your ePortfolio.   Knowing this…

  • Do you want an easy method of writing up your Learning Log Entries in a way that helps you to “showcase” yourself?   
  • A method that helps you provide evidence for the 13 Professional Capabilties?  
  • One which also helps you to reflect so that you can find and tease out those golden nuggets of key learning points that will transform the way you practice?

Then click the link below.

Ram’s Easy Peasy Way to Write Learning Log Entries

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Don’t miss your scheme’s induction

Your induction programme run by your GP training scheme will tell you everything you need to know for your training in a nutshell. Most GP scheme induction programs run over 1-2 days .   This provides a space for the TPDs to get you know you and you to know them.   You will understand how GP training works in your area.    It also provides a platform for to ask questions.   

Please do not miss your scheme’s induction programme.  It’s one of the important things for you to attend – and as early as possible.  So, before your post starts, get to find out the dates (usually from your GP training scheme’s administrator).  Then contact someone in your post to let them know of the dates and ask if you can book study leave for it.    In a GP post, contact the Practice Manager and Trainer.   In a hospital post, contact the Rota Co-ordinator and the Hospital Consultant who is your Clinical Supervisor.   

The link below provides a page full of resources that many schemes will use in their Induction Programme.  You may want to look at some of these just as a “heads up” sort of thing.  Alternatively, you can revisit this page as a follow-up from your attendance at the local Induction Programme.

Click here for more on the Scheme’s Induction

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Get to know different staff​

In a hospital ward, you work as part of a team.  The doctor is NOT at the top of this team.   You are all a bit like cog-wheels – some bigger or smaller than others, but all essential to the whole working process.    So, in order to keep all these cogs well oiled, get to know each cog in your system.   Form good working relationships with everyone around you, not just the doctors – people like the nurses, health care assistants, ward clerks and so on.  In return, you will see that they will go the extra mile for you.    And, when you start a new post where you know very little about the clinical protocols for that department – staff like the nurses will keep you on track and help you.   The ward sisters, for instance, will often know the protocols like the back of their hands.  So, get to know them and they will help “train you up”.   So, in a nutshell, break away from the old attitude of only wanting to belong to “the doctor group” and cordon everyone else off.  You need to work together.

Of course, you will want to get to know the doctors too.   Get to know your hospital consultant and registrars.   You’re more likely to have an amazing educational journey if you like them and they like you.    

At the end of the day, try and form good relationships with everyone.    Maintain a good ethos within your department.   Doing so will help you have a happy time as a doctor – and happy doctors tend to thrive in their placement, not just survive!

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Get familiar with the Ward and Surroundings

  • What is kept where?   For instance the blood forms, blood bottles, drains and so on?   Where are the ward notes?   Is there a computer?   Tablets for ward rounds?
  • Where’s the sluice?
  • Is there a quiet room for you to concentrate? e.g. important for when prescribing
  • Where is the crash trolley?
  • What is the procedure for calling the crash team?
  • What is the procedure for spillages?  Where is the mop, bucket and disinfectants kept?
  • Know your fire exit procedure.
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Define your daily work routine​

It’s important to get a work routine going that covers all the important duties of your job as a ST trainee doctor for your department.  If you don’t have a routine, you’ll end up missing things and that could mean serious clinical mistakes and errors.    Perhaps have a chat with the doctor who you have just replaced.   Then discuss with your specialty registrar/hospital consultant.   For example, 

  • Doing ward rounds – what’s the schedule.
  • When does departmental teaching take place?
  • MDT meetings – when do they happen and what is your role, if any.
  • How does the on-call system work?  What will be your role?  How often?
  • How to order bloods from the phlebotomist.   Or do you have to do them yourself?   Which nurses can take bloods and help you out.
  • How does the computer system work.   What do you document and how?
  • How does the prescribing system work?  What is your role?
  • How do you retrieve physical notes.
  • How do you retrieve blood results.   Are there daily bloods that need retrieving?
  • Do you have a physical pigeon hole?  What goes in there?  What do you need to check regularly for that is in there?
  • Checking your work email for updates.
  • And of course… Having a system of capturing and doing the tasks generated from your clinical encounters  and ward rounds (e.g. clinical tasks)
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Get familiar with the Hospitals Medical Computer System

  • Ask someone to show you the Hospitals Medical Computer System (like the Cerner EHR platform).  Ask them to show you the common things you will need to do in the system (e.g. writing up a clerk-in, prescribing, ordering bloods, retrieving bloods, x-rays, scans, recording allergies, looking for allergies and so on).
  • There are often loads of YouTube tutorials – so go and find them.
  • Ask if there is a test patient that you can play with.  Most systems have a test patient.  

If you’re not good with typing – NOW is the time to learn.   If you are bad at typing, it will make your life really difficult – trust us.  So time to put some serious training in.  

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Book onto a BLS/ALS & Adult/Safeguarding course ASAP

What you need to book onto depends on the hospital post.    BLS & ALS is essential for every adult hospital post.   In any post involving children, you will need to do Paeds BLS & PALS.   

In terms of safeguarding, again for all hospital posts you should do a yearly Adult Safeguarding course or training workshop.   For any post involving children, you must do a Child Safeguarding course or training workshop every year too.

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Play with your ePortfolio​

Log into FourteenFish and start getting familiar with the layout. Simply log in 3-4 times a week for the first 2 weeks just to get a feel for it. It takes a while to get used to it.  Then, when the time is right for you to start adding stuff, it won’t be such a headache and you’ll find it nice and easy.   It’s horrible writing up things like Learning Log Entries if there is the added problem of not knowing where to click or which buttons to press.    So, get rid of that unnecessary burden by simply getting used to the system in the first couple of weeks of your post without the pressure of having something to add. 

Click here to log into FourteenFish

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Does your English need improving?

This mainly applies to those of you who qualified in medicine from a country outside of the UK.     You decided for yourself by asking yourself – “Do I need to improve your spoken English?”.   If yes, then how will you do it? Make a plan to start doing it in ST1, so that by the time it comes to the start of ST3 (i.e. 2 years later), you will have improved significantly for you to pass the exams like CSA and RCA where your level of English fluency is so critically important.   Consider a combination of….

  1. Watching a TV series in English
  2. Watching your favourite movies again but this time in English
  3. Speaking to your children at home in English,
  4. Attending a Language School/Class (search on MeetUp App or search online for something local)
  5. Finding a language teacher or native friend to help you on a 1-1 basis.

One good method, in terms of conversation, is to try and speak opportunistically to as many people in English as you can every day. Make notes on your areas of difficulty and discuss with either your English language teacher, GP trainer, a English friend or relative.   Another good way is for your friend or teacher to listen to you while you read them a story book – and they correct you as appropriate.   Pick one of the following books and see how you get on.   These are all great “story style” books written by authors who are medical doctors.  You will also hopefully learn some of the wisdom from the experiences of these doctors.

  • This is Going to Hurt: Secret Diaries of a Junior Doctor – by Adam Kay.
  • The Doctor Will See You Now by Amir Khan
  • Complications OR Better by Atul Gawande
  • SeaSickness by Peter Tate
  • The Inner Consultation by Roger Neighbour (you learn two things – medical communication skills and language skills)

Once you have developed a plan – make sure to do it regular – e.g. every Tues 6-8pm. 

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The first 3 months

Plan your courses in advance

Do remember that although you’re a GP trainee, you are also an employee who is paid to do a job.   Although you will be entitled to study leave, that doesn’t mean you can just take it when you like.   It has to be co-ordinated. 

Hospital departments and GP practices have a service to deliver to patients. Therefore, they can’t just release you at the drop of a hat for you to attend a course that you have booked at the last minute. So, book your training courses with plenty of advance notice (at least 6 weeks), including the induction course run by your GP training scheme.   Courses to consider at this stage are:

  • BLS & ALS courses
  • Adult & Child safeguarding courses
  • A knowledge update course for your specialty – e.g. family planning or contraception, child health, reading ECGs, spirometry, COPD, diabetes
  • Courses targeting IMGs (if you’re an IMG)
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Start reading a consultation book

We know you’re in a hospital job but don’t forget you are training to be a GP.   Reading a book on Communication and Consultation Skills will really help you harness the power of effective communication in gathering clinical information quickly – even in the hospital setting.     Many trainees say “but we don’t have the time for consultation skills – we need to do a clinical history and examination quickly so we can sort out the patient”.   We would like to ask you something for you to consider…

How much time do you have on average for a clinical clerk-in on the wards?  Would you say 20-30 minutes?   Well, listen to this – in GP land, we have 10 minutes per patient.  And most of us manage to do this because we have spent time and effort with developing our Consultation & Communication skills.   These help us with taking an accurate history in a timeefficient way, making good decisions, and explaining things to patients in a way that is acceptable to them. Communication skills also help us enormously when things go wrong. 

Would you like to be able to do the same?   There’s no reason why the techniques in these books cannot be used for the hospital setting.   And besides, now is the time to learn the basics, so that by the time you come to GP land, your GP trainer can help polish those skills to an exceptional level, rather than just having to cover the fundamentals.  

If you like reading novels, we suggest

  • “The Inner Consultation” by Roger Neighbour.  An old classic, but still relevant today with a great story-telling narrative.
  • “Bedside Matters” by Peter Tate and Francesca Frame.   Conversational in style and has great reviews and written in 2020.

If you’re in a hospital post, either

  • “The Doctor’s Communication Handbook” by Peter Tate.   A classic. 
  • “The Naked Consultation” by Liz Moulton.   

If you don’t know which of the above books to go for… head over to Amazon – and read the synopsis of each book and the accompanying reviews.  Then simply pick one that grabs your fancy.  To be honest, they are all pretty good.  You may have heard about the book “Skills for Communicating with Patients” by Silverman et al – It is a great book and one of our favourites – because it’s the only evidence-based communication skills book out there and is VERY practical.  But is heavy going for ST1s or ST2s, so, best reserved for ST3s.  

Click here for more our Communication Skills Database

Click here for recommended Consultation Books

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Remember your ePortfolio

By now, you should be doing around 1 log entry per week. Please get your Educational Supervisor (ES) to look at these and see how they fair in terms of reflection, learning and evidence for the capabilities. Get your ES to show you how you can write them in a more reflective and educational way.  For example, by using the ISCE criteria to write your log entries, you can end up creating more powerful learning moments for you.

  • I for enough Information about the situation,
  • S for Self-awareness and describing how the situation made you feel and any accompanying thoughts,
  • C for doing some Critical analysis to make sense of the situation
  • E for Evidence of learning – i.e. showing exactly what needs to be done/change in behaviour to make you or the system you operate in better.

In terms of numbers…

  • 1 log entry per week.
  • In other words, 4 log entries per month.
      • 3 of these need to be on a clinical encounter with a patient (and recorded under Clinical Case Reviews).
      • The other one can be on anything you like – for instance, writing up a HDR session and reflecting.
      • You could make it easy for yourself and decide the last week of every month will be a log entry on “something else like HDR”. All others will be Clinical Case Reviews

Revisit our pages on Learning Logs & Reflection

Revisit Ram’s Easy Peasy Way to Write Learning Log Entries

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Understand WPBA + do a mini-CEX & a CBD

Start to read and get familiar with all the different types WPBA. Almost everything you would want to know (plus hints and tips not available anywhere else) can be found on this Bradford VTS website – under main menu of the HOMEPAGE, click > GP TRAINING & MRCGP > WPBA.  By end of the first 3 months, you should have done at least one mini-CEX and one CBD.

Click here for an intro to WPBA

Click here for the CBD resources page

Click here for the mini-CEX resources page

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Remember in hospital, you’re still a GP trainee

When trainees start their hospital post rotations, they quite rightly focus on the particular specialty that are working for. But what trainees often do is to forget all about General Practice and they forget they are training to be GPs! So, we are NOT asking you to lessen your enthusiasm for learning about a particular specialty. Instead, in each of your specialty posts we are asking you to think about the things that will serve you well as a GP.

So, think about the following…

  • Practice your consultation skills in all hospital posts.  Just work on an small area from a consultation book you have read bit-by-bit.
  • Perfect your examination technique and get your mandatory CEPS done in hospital rather than waiting to do them all in GP.
  • Learn about managing heavy menstrual bleeding in O&G rather than going to theatre to do Caesarians.   Learn about the respiratory management of COPD rather than assisting with bronchoscopies every week.

Click here for more on Comm Skills in Hospital

Click here for more on CEPS

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How to Study

Isn’t it interesting that most of us are never taught “how to study”.  Yet the research says there are numerous methods – some more highly effective than others.  In fact, some of the methods we think are good are in fact wasteful ineffective methods that consume a lot of time and energy for little effort.   

Over the next 2-3 years, you will be learning a lot of new things.  Not only that, but you will do some exams to demonstrate your knowledge and skills.    Therefore, it is probably a good time to start reading up about some of the research around “how to study effectively” so that you can change any bad habits and adopt some new ones.   Doing this in ST1 – which is probably the easiest of all the three years – is therefore the ideal place to do this.   

Read the research on Bradford VTS on what makes effective Studying.  Discuss it with your trainer and/or Educational Supervisor or TPD.  Summarise the key learning points that you will implement (and even record it as an ePortfolio learning log to demonstrate evidence for the capability Performance, Learning & Teaching).

Click here for our page on How to Study

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If you plan to do a teaching session…

Some trainees think that teaching is easy – you just get up and do it.     But effective teaching requires a lot of effort and skill on the part of the teacher.  Take your GP Trainer – did you know that he or she has been on numerous courses to learn not only some theories around what makes effective teaching and learning but also demonstrate they have the practical skills to do it?  Not only that, but they have to keep showing that they are maintaining their educational skills by being revalidated every few years.  So, your GP trainer is a highly skilled educator. 

So, if you plan to do or have been asked to do a teaching session – perhaps at HDR, at a GP or hospital team meeting, why not take the opportunity and learn some basic teaching skills.   This is a lot better than just trying to copy what “you think” is good from what you have observed in other teachers around you.   If you learn some of the theory NOW, you will understand what exactly you are doing on an educational level.  It will also help you understand why some teachers are more effective than others.    Have a look at these…

The good (effective) teacher or teaching.  What does the evidence say?

Teaching for Beginners

Small Groups & Facilitation Skills

Presentation & Workshops

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Don’t forget to visit Bradford VTS often

And finally, there are tonnes of other things on this website. We have over 2000 resources. But please don’t feel overwhelmed. You have 3 years to dip in and out of this website and learn things gradually and in a relaxed way. The purpose of this site is to demystify GP training and use easier language than the RCGP website to help explain things in a more meaningful and practical way.

And of course, there are tonnes of things like help sheets and training material that you simply cannot find elsewhere. It’s mostly free too! There may be a small charge for the odd thing here and there, primarily to help raise funds to keep this site alive. Please support us through a voluntary contribution, buying from our book store etc.

Click here to see our ONLINE LIBRARY

Click here to see our ONLINE VIDEO LIBRARY  
(Don’t forget to subscribe to our YouTube channel)

Click here to make a small contribution like £30 to help keep this site alive.  Please…  It’s unfortunately surprising how many are willing to pay £500 to attend an RCA/CSA or GP update course but not give a mere £30 to a website which aims to give nearly everything for free.   We don’t get funding from any major organisation, so please consider pledging a small something.   We do all of this in our spare time.

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The last 3 months

How is your ePortfolio going?

If it is going badly, try and work out why and discuss it with your Educational Supervisor (ES). Perhaps you need more training with your ES on how to write a good learning log entry. Learning log entries should not only provide evidence for the capabilities, but they should also be an rewarding educational experience for you. If this isn’t the case, discuss with your ES.

Your ePortfolio is one of the main things that is used in all your assessments like ES and CS meetings, and ARCP panels. So it is right that you should pay a lot of attention and respect to it. Write things carefully – concisely – to demonstrate evidence – to show learning – rather than lengthy write ups of mindless waffle.  Remember, there should be 4 log entries per month. 3 of these need to be on a clinical encounter with a patient (and recorded under Clinical Case Reviews). The other one can be on anything you like – for instance, writing up a HDR session and reflecting.

In terms of WPBA – get at least the minimum number of things like CBDs, COTs and CEXs – in fact you should aim to get a lot more!   And make sure you do them in a timely way – throughout the post, not all done at the end as a desperate last measure.  Remember, your ES will NOT remind you when these are to be done.  The responsibility is yours to ask your hospital consultant to do them – because we are trying to get you to become an autonomous learner, where you don’t need your hand holding!

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Are you working on your PDPs?

Every GP Trainee needs to write some PDPs for every post they start.  Why?  Because when you qualify as a GP, you will do the same every year!   A PDP is a Personal Development Plan – usually consisting of 3-5 things that you want to achieve to help you be even better than you currently are.    In this way, every GP becomes incrementally better year-on-year.  

They needn’t be big things, but they should make a difference to your working life.   So, for instance, if you feel your general clinical knowledge is good except for in contraception and family planning, then you may want to book onto a workshop or course on that.  Sometimes a PDP might be achieving a better work-home life balance.   Achieving a better balance makes us happier and happier doctors always perform better than sad grumpy ones!

The basic rule for defining a PDP is that they should be “SMART”.   If they are “SMART”, they are more likely to be achievable.   SMART means..

  • S for being Specific which what you are trying to achieve (e.g. ‘improve my knowledge of contraception’ rather than ‘improve my clinical knowledge’)
  • M is for the thing you want to achieve being Measurable (e.g. attendance a course).
  • A is for Attainable – in other words, what you plan to do is do-able and not something almost impossible.   “attend a course on consulting skills” is do-able.   “read 10 different books on consulting skills” is incredibly difficult.
  • R is for Realistic.  For example, “read a consultation book before the end of next week” is difficult.  “Read a consultation book over the next 3 months” is realistic. 
  • T is for Timebound.  In other words, you define the time period over which you will achieve what you set out to do.

Click here for our resources page on PDPs

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Do another mini-CEX & CBD

  • Time to do another mini-CEX and a CBD.  By the END of ST1 or ST2 you need to have done a minimum of 4 x mini-CEX and 4 x CBDs.    That means x2 of each in the first post and x2 in the second.   
  • Remember, mini-CEXs are done in hospital posts only.  In a GP post, do COTs instead.   So, if your ST1 or ST2 year is made up of 6 months of GP and 6 months of a hospital post, then by the end of that year, you will need to have done 4 x CBDs, 2 x COTs, 2 x mini-CEXs.  
  • However, demonstrate that your more than just an “average” GP trainee – try and get more than this MINIMUM number.    

Click here to revisit the intro to WPBA page

Click here for the CBD resources page

Click here for the mini-CEX resources page

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Get ESR & CSR done

Please take your Educational Supervision (ES) sessions seriously.  The assessment and outcome of these ES meetings feed into the ARCP panels which determine whether you have made good progress to enable you to proceed onto the next ST year.   

There have been many instances where trainees have not been allowed to progress and instead repeat part of their ST year because of poor educational or clinical performance.  Remember, the only judgement the ARCP panels make of you is based on your ePortfolio.   And many of the people on those panels will NOT know you as a person.  They have only your ePortfolio to judge you.  And the Educational Supervisor will make and assessment of your ePortfolio also and the panel will look at the ES report.   

So, make your ePortfolio look good, and prepare well for your ES meeting.   Expect your ES meeting to last 2-3 hours. There are 3 sections of your ES prep form to pay a good detailed amount of time

  1. “FINDING THE EVIDENCE FOR THE CAPABILITY SELF-RATING SCALES”.   
  2. “FORMULATING ACTION POINTS FOR THE CAPABILITIES”
  3. “PDPs”

We have advice for both of these in the links below.  

Also ask your GP trainer to fill out a CSR – Clinical Supervisor’s Review.

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Remember in hospital, you’re still a GP trainee

When trainees start their hospital post rotations, they quite rightly focus on the particular specialty that are working for. But what trainees often do is to forget all about General Practice and they forget they are training to be GPs! So, we are NOT asking you to lessen your enthusiasm for learning about a particular specialty. Instead, in each of your specialty posts we are asking you to think about the things that will serve you well as a GP.

So, think about the following…

  • Practice your consultation skills in all hospital posts.  Just work on an small area from a consultation book you have read bit-by-bit.
  • Perfect your examination technique and get your mandatory CEPS done in hospital rather than waiting to do them all in GP.
  • Learn about managing heavy menstrual bleeding in O&G rather than going to theatre to do Caesarians.   Learn about the respiratory management of COPD rather than assisting with bronchoscopies every week.

Click here for more on Comm Skills in Hospital

Click here for more on CEPS

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How to Study

Isn’t it interesting that most of us are never taught “how to study”.  Yet the research says there are numerous methods – some more highly effective than others.  In fact, some of the methods we think are good are in fact wasteful ineffective methods that consume a lot of time and energy for little effort.   

Over the next 2-3 years, you will be learning a lot of new things.  Not only that, but you will do some exams to demonstrate your knowledge and skills.    Therefore, it is probably a good time to start reading up about some of the research around “how to study effectively” so that you can change any bad habits and adopt some new ones.   Doing this in ST1 – which is probably the easiest of all the three years – is therefore the ideal place to do this.   

Read the research on Bradford VTS on what makes effective Studying.  Discuss it with your trainer and/or Educational Supervisor or TPD.  Summarise the key learning points that you will implement (and even record it as an ePortfolio learning log to demonstrate evidence for the capability Performance, Learning & Teaching).

Click here for our page on How to Study

Show

If you plan to do a teaching session…

Some trainees think that teaching is easy – you just get up and do it.     But effective teaching requires a lot of effort and skill on the part of the teacher.  Take your GP Trainer – did you know that he or she has been on numerous courses to learn not only some theories around what makes effective teaching and learning but also demonstrate they have the practical skills to do it?  Not only that, but they have to keep showing that they are maintaining their educational skills by being revalidated every few years.  So, your GP trainer is a highly skilled educator. 

So, if you plan to do or have been asked to do a teaching session – perhaps at HDR, at a GP or hospital team meeting, why not take the opportunity and learn some basic teaching skills.   This is a lot better than just trying to copy what “you think” is good from what you have observed in other teachers around you.   If you learn some of the theory NOW, you will understand what exactly you are doing on an educational level.  It will also help you understand why some teachers are more effective than others.    Have a look at these…

The good (effective) teacher or teaching.  What does the evidence say?

Teaching for Beginners

Small Groups & Facilitation Skills

Presentation & Workshops

Show

Don’t forget to visit Bradford VTS often

And finally, there are tonnes of other things on this website. We have over 2000 resources. But please don’t feel overwhelmed. You have 3 years to dip in and out of this website and learn things gradually and in a relaxed way. The purpose of this site is to demystify GP training and use easier language than the RCGP website to help explain things in a more meaningful and practical way.

And of course, there are tonnes of things like help sheets and training material that you simply cannot find elsewhere. It’s mostly free too! There may be a small charge for the odd thing here and there, primarily to help raise funds to keep this site alive. Please support us through a voluntary contribution, buying from our book store etc.

Click here to see our ONLINE LIBRARY

Click here to see our ONLINE VIDEO LIBRARY  
(Don’t forget to subscribe to our YouTube channel)

Click here to make a small contribution like £30 to help keep this site alive.  Please…  It’s unfortunately surprising how many are willing to pay £500 to attend an RCA/CSA or GP update course but not give a mere £30 to a website which aims to give nearly everything for free.   We don’t get funding from any major organisation, so please consider pledging a small something.   We do all of this in our spare time.

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Got any suggestions or advice?

Got any advice or suggestions?  Anything we’ve missed or is inaccurate?  Then leave a message below.   Got a resource to share? Contact rameshmehay@googlemail.com.  Make GP Training Better Together’

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