Welcome to Oswald Medical Centre.

We hope you find your time here both enjoyable, useful and relevant for your future career.

DOCUMENTATION

Before you start work, there is some mandatory documentation to be dealt with such as copy of your GMC registration. drivers license, insurance etc. You will need to get in touch with the admin team to complete this.

There is an assigned  member of the admin  team who will look after your documentation and deal with any other issues that arise.

INDUCTION

There will be a 2 week induction period when you first arrive.

This time is to get you familiarised with the premises, computer system and staff.

You will also be given an overview of your curriculum, mandatory assessments and other assessments expected of you during your time here.

During the induction period you will not be expected to see patients on your own but will be sitting in with your trainer,other GPs and other staff during consultations with patients. The aim of these sessions is to get used to different consulting styles and get an overview of the role of other staff members.

You will also get familiarised with the IT system with informal training by other members of staff and also formal training.

You will get a time table of the induction period

NORMAL WORKING WEEK

Following the two week induction period, you will start your regular working pattern.

The normal working week consists of 10 sessions.

You will get your time table one week in advance.

HOME VISITS

Home visits are an integral part of General Practice in the Uk and an ideal opportunity to learn about getting a holistic approach to patient care.

Home visits are usually assigned at the end of the morning surgery.

You are expected to be involved on the  home visit rota. This may seem daunting when you first think about it but initially you will be doing home visits accompanying other members of staff until you are ready to do them on your own.

There has been very good feedback about the usefulness of doing home visits by previous trainees and it is generally seen as a very good training opportunity of learning to take more responsibility and own initiative in patient care.

You will be expected to discuss your home visits with your trainer after the visit. Also your trainer or other member of staff will always be available on the phone if any difficulty should arise during your home visit.

THE DOCTORS BAG

A bag will be provided for you to take to home visits It ia stocked with some basic drugs needed in emergencies, a bp apparatus. opthalmoscope /otoscope set. FP10 prescription pad,  BNF, equipment and sample tubes for phlebotomy, xray request forms and some other items. Once you take charge of your bag, you will be responsible for the safety and upkeep of its contents.

CONSULTATIONS

The consultation is the cornerstone of general practice. In the UK, GP's generally consult at 10 minute intervals. This may at first seem daunting to the new trainee as there are many tasks to be achieved in a short time. However with practice and experience, it will become easier.

Fy2  doctors will start seeing patients at half hour intervals. This will allow you to get familiarised with the IT system and general layout and contents of the consulting room.

Within a few weeks you should be able to start consulting at 20 minuite intervals. Some trainees get down to 15 minute consultations

GPST trainees generally start at 20 minute intervals and should aim to be down to 10 mts near the end of their placement.

You will not be pushed to doing shorter consultations till you are ready.

VIDEOING CONSULTATIONS

You are expected to regularly video your consultations with patients. These will be reviewed with you trainer during weekly tutorials. You should aim for at least one video per week. Reviewing the video of the consultation is a powerful tool to hone your consulting skills former trainees have found this extremely useful.

camcorders are available in the practice

You will have to obtain consent from patients before the consultation is videoed and a consent form is available from this website or on-line. The consent is usually obtained by the receptionist when the patient checks in at reception but you can also get it when the patient enters the consulting room. The patient needs to sign the form before and after the consultation.

videos of consultations are usually erased once they have been reviewed.It is very important to ensure confidentiality of the patient and keep the camcorders safe. You should retain the consent form until the the recording has been erased.

ASSESSMENTS

Workplace based assessment allows your trainer can get an overall impression about how you actually perform in the workplace which gives a  more valid judgement of competence than just exam results. 

Your trainer will complete a clinical supervisors report at the end of your posting and make necessary recommendations.

Evidence of the training you receive should be recorded in your e-portfolio. There is a reflective log section in the e-portfolio which is an ideal place to record experiences such as tutorials, record of clinical meetings, reflection on patient encounters etc.  

There are also a minimum number of mandatory assessments to be completed during your posting here - these are case based discussions, mini cex or cot, dops and for gp trainees, msf and psq. All these should be recorded in your e-portfolio.

It is very important to gather enough good quality evidence of your training and experiences and record them in your e-portfolio as this will be the main source of proof in case your competence is questioned. 

AUDIT OR PROJECT

During your time here you should aim to complete a full audit cycle or Fy2 doctors may prefer to do a project. You should try to identify your audit topic early on in the posting and discuss it with your trainer. Have a look at what previous trainees did. Usual audits revolve around QOF targets or topics identified by medicines management.

PRACTICE LIBRARY

The practice maintains a library stocked with books relevent to general practice. You can use these books for quick reference or you can borrow them for longer use. There is a register to sign books in and out when you are borrowing them. Though online resources are becoming more popular and relevent for clinical topics, the library is particularly useful for books on certain non clinical topics such as consultation models and for references that may need a subscriotion online. The main library is maintained at Hyndburn.

THE TUTORIAL

You will have one session set aside for a weekly tutorial in protected time with your clinical supervisor. This time is used to review videos of consultations, complete mandatory assessments and discuss a relevant topic chosen in advance. in line with the principals of adult learning, the subject should ideally be chosen by the learner and this should be done well in advance so as to have adequate time to prepare both for the learner and tutor. Tutorial topics can come from your curriculum or be chosen from identifying a learning need identified in the workplace.

Here are some examples of common tutorial topics but you could choose any subject that is relevant to you.

chronic disease

Diabetes

Heart failure

copd

acute medicine

headache

asthma

chest pain

skin rashes

mental health

the ill child

contraception

preventative medicine

primary prevention of cardiovascular disease

lipid management

nonclinical topics

ethics

practice finances

clinical governance

PAPERWORK AND LAB TEST RESULTS

General Practitioners have to deal with a lot of paperwork such as hospital letters and discharge summaries, requests for medical reports, requests for acute and repeat prescriptions etc.

As a trainee it would be useful to get an idea of how to deal with this though this may seem mundane. Dealing with hospital correspondence is a good way of experiencing the inter-phase between primary and secondary care.

You will not be asked to do any work which involves a monetary consideration.

The practice operating system is directly linked to the laboratory through ICE. You will have your own in-box for lab results. Any investigations you request or results of x rays requested by you will come back to your in-box. Please make sure you deal with these promptly and it is important not to delay actioning any significant results for patient safety. You will get training on how to order tests and action results.

please ask your trainer if you are not sure how to action results or have any doubts 

PRACTICE CLINICAL MEETING

Every Wednesday morning from 8.30 am there is a practice clinical meeting attended by the doctors and sometimes practice nurses or other pct members. You are expected to do PowerPoint presentations on relevant clinical topics at these meetings. We also look at referrals and their  outcomes at this meeting. Occasionally speakers from outside give talks on relevant subjects.

EXTENDED PRIMARY CARE TEAM

The extended primary care team includes midwifes, health visitors, social workers, physiotherapists, community pharmacists, opticians etc.

During your time here you should try and spend some time with some of these teams so as to get an idea of work carried out in the community and you can arrange time with them during your protected audit or admin time.

ANNUAL LEAVE

Annual leave entitlement for trainees is 30 working days per year which must be equally distributed in your various rotations during the year.

For foundation year 2 trainees this equates to 10 working days during your 4 month posting in general practice.

For GP specialist year 2 trainees, this equates to 15 working days during your six month posting at the practice. 

GPST 3 trainees can take 30 days during your years posting in the practice.

All leave must be applied for well in advance and an annual leave form must be completed which must be authorised by your clinical supervisor.

Please contact the responsible member of the admin team regarding any annual leave queries.

STUDY LEAVE

Trainees are allowed a maximum of 30 days study leave per year which must be distributed equally in your various postings. Of this some will be used for your mandatory release course at the learning centre.

FY2 doctors are allowed a maximum of 5 days  study leave in addition to the half day release course during your 4 month posting in general practice.

GPST2 doctors are allowed a maximum of 6 days study leave in addition to their half day release course.

Study leave will be granted for specified relevant courses only and must be applied for well in advance. You should bring evidence of having enrolled on the course before study leave is granted.

A study leave form must be completed and this must be authorised by your clinical supervisor.

Please complete study leave formalities with the responsible member of the admin team.

SICK LEAVE

If you were to fall sick at short notice, please let the surgery know as soon as possible so that they may be able to re-arrange any appointments booked for you. Its good practice to  keep in touch with the responsible admin team member regularly to know your likely return date so that you can be reinstated on the rota.

CONTACTS

You will get a booklet with useful contact numbers and addresses both internal extensions and important external numbers. You should keep your clinical supervisors mobile number and the contact number for the practice manager and your responsible staff member at all times. Don't hesitate to contact them at any time during normal working hours and in emergencies they will be happy to help you even outside working hours.