GP-based Training
Except in very exceptional circumstances your ST3 year will be spent in one general practice. One GP will be named as your trainer and they will also act as your educational supervisor throughout your training. You will normally know who this person and this practice is from the start of your training programme which will enable you to build up a rapport before you start at the practice.These GPs and their surgeries have gone through a rigorous training and quality assurance process prior to being awarded Trainer status (and training practice status) by the Oxford deanery. We would encourage you to make use of all members of your team and enjoy the contributions from the entire practice team, including practice manager, administrative staff and allied health care professionals. Occasionally there may be a need to change your trainer or training practice due to extenuating circumstances.
The normal working week in General Practice training is ten sessions. You should be released for Tuesday day release teaching and deanery courses, however on Tuesdays where there is no teaching you will be expected to work normal surgery hours in your practice.
GP Principals and Registrars used to take a half day from the working week to compensate them for regular unsociable out of hours work. Now that GP Specialty Registrars work only the equivalent of one session out of hours per month the half day is no longer applicable.
The GPC and COGPED have recommended that the standard GP specialty registrar working week will be divided into seven clinical sessions, and three educational sessions. The educational sessions comprise 2 sessions usually spent at Tuesday day release and 1 session with your trainer, usually in the format of a tutorial. A session has been defined as a 4hr block by the BMA GP trainee subcommittee, endorsed by COGPED.
Clinical sessions will include:
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Supervised/supported consulting time, with appointments at a maximum of every 10 minutes for face to face consultations.
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Supervised/supported home visits, nursing home visits, rounds, undertakers visits for the purposes of death administration.
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Administrative work to include: pathology results, letters, reports (for educational purposes only), general administration.
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Time spent with other members of the practice and/or healthcare team for the purposes of care and learning - e.g., practice nurses, diabetic nurses, chronic obstructive pulmonary disease (COPD) nurses, research nurses, midwives, counsellors, OT, physiotherapists, receptionists, ambulance crews, triage nurses, GPwSIs, alternative and complementary therapists, undertakers
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Time spent in specialist clinics e.g. wart clinics, joint injection clinics, family planning clinics
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Time spent in directly supervised surgery as part of consultation observation tests (COTS), direct observation of procedure skills (DOPS)
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Time spent videoing consultations as part of consultation skills training
Non clinical sessions may include:
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Independent study/revision
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Tutorials with GP supervisors
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A Training Programme session
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Administration for the purposes of audit/research in general practice
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Videotape, COT, DOPS analysis as part of educational furtherance
Case based discussions selected from outside the debrief time Sessions need not be completed all in one go, but may be broken down appropriately throughout the week, for example, you may have 1 session used by 3x1 hour tutorials, and 1 hour looking/analysing videotapes or COTs. Similarly, a session during the week may consist of a 2.5 hour clinical surgery, a 30 minute debrief and a home vist. You should expect to undertake approximately 1 hour of admin time per 3 hour of clinical time.
As part of your training you can undertake a clinical session within extended hours – if available. Extended hours are not offered by all local surgeries. These sessions usually happen on certain weekdays in the evening and/or on Saturday mornings. If you work one if these session you must of course be supervised and supported in the same way you would be during core opening hours. The clinical session undertaken in extended hours would replace a clinical session undertaken in core hours. It is important to ensure that the structure of the working (and teaching) week remains compliant with Working Time Directive regulations. The clinical session undertaken during extended opening hours does not count towards the required number of Out Of Hours sessions. The number of clinical sessions undertaken in extended hours by a GPStR should not exceed the number undertaken by a partner within the practice.