Hospital Posts on the Bradford Scheme

1. Hospital Posts on the Bradford Scheme how to make the most of them

2. Hospital Posts You will gain useful clinical knowledge But how else can you make your experience useful for your future in GP? What could you reflect on and put in your eportfolio?

3. Generic Aspects of Hospital Practice Useful for your Future as a GP Medical teamwork Safe prescribing Multidisciplinary teamwork Communication skills How families behave Significant event analysis Ethical issues The hospital-GP interface

4. Medical Teamwork Support for colleagues Allocation of work Effective handoverof important information – essential in hospital shift system, especially useful in GP if you work LTFT

5. Safe Prescribing Hospital ‘zero tolerance’ policy for prescribing in allergic patients Easier in GP when prescribing on computer Sounds obvious but - look it up if its an unfamiliar drug Be extra careful when prescribing for children

6. Multidisciplinary Teamwork Understand the roles of team members Especially other health professionals Respect their skills and contribution to patient care Ensure effective communication with other team members

7. Communication Skills With patients With relatives With colleagues With other team member Record keeping

8. How Families Behave Many family interactions visible in hospital specialties especially A&E, Paediatrics, Medicine for the Elderly and Palliative Care In GP family are generally in the background – but in hospital they’re often there for you to observe Exceptions in GP – patients with dementia, children

9. Significant Event Analysis Looking at what’s happened when something went wrong or nearly did so Looking at the feelings of everyone involved Reviewing the organisational systems involved Working out how to prevent a recurrence

10. Ethical Issues Capacity to consent Informed consent Confidentiality End of life issues Reproductive health issues (in O&G) Take responsibility – if you have misgivings about a practice, even if it is well established, talk to your supervisor or TPD advisor

11. The GP-Secondary Care Interface Understanding what secondary care has to offer Communication between GPs and hospital doctors Understanding referral pathways, and what you’ll be referring patients for, when you’re a GP

12. What Previous Registrars Say “It's important to realise, even though you’re doing a hospital rotation, you really need to get out what GP's actually need to know” “For instance, in Obs and Gynae instead of being in theatres a lot, spend more times in Gynae outpatient clinics - see what GPs refer, learn acute assessments in MAC, learn how to insert a speculum etc"

13. What Previous Registrars Say • “HDR attendance - whilst in hospital it is possible if you really try and registrars have managed to attend a good number even when doing A&E and Medicine” • “Try and sit in on lots of outpatient clinics” • “Get all your DOPs done before finishing hospital posts (much easier getting a reg in A&E watching you do a PR then trying to do it in GP-land)”

14. What Previous Registrars Say “In A&E - spend as much times as possible in minors” “In Paeds - take heart that PAR is really useful for seeing lots of sick kids as you rarely see any in GP-land” “In Gynae - do lots of clinics and get good at gynae examinations.”

15. And Finally . . . If you haven’t already – become a member of the BMA while in training Employment issues – holidays, maternity pay etc – can be a minefield so worth having proper representation Good luck and keep up the good work!