ST3 Introduction

1. ST3 Introduction Programme Directors: Dr Christine Marshall Dr Richard de Ferrars [Dr Andrew Cochrane] Introduces self Clarifies roles

2. Name the Musical and Song… Greets patient Demonstrates interest & respect

3. Daft Diversion... Watch the bottom right... Meaning and relevance to follow Greets patient Demonstrates interest & respect

4. What Would YOU Like To Know About? We have several areas to run through but what is on your mind? Opening question Identifies the reason for the consultation Agenda setting

5. ST3 Introduction • Enhanced ST3 • MRCGP Exam Overview • Year Planning • KSS Policies • Overview of the VTS • E-Portfolio & Learning Log • OOH Training • Local Training Agreement. Provides structure to the consultation Sequencing

6. ST3 Representative • Bindu Babu • Deputy please? • VTS Rep at KSS Trainee’s Committee. Encourages the patient to contribute

7. Enhanced ST3 • First real step towards ST4 • Additional 3 months as ST3 • Closing date – 1st September… • Must have passed AKT with over 70% • Must undertake CSA early (Nov/ Dec) • Develop further skills • CCG work • Stage 1 Educators Pathway. Sequencing Timing

8. MRCGP Overview Provides Rationale

9. AKT Hurrah - Vast majority have negotiated this challenge Remainder - do take it in October - keeps rest of year free for CSA Failed twice before? Time pressures? If you had problems with written exams at medical school, consider a dyslexia assessment Costs about £300 Gain additional time in exam (30 or 45min). Sharing of thought

10. CSA – Lots of Choice! Now held monthly from October to May KSS and VTS set a pace aimed at Jan / Feb / Mar - November: Cumberland Lodge - December: KSS day at the RCGP exam centre - January: Thursday pm sessions Enhanced ST3 – need to work ahead of the pace. Provides rationale Examination

11. CSA – Lots of Choice! Nov/ Dec - this is early, risk wasting £1700 (and one of your 4 attempts) - needed by some (maternity, enhanced ST3) Jan/ Mar - Makes sense for most - Allows Apr/ May re-sit without extension May - Will need extension to re-sit VTS teaching is aimed at January - March date Take your trainer’s advice!. Offers choice

12. WPBA Assessments Portfolio close will be end of May • Get ES review 1 done by mid January Half the assessments before review 1 • Get ES review 2 done by mid May Half the assessments before review 2 Full year = CBD x12 COT x12 (some kept on video please) MSF x2 (Need 10 back: 5 clinical, 5 non-clinical) PSQ x1 (Feb/ March/ April) DOPS – each at least 1 satisfactory. Clarification

13. Planning the Year The tube map - looks complex at first glance but is very useful….. Uses visual methods of conveying information

14. VTS Website – ST3 MRCGP Page

15. MRCGP Summary AKT - well done if passed in ST2 - others, please take in October CSA - Nov & Dec for some - Jan Feb Mar for most WPBA - use the planner and keep to speed. Chunks & checks Uses repitition & summary Offers choices

16. KSS Policies & Plans • Chaperone policy • Dress code • Car allowance • Language workshops Contracting

17. Chaperone Policy Sensitivity Assesses patient’s starting point Encourages patient to contribute

18. KSS Policies & Plans • Chaperone policy • Dress code • Car allowance • Mileage for home visits, travel to teaching • Up to 20 miles to & from home when NEED car… • NEED car if you do a visit or travel to teaching… • Language workshops • English NOT 1st language • Saturdays (two) in October. Contracting

19. VTS Overview Much mystery surrounds the activities of the GP trainees on Thursday afternoons….. Elicits patient’s health beliefs

20. VTS Overview How can we all get the most out of the VTS? • Time-keeping • Participation • Cumberland Lodge Cumberland Lodge dates: November 19 - 20 March June Ideas & concerns

21. The Learning Log/ PDP Shares own thoughts Picks up verbal & non-verbal cues

22. Categories of Log Entries How should Trainees use the learning log? 1) Simple list of useful information from teaching: CURB scoring Causes of amenorrhoea 2) Recording of a “required event” Audit project Child protection Statement of Leave OOH session Leadership CPR/ AED 3) Genuine educational activity Tutorials, VTS sessions Interesting cases, followed by reading up 4) “Domains of competence” event Reflection from a competency, not a clinical, perspective Organises explanation

23. Categories of Log Entries How should Trainees use the learning log? 1) Simple list of useful information from teaching: OK to record but don’t bother sharing (unless you want to see how sarcastic your ES can be) 2) Recording of a “required event” As and when appropriate Do count towards 2-per-week target 3) Genuine educational activity Tutorials, VTS sessions, interesting cases & reading No more than 1-per-week about a teaching session 4) “Domains of competence” event Reflection from a competency, not a clinical, perspective Superb for ES Reviews – try and write 2-3 per month

24. Required/ Mandatory Events Level 3 Child Protection VTS session, e-modules if on leave ST3 GP Audit One 8-stage audit cycle – see website Leadership event See VTS website for options Form to complete is on KSS website CPR/ AED certificate Usually done in term 3 Two Significant Events [Complaints], near misses, cancer diagnoses All of these MUST be shared. Uses explicit categorisation

25. Audit & Leadership • Move away from 8-point audit • Move towards CCG project work (QIP) • Mandatory move if doing enhanced ST3 • Optional for others: • Hampshire CCG (Drs Peter Bibawy & Jane Elliott) • Making use of ‘Private Study’ session • 2-3 sessions earlier part of the year • 6-8-10 sessions later in the year (post CSA) • Interested?. Offers choices

26. E-Portfolio Non-verbal behaviour

27. Out-of-Hours 25% pay supplement £50 supervision fee • You all hate it • Hard work for supervisors • Look at the VTS website 72 hours is mandatory (may increase) Good preparation for CSA so NO GAPS PLEASE Log-entry at end of each shift OOH sheet from supervisor IF NOT YOUR TRAINER Ask your supervisor to work through the FPCS Induction Forms with you – on the VTS website PROFESSIONALISM Booked shift = be there (unless you have died) Empathy & support

28. Out-of-Hours Traffic Light – PLEASE DISCUSS WITH YOUR ES • Red = ST1/2 (observe only) • Amber = first few ST3 months. Avoid phone triage until after training Can see patients at base from the start Supervisor can go on a visit with you If left at base, must have phone or alternative • Green = last 3-4-5 shifts Can do anything including solo visits Supervisor could be by phone. Empathy & support

29. Local Trainers Agreement Use of notes

30. Daft Diversion... Any answers? Greets patient Demonstrates interest & respect

31. Daft Diversion... Calgary-Cambridge consultation model Doctor-patient relationship and patient-centred consulting Does NOT mean doing what the patient wants Facilitating them to reach agreement on what is best for them Trainer-trainee relationship and adult learning Does NOT mean doing what the trainee wants Facilitating them to reach agreement on what is best for them.

32. Trainer-Trainee Relationship Consider the analogy to the doctor-patient relationship? Develop relationship & rapport – chat time! What can go wrong at the start? What happens over time? What happens when patients disagree?

33. Local Trainers Agreement • The Working Week • Annual Leave • VTS & Educational Activities • Study Leave • Private Study (Flexible Education Session) • Out-of-Hours Training • Read through NOW. Any questions? Checks patient’s understanding of information

34. ST3 Introduction Enhanced ST3 MRCGP Exam Overview Year Planning Chaperones Overview of the VTS E-Portfolio& Learning Log OOH Training Local Training Agreement Checks with patient End summary

35. The End Safety netting Final checking