Transcript Time Out Of Programme

London School
General Practice
Time Out Of
Programme
Dr Patrick Kiernan
Programme Director
2014
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Context
• Crisp Report mutual benefit /meet needs
sustainability
• Gold Guide recommendations
• BMA Broadening your Horizons
• NHS Medical Careers website – Volunteering
• Academy of Medical Royal Colleges - Statement
• All Party Parliamentary Gp on Global Health -Report
• RCGP and GP Schools support - Global Health
• Requests from GP Trainees
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Evidence
• Hollister C. OOPE in developing world: how does it
benefit GP training? Educn. for Primary Care (2012)
• Franey et al. The postcode lottery of GP training:
Time Out of Programme. BJGP (2013)
• Manir S. International OOPE: is it worthwhile?.Educn.
For Primary Care (2013)
• Kiernan P et al. Evaluation of skills of GP Trainees
returning from OOP. Educn. for Primary Care
(2014)25:12-17
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Evaluation of effect on skills of GP Trainees taking OOP in
developing countries . Kiernan P. O’Dempsey et al.
Method. Interview GP trainee and trainer. Evaluate impact on clinical skills,
decision making, management and leadership skills
Results. Reported increase in a range of skill levels in above areas of the
RCGP Competency Framework . Exposure to greater clinical practice.
Increased confidence in UK practice.
Discussion. Evidence if GP trainees work in poorly resourced and challenging
overseas environments then potential to:
• enhance skills and competencies beneficial and transferable to the NHS
and difficult to achieve within a thee year programme,
• provide a de facto 4th year of training
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Types
• Time out of programme clinical experience
(OOPE)
• Time out of programme for clinical training
which has approval from GMC (OOPT)
• Time out of programme for research (OOPR)
• Time out of programme career break (OOPC)
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Why do OOP
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Understanding Global health
Enhance competencies and skills
Training post on return
Equip GP trainees for future leadership roles
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Benefits to the doctor
“Hard Skills”
Clinical
Resource
management
Global Health/
Organisational
Doctor
Communication
Language
Teaching
Leadership
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Benefits to the doctor
“Less tangible skills”
Flexibility
Independence
Confidence
Doctor
Problem
solving
Resourcefulness
Ethical
dilemmas
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Benefits host community
• Generalist - PHC
• Chronic disease management
• Service developments - ment hlth/pall care
• Teaching and training
• Audit
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Trainee barriers to involvement
• Increased uncertainty and commitment
• Reduced remuneration
• Personal/Partner/Family responsibilities
• Personal safety
• Lack of continuum in combining GP career
with development work
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Establishment barriers to involvement
• Not promoted
• Organisational complexity
• Disruptive
• Value importance of OOP
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London GP School Role
• Publish and Promote OOP – ST1
• Supportive
• Guidelines reviewed regularly
• Process applications - efficiently – consistency
• Security of returners jobs
• Evaluation
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Guidelines
• Between ST2/3 or 3/4
• One year posts - relevant experience –
mutual benefit - avoid “medical tourism”
• Support trainees self construct posts
• Support applications with p/t
studies/qualification/research integrated
in OOP
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Organisation
• Website - past trainees/jd/ evaluation/podcast
• South Africa and Zambia and India
• In-country Partner agencies
• Quality management of posts
• Funding
• Recruit early/application process/selection
• Preparation and induction – other trainees
• WPBA /Supervision – de facto 4th year
• Debriefing
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St Francis’ Katete
Zambia
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UK Promotion
NHS Scotland
Yorkshire and Humber
East Midlands
East of England
London
Severn and South West
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Education and Training
• Pre arrival induction
• Arrival - partner agency
• In hospital - clinical supervisor
• In country - partner agency
• E portfolio - educational supervisor
• Debriefing - educational supervisor
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Trainee Comments
 “Got to do far more than any of peers at stage in training.
Learnt a lot about acute medical skills which may have taken a
couple of years of general medicine in UK”
 “Start to learn to be proactive because problem solving and
taking initiative all the time ”
Trainer comments
 “Always seems confident because has had to stand on own
two feet during placement overseas “
 “Good at integrating information and seeing overall picture.
At meetings is able to provide good suggestions for service
improvements more than would expect of GP trainee”
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Key Points
• Window of opportunity for GP Trainees
• Inequalities of access to OOP
• Promote OOP across all LETB with named lead
• Standardise process and quality management
• Improve pre-OOP induction and training
modules
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Key points
• UK Training programmes with global health –
- diploma -South West
• Collaboration with RCGP Int Ctte
• Repository of quality assured posts –
continuity - LETB/Royal Colleges/THET
• Evaluation sustainability capacity building
• Share best practice across different specialities
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