Transcript Planning your Registrar year

Planning your Registrar Year
Louise Willcocks
Swindon/Bath GP Registrar DRC
March 2007
AIMS
• Starting out
• Exams
• Certification and paperwork
• Top Tips
Starting out
• EMIS
• A-Z map for home visits.
• Doctor’s bag and stuff
• Remembering everyone’s names.
• Who/what/ how and when to refer?
• Half day for study (shopping).
• DRC once a week.
• No weekends
• No nights/evenings
• No bleeps
The Year
• Goes really fast
Exams – Summative Assessment
• COGPED MCQ
• Video
• Audit
• Trainer’s report
• CPR certificate
COGPED MCQ
• May 2007.
• Free
• Can resit up to 5 times
• 3 hrs long
• Quite random questions e.g. DVLA/sick
certs/fitness to fly/dandruff.
• Don’t read into questions too much.
COGPED MCQ
• If you pass the MRCGP MCQ automatically
pass the summative.
• Questions are of a different standard in
the two exams.
• Final COGPED MCQ is May 07. If you failwhich you won’t- will do AKT.
VIDEO
• Can submit to SA or “single route” for
MRCGP.
• Criteria for SA and MRCGP different. NOSA
and RCGP websites give information on
this.
• 2 hours long. No consultation longer than
20 mins.
“Single Route” Video
• Logbook on RCGP website.
• 7 consultations, at least 1 child under 10
yrs and one psychosocial.
• 15 mins maximum for each consultation.
• Judged by 14 criteria (10 pass and 4
merit). Need 4/7 for each pass criteria to
pass.
• Need to send logbook with video
• Need to keep consent forms and all
patients must be consented.
COGPED video route not available from
August 2007. ?Submit videos Oct 2007.
Tips for video
• Start early on
• The more you do the easier it gets.
• You can have a printout of the MRCGP criteria
•
•
in front of you as long as not in camera shot.
Check sound quality, position of camera,
date/time on tape recording.
Make sure patients not exposed on camera.
Audit
• Keep it simple
• Start asap
• Discuss with Trainer/practice/colleagues
for ideas.
• Relate to recent guideline
changes/QOF/hot topics.
Audit
• Tips on Bath web site.
• 8 proforma
• 3000 words double spaced and
anonymised.
• Send 3 copies and keep one for yourself.
Trainer’s report.
• Do as you go along
• Familarise yourself with it. Generally
trainer fills it in.
• Send it into deanery approx 6 weeks
before reg year finishes with VTR1.
Exams- MRCGP
• MCQ
• Written paper
• Video
• Oral
Each module costs ₤340. Closing date for
applications 9/2/07.
Syllabus available on RCGP website which is
invaluable.
For MCQ preparation PEP CD’S and
onexamination.com are fantastic
resources.
Courses like hot topics and revision course
(Portsmouth or Taunton.)
Study Group
• Essential preparation for written paper.
• Past papers on line RCGP website.
• Look at past examiners comments. If
question done badly topic may come up
again.
Good gossip session.
Food and wine essential!
Exams- nMRCGP
From August 2007 single training route
and new assessment process.
• AKT- applied knowledge test
• CSA- clinical skills assessment
• Enhanced trainer’s report
AKT
• 200 questions
• Machine marked
• Extended matching questions and single
best answers.
• 3 times a year Feb/May/Oct
CSA
• OSCE format
• Assesses clinical, professional,
communication and practical skills.
• ? To be held 3 times a year.
Enhanced Trainer’s report
• Similar to current Trainer’s report but more
in depth.
• Requires evidence as proof of reaching a
certain standard.
Out of Hours
• Minimum 72 hours.
• Log book to be completed
• Should be supervised.
• Shifts short 3-5 hrs so start soon.
• Variety of shifts weekends/evenings, base
or visiting.
• Often good fun
• Might want to do more of it when you
finish GPR year.
• Log book doesn’t need to be sent
anywhere.
• Keep a log of interesting patients for PDP.
Certification and paperwork
• Join RCGP costs ₤350 in order to complete
CCT.
• Submit your VTR2 forms once you have
done this to RCGP certification unit. Make
sure all the dates are correct, stamped
and filled in correctly. They will get sent
back if not.
• Do this as soon as possible. Dull but
essential and will save lots of hassle later.
• Then known as an associate member and
in theory get BJGP.
• Before the end of the job need to register
with PMETB.
• Submit VTR1 form with ₤500 and should
then receive CCT. Can’t do this till 6 weeks
prior to finishing.
• Look at NOSA website and RCGP for
guidelines and application forms.
Top Tips
• PDP keep a record of your tutorial topics,
list of education meetings, interesting
patients, referrals e.t.c. Do as you go
along, it’ll be a lot less tedious and easier
in the long run.
• Keep electronically or paper.
Journals
• BMJ
• BJGP
• Pulse/Doctor/GP
• BMJ careers
• Internet up dates e.g. doctors.net
Courses
• Exam related- revision courses
• Hot Topics
• Others- DFFP, DRCOG. Minor surgery.
No study budget so can get expensive.
Contacts
• Summative assessment
– http://www.nosa.org.uk
–
Moira Linden; 01962 893 813
– [email protected]
• RCGP certification
– 020 7930 7228
– [email protected]
• PMETB
– 0871 220 3070
– [email protected]
– [email protected]
• HOT Topics course
– 0191 489 0555
– www.nbmedical.co.uk
• MRCGP course
–
Carol White; 01264 355 005
– [email protected]
Audit criteria
1.Reason for choice of audit
Potential for change
Relevant to the practice
2.Criterion/Criteria Chosen
Relevant to audit subject and justifiable, eg. Current literature
3.Standards set
Targets towards a standard with a suitable timescale
4.Preparation and Planning
Evidence of teamwork and adequate discussion where appropriate
5.Data Collection (1)
Results compared against standard
6.Change(s) to be evaluated
Actual example described
7.Data Collection (2)
Comparison with Data collection (1) and standard
8.Conclusions
Summary of main issues learned
Video criteria
PC1 the doctor is seen to encourage the patient's contribution at appropriate points in the consultation
PC2 (M) the doctor is seen to respond to signals (cues) that lead to a deeper
understanding of the problem
PC3 the doctor uses appropriate psychological and social information to place the complaint(s) in
context
PC4 the doctor explores the patient's health understanding
PC5 the doctor obtains sufficient information to include or exclude likely relevant significant conditions
PC6 the physical/mental examination chosen is likely to confirm or disprove hypotheses that could
reasonably have been formed OR is designed to address a patient's concern
PC7 the doctor appears to make a clinically appropriate working diagnosis
PC8 the doctor explains the problem or diagnosis in appropriate language
PC9 (M) the doctor's explanation incorporates some or all of the patient's health beliefs
PC10 (M) the doctor specifically seeks to confirm the patient's understanding of the
diagnosis
PC11
the management plan (including any prescription) is appropriate for the working
diagnosis, reflecting a good understanding of modern accepted medical practice
PC12
the patient is given the opportunity to be involved in significant management decisions
PC13 (M) the doctor takes steps to enhance concordance, by exploring and responding to
the patient’s understanding of the treatment
PC14
the doctor specifies the appropriate conditions and interval for follow-up or review
Constructs
Clinical
Patient
Self-management
Agenda
Decision Aids
Benefits
Education
Death & Driving
Support Groups
Ideas, concerns & expectation
Transcultural
Doctor
Risk management
Up to date
DEN’s
Evidence-based
Confidentiality/Consent
Health promotion
Open questions
Prejudice
Prescribing
Empathy
Record-keeping/Referrals
Practice
Protocol
Register
Audit
Change management
Training
IT
Contract/clinics
Ease
Wider
Goldberg & Huxley’s filters to care
Rationing
Inverse care law
Medicilisation
Screening
Health
Inequalities
Teamwork
Ethical
Consultation
Prescribing
Any Questions?