Becoming a GP trainer

Becoming a training practice will often improve standards in the surgery, writes Dr Linda Miller.

A GP trainer should be able to give feedback in a supportive and non-judgmental way (Photograph: Alexander Raths)
A GP trainer should be able to give feedback in a supportive and non-judgmental way (Photograph: Alexander Raths)

A GP trainer supervises a trainee during their time in practice. This includes inducting the trainee, debriefing after consultations and tutorials.

The trainee will spend time with other members of the practice team but the trainer will have the overall responsibility for ensuring that the trainee gains the broad experience necessary to become a GP and to pass the MRCGP exam.

Weekly half-day release sessions organised by the local programme directors cover other aspects of the curriculum. These may follow a pre-planned programme of group work and external speakers or may evolve in a learner-centred manner.1

Pastoral role
As well as providing educational support, the trainer should be able to support the trainee when unexpected events arise in a trainee's personal life.

Bereavement or becoming a parent for the first time may well coincide with GP training and the trainer should be able to provide a pastoral role.

The trainer also acts as a role model for the trainee. This involves encouraging appropriate communication with colleagues in secondary and primary care, change management, delegation and team leadership skills.

The trainer encourages reflection and self-directed learning. They help with writing a personal development plan, recording significant events and identifying a patient's unmet needs (PUNs) and the doctor's educational needs (DUNs).

Trainers should also encourage habitually using online resources to expand knowledge. Encouraging trainees to do audits and seek feedback from patients and colleagues will prepare them for appraisal and revalidation.

The skills required
When I asked some experienced GPs what skills they valued in their trainer, many felt that being approachable was essential. One GP recalled that her GP training was the first time in her career that she did not feel overburdened with work. The gradual transition from 30-minute to standard 10-minute consultations was vital.

The ability to give feedback in a supportive, non-judgmental way is essential. Being encouraging and positive about a trainee's skills and development is important in boosting confidence and self-esteem. A trainee needs to be resourceful and a good team worker but able to safety net and ask for advice when uncertain.

Recognising your limitations is one of the most important skills for a doctor, and a trainer needs to be sure that their trainee does not view this as failure. It is equally important that they are not over confident about their own diagnostic abilities.

Many GPs recall the wisdom of their trainer and valued being encouraged to find their own answers rather than being told how to do things in a didactic manner.

Many have fond memories of their trainer and memorable incidents that arose during their training. A sense of humour is a valuable asset for a trainer.

Applying
The first step to applying is to check your local deanery website and find out about the local training course. You may also find it helpful to talk to some trainers to get an understanding of what is involved. You should also talk to your colleagues in your practice. The criteria to become a training practice are rigorous and the whole practice team needs to consider the implications and benefits.

The training for trainers varies widely in duration and content across the UK and is not standardised. One example of the training available is the London teaching the teachers (TTT) course at the University of Westminster which is very popular and oversubscribed. Applicants must have the MRCGP and either have taken the London deanery introduction to teaching in primary care course or attended an open evening at the university. The open evening is an opportunity for course organisers to assess candidates' aptitude for small group work.

Course days are once a month and consist of group work to encourage networking, teaching practice, observation and feedback. The course is designed to model teaching strategies and provides an understanding of educational theory. Course materials are comprehensive, and include a large resource folder of literature to read. Assessment involves two formative essays, three summative assignments and a 20-minute small group teaching assignment.

TTT students develop small group facilitation skills using material from practice, role play or DVDs. Tutors give detailed and individual feedback. TTT is a good grounding for any GP with an interest in teaching whether it be undergraduate, postgraduate or as a trainer.

Once qualified as a GP trainer, you should attend regular trainers' workshops and away days in your local area. These are a great opportunity to share experiences with other trainers and continue personal development as a trainer.

There are many benefits to becoming a training practice. Not only does it add kudos to the practice, it may even improve standards. Teaching makes individuals more reflective about their own work, adds enjoyment and reduces the risk of 'burnout'.

  • Dr Miller is a GP trainer in west London

Reflect on this article and add notes to your CPD Organiser on MIMS Learning

CPD IMPACT: Earn More Credits

These further action points may allow you to earn more credits by increasing the time spent and the impact achieved.

  • Write a list of the skills required to be a GP trainer. Consider whether you have the necessary skills required and ask for feedback from colleagues.
  • Hold a practice meeting to discuss the merits of becoming a training practice. Think carefully about the advantages and disadvantages.
  • Find out about the local trainers group andask to attend a meeting. Aim to get a sense of the responsibility involved by discussing this with some trainers.

References
1. Awan T. Structured, curriculum-based group teaching or unstructured, learner-centered group approaches? Educ Prim Care 2009; 20 (6): 462-7

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