Training Year - Start your training on the right foot

Those starting their GP registrar year in February can expect hard work and enjoyment.

Starting a new job always produces mixed feelings, and your GP registrar position will be no different. It is pleasant to contemplate a whole year in the same job after the usual round of six-month posts, but there are lots of anxieties too, such as working independently, home visiting and the distant prospect of an exam at the end of it all. It can all seem a bit daunting. Conversely, most doctors rate their training year as their most enjoyable. So how do you get going with this mammoth task?

Step-by-step plan

Planning is important, but begin with easy steps. You have your trainer at your disposal, whose main aim is to help you have a successful year.

You should have been in touch a few times already, visited the practice, and have a rough idea of how things work.

The training year is structured, and you will have an introductory programme covering essentials such as tutorial times and topics, sessions for sitting in with doctors and other practice staff. After a week or two you will start your own surgeries. You will find that you are always trailing round after someone in the early stages. Use these contacts to find out as much as you can about the way the practice works. This, plus early location of the coffee room, fire exits and toilets, will help you get off to a good start.

Establish good relations with staff

The practice manager is an important person to impress. A friendly and organised approach is preferred and an appreciation of his or her role will give you an invaluable ally for the year, both in the training sessions, which you will undertake together, and in helping you with the non-clinical aspects of your work.

You will have sessional attachments to the community nurses, practice nurses, health visitors and reception/administration. You may be given a list of learning objectives for these, but use these as a basis only.

Speak to the staff in advance to ascertain what they think you should learn.

At the reception desk, dealing with aggressive patients is an art that most receptionists are unfortunately required to learn. You will not have the chance to acquire all this knowledge first hand again so try to make the most of every opportunity. At this stage, it is also useful to discuss which tasks you can and cannot delegate to practice staff.

Learn through observation

Your initial tutorials will be on 'nuts and bolts' topics such as writing prescriptions, using the computer and on the consultation itself. Read what you can on these topics. There are several good websites, particularly on consultation theory.

Practical aspects can be picked up when sitting in with other doctors.

Try to look at different styles, how the doctor greets the patient, and why some consultations work better than others. Take notes for discussion later. Appreciation of how others work will help you develop your own style in due course.

You will also discuss your own learning needs with your trainer. At first these are quite general - you may not have much experience in a large area such as mental health, but you will uncover more specific areas for discussion when you start consulting yourself. There are again several useful websites available, but case discussion after surgery time is also rewarding.

As you are starting in February, you may find that you are out of step with the majority of the other registrars in your group, who tend to be August starters. Unfortunately for you, the day-release courses tend to be based around this majority. The best solution is to find others in the same situation for support and study.

Learn the computer system

Computer literacy is essential in general practice nowadays, but not usually a problem for most registrars and you will have some help in learning to use your practice's system. There are several packages, some better than others. Your practice may not use paper records which will require a honing of your keyboard skills.

You also need to make sure you understand how to deal with repeat prescriptions, abnormal lab results and incoming mail, most of which will initially belong to the previous registrar. Fortunately, your administrative workload is likely to be much less than the partners' workload.

Remember, your training year is meant to be enjoyable as well as hard work, so get to know your colleagues, have fun and get integrated into the practice team because you will not get this chance again.

- Dr Glenesk is a GP in Aberdeen and a summative assessment examiner

LEARNING POINTS

How to secure success in your training year

- The training year is initially structured and you will have an introductory programme covering essentials such as tutorial times and topics, sessions for sitting in with doctors and other practice staff.

You will have sessional attachments to the community nurses, practice nurses, health visitors and reception/administration staff.

Establish a good relationship with the practice manager.

A friendly, eager-to-learn and organised approach is generally preferred.

Practical aspects of the consultation process can be picked up when sitting in with other doctors. Appreciation of how others work will help you develop your own style in due course.

Computer literacy is essential and you will have some help in learning to use your practice's system.

Your training year is meant to be enjoyable and also hard work, so get to know your colleagues, have fun and get integrated into the practice team.

RESOURCES

www.gp-training.net; www.skillscascade.com; www.prodigy.nhs.uk; www.gpnotebook.co.uk.

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