Becoming a GP trainer

Training is a group effort that requires hard work, preparation and trust, writes Dr Prashini Naidoo.

Training requires a committed practice with an adequate, but not onerous workload (Photograph: SPL)
Training requires a committed practice with an adequate, but not onerous workload (Photograph: SPL)

An interested GP principal, having taken a few years to establish him or herself in general practice, may consider vocational training as a new challenge.

Alternatively, the established trainer in the practice may look at delegating training to a new pair of hands.

Being a part-time principal need not be a bar to training. Usually the minimal requirement is for four sessions of general practice per week.

The website of the local deanery should be able to provide details of what is required in order to become an accredited GP trainer. In some areas, there are several paths to becoming a trainer and it is a matter of selecting a preferred route, after initial discussions with the deanery.

A few essential ingredients are required to produce a GP trainer:
  • A GP with at least two years' experience
  • An interested and committed practice
  • An associate director of primary care education
  • An approval visit
  • A successful approval report

Training courses
Some potential trainers opt for residential courses, with a format of large and small group teaching, facilitated by experienced educationalists. A written assignment is usually required a few weeks after the residential course.

Others prefer tackling the gentle hills of a postgraduate certificate in education. Most of the distance-learning modules require written assignments, though some require at least a few days of attendance at a university.

A few potential trainers take an MSc in Educational Theory and Practice. The modular MSc tends to cover the same ground as the postgraduate diploma, topped off with a dissertation, usually 20,000 words in length.

It is best to choose a route that you will find interesting, that is compatible with your learning style, and that you can successfully complete within your time constraints. On completion of the course, you should be familiar with the educational aims of vocational training and the various methods of teaching and assessment.

The practice needs to be committed to training. If other members of staff do not support the idea, the potential trainer should carefully re-evaluate his or her decision to take on training. This is sensible as the entire practice is usually involved in training and the trainee's presence invariably impacts on everybody in the team.

While the trainer holds responsibility for the training program, teaching is often delegated to subject matter experts. The practice nurses tends to teach smears, the GPSI in family planning teaches contraception and the practice manager often leads on business and employment issues.

The office manager or senior receptionist usually instructs the trainee on how to use the computer system and is often asked to input data, such as patient satisfaction scores onto the e-portfolio for the trainee.

GP trainees are expected to attend primary healthcare team meetings, educational meetings, and partnership meetings, which gives them access to the practice's financial and employment information.

The practice visit
On successful completion of the 'Becoming a GP trainer' course, the potential trainer submits a written application, downloadable from the deanery website, to the local associate director who convenes a panel and arranges a practice visit. It is not only the potential trainer that is inspected; the practice is also checked for its standards of patient care, evidenced by its QOF scores, audit program and percentage of summarised notes.

Service commitment
During the practice visit, the inspection team try to determine the balance of service commitment to training opportunity available at the practice. The practice needs a large enough list size and workload to offer the learner adequate clinical experience.

However, if workload is too high it would be difficult to make time available for mandatory tutorials, vocational training programs and GP trainer groups. The GP trainer is expected to attend GP trainers' groups, which provide ongoing support and peer education.

The trainee usually has 15 days per six months for study leave, including attendance at day-release courses. However, with 'Consultation Skills Assessment', a mandatory examination for all GP trainees, most trainers run regular, often weekly, joint surgeries with trainees. In joint surgeries, consultations are taken in turn.

The trainee observes an experienced consulter and the trainer assesses the trainee's consultation and records it as a consultation observation tool on the e-portfolio.

These clinics tend to be booked at slightly longer consultation times, usually 15 or 20 minutes. Hence, the number of appointments the practice is able to offer its patients is affected by the time devoted to training.

The trainee is expected to have a well-equipped consulting room, preferably of his or her own. The practice is expected to provide equipment so the trainee can consult effectively in the surgery and on home visits.

The associate director's report to the deanery also comments on patient involvement, quality improvement, records, registers, IT, management and premises. A successful practice is one that is well organised, able to provide opportunities for learning, demonstrates appropriate values such as cohesive team working, staff development through appraisal and continuing professional development.

If you and your practice are committed, training usually is a rewarding experience.

  • Dr Naidoo is a GP trainer in Oxford

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