Becoming a GP trainer requires a delicate balancing act of continuing to provide a service to your patients and being a teacher.
One of the great joys of being a GP trainer is seeing a new doctor develop and gain confidence in the community, an environment so different from working in a hospital.
This is not just about learning how to manage conditions such as chickenpox or fungal nail infections, which a GP in training is unlikely to have seen before, but more than that, it involves dealing with uncertainty and seeing patients present with undifferentiated illness.
|How to succeed as a GP trainer|
Involve the team
It is important to have the whole team on board with training, as it will involve many changes.
Being a GP trainer (now called an educational supervisor) is very much about supervising. Your registrar will need to ask you questions about their patients, for example, a skin rash they have not seen before.
This all takes time and you, as the trainer, will be unable to see your usual number of patients, because you need to build this time into the system, with gaps between appointments or longer appointments.
At the start, you will need to review your registrar’s patients regularly, sometimes sitting in on their surgeries and checking through the patients they have seen.
Talk to other trainers and ask what they do, then develop a system that suits your practice. Involve the practice team in supervision, or consider establishing more than one trainer, which is particularly useful when you go on annual leave.
Training to be a teacher
You do not become a GP trainer overnight. Each region differs as to what sort of course you need to attend, and some regions will expect you to complete a Certificate in Medical Education first.
This involves spending time away from the practice and needs to be agreed by all of the members of the practice team beforehand.
There are many benefits to being a training practice, because this achieves new standards. It is great
to experience the stimulation and challenge of working with a recent graduate, who has knowledge of the latest evidence-based medicine.
You will also need to attend quarterly trainers’ workshops, to discuss problems and receive updates.
The weekly tutorial
GP registrars and their trainers require protected time for teaching.
Although teaching need not always be by the trainer, whoever provides it will need dedicated time away from routine patient appointments to prepare and give the tutorial.
Remember that the GP registrar needs educational time, as well as clinical contact. The extra consultations they are able to offer, you will lose in providing supervision.
Some trainers also become involved in the Vocational Training Scheme and give joint tutorials to several GP registrars, as part of cluster-based learning.
The exit examination in GP training is the MRCGP, a large component of which is workplace-based assessment.
GP registrars need to reflect on their daily practice and record this learning in their ePortfolio, for example, any challenging clinical encounters. They will also need to write a personal development plan.
There are many aspects to the ePortfolio and the trainer needs to read and comment on these entries, which again takes time.
Given the GP’s busy timetable, this is not always straightforward and often migrates into personal time. Similarly, every six months, you have to write a report on the GP registrar’s training, the Educational Supervisor’s Report, so their progress can be reviewed by the Annual Review of Competence Progression panel.
The struggling registrar
Every so often, you will come across a GP registrar who needs a lot more of your time. This could be at the start of their six- or 12-month post, when they run 20-minute consultations and need to ask about most cases, or require many of their patients to be reviewed, or later in their training, if they are finding consultations a bigger challenge than they expected.
This could involve many case-based discussions, which also form part of the ePortfolio, and your feedback on video consultations.
An enjoyable role
I enjoy being a trainer, not least seeing former registrars who are now local GPs – some become trainers themselves. However, to do the job well takes time.
The key is a supportive and committed practice team who understand that you may not see the same number of patients as you used to.
Similarly, bringing your patients on board is vital – you need their consent for training and they may not always be able to see you.
The patient participation group can be a powerful ally in helping you inform the practice population of the benefits of bringing in a new and enthusiastic pair of eyes, while also preparing the doctors of the future.
- Professor Charlton is a GP trainer in Hampton-in-Arden, and training programme director and professor of primary care education, University of Nottingham
Photo: JH Lancy