Identifying yourself as a GP trainee

Patients must be informed that they are seeing a GP trainee - and they have the right to refuse to take part in teaching, explains MDU medico-legal adviser Dr Beverley Ward.

The GMC is clear that patients must be given the information they need to understand who is involved in providing their care, and what their roles are. Sadly this was not the experience of Dr Kate Granger, MBE, a registrar in elderly medicine, who had terminal cancer.

She started the 'Hello, my name is' campaign in 2013 after she became frustrated with the number of staff who failed to introduce themselves to her when she was a patient.

Dr Granger sadly died in 2016 but her campaign led to over 400,000 health workers across 90 countries pledging to always introduce themselves to patients.

As Dr Granger’s experience showed, patients want to know who is treating them and they also have a right to know that person’s level and experience. For this reason, it’s important that you introduce yourself by name, and also clearly explain your role and experience. As a GP trainee, you may want to clarify your experience by explaining that you are a qualified doctor, in training to qualify as a GP.

Keep patients informed

The GMC’s consent guidance makes it clear that patients should be informed that they have a right to refuse to take part in teaching, and be given the option to see another doctor at the practice if they prefer. It follows that patients are told when they book an appointment that it is with a GP trainee. This could be done via a notice displayed prominently in the waiting room and on the practice website explaining that patients may see a GP trainee and that they can ask to see a qualified GP if they prefer.

You may need to discuss the patient with your trainer, either during or after the consultation, or even ask your trainer to review the patient during the consultation, and it is important to explain this to patients at the start of the consultation in case they object.

Recording consultations

As a GP trainee you might also wish to video your consultation as part of your training, or use it for a case presentation to your colleagues. The GMC’s confidentiality guidance has specific guidance about obtaining consent for this.

The GMC says you must get consent before making recordings for teaching or training purposes, which ideally should be in writing, but can be given verbally if this is not practical. The patient’s consent should be documented and kept with the recording.

You will need to explain the purpose of the recording, how long it will be kept and how it will be stored. The patient should be told they can withdraw consent at any time, and this will not affect the quality of their care, nor their relationship with you or anyone at the practice.

By being upfront with patients about your training and experience, you can help to avoid any misunderstandings such as the one outlined in the anonymised example below.

Case history

A GP trainee saw a woman with a vasculitic rash on her torso. She examined the patient and didn’t think it was anything serious, telling the woman to come back in a couple of weeks if it hadn’t cleared up. At the end of surgery the trainee discussed the case with her trainer who suggested that it may be appropriate to arrange some tests.

The trainee rang the patient to explain that her trainer has suggested some tests and asked her to return to the practice. The woman was upset at having to return to the surgery as she would need to take more time off work. She said she hadn’t realised the GP was a ‘trainee’ and if she’d known, she’d have asked to see a ‘proper GP’ instead.

The trainee was taken aback by the woman’s reaction, but apologised for any misunderstanding caused. She arranged for the patient to see one of the GP partners when she returned a second time. The GP partner saw the patient at an evening surgery, to avoid her needing to take time off work, and apologised again for any inconvenience caused.

He also explained that the practice had instigated a system whereby the receptionist would explain to patients that their appointment was with a GP trainee and offer them an alternative GP if they objected. The patient thanked the GP and was grateful for the explanation.

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