The COVID-19 pandemic is a huge challenge for the NHS. As GP registrars, you form a crucial part of the team required to deal with COVID-19.
However as a result of the outbreak, normal, structured training will take a back seat for the foreseeable future. There are ways to maximise your training throughout the pandemic and ensure you stay on top of your requirements when training life returns to normal.
What do we know so far?
- Exams have been suspended until further notice - however, the RCGP has said that it hopes the AKT will begin again in July, with ST3s having priority. It is also in the process of developing an alternative assessment to the CSA. More details on both of these are here.
- ARCPs are to continue although with a reduced panel number.
- Educational supervisors reports are to continue.
- Formal group teaching is to be suspended and will likely be delivered in different ways throughout each training programme.
- You maybe expected to redeploy if deemed necessary.
This has obviously caused a lot of uncertainty for many trainees, particularly for those scheduled to sit exams and complete training, alongside wondering how you will complete workplace-based assessments.
Although you may not have a confirmed date for your AKT exam, you can continue to prepare as before.
Continue to practise questions online and via virtual resources. Continue to use websites such as eLFH or the RCGP knowledge modules on offer. You will still be assessing many cases in practice that are non-COVID-19-related so continue to identify knowledge gaps and use any spare time you may have constructively to plug these gaps.
Arden templates often allow you to reflect on areas that you may have identified as an area that you need to develop.
Could you continue to prepare for the AKT in a group setting via FaceTime, Skype or other platforms i.e presentations on any new guidelines encountered?
Although you are unlikely to be able to meet as a group or go on a course currently, telephone and video working will allow you to still practice a Cambridge Calgary approach to consulting using the domains set out by the CSA criteria
- Data gathering
- interpersonal skills
- Clinical management
Use a standardised telephone assessment tool that will help you approach telephone consultations. The marking schedule used on the audio COT may be helpful here or any telephone triage skills information that your training programme may have circulated.
The RCGP's proposed alternative to the CSA will likely involve submitting audio or video consultations that you have conducted.
If you are still having tutorials with your trainer, can you listen to a recording of your calls again? Can you still do a joint surgery? This applies to both video and telephone consulting. Ensure the patient knows that this is a training surgery and that they are happy your trainer will be present.
You could consider continuing any group CSA preparation using platforms such as skype, FaceTime or apps such as WhatsApp or Zoom to arrange a joint meeting with your group. Although not ideal, it provides you with a way of continuing any hard work you will likely have already put in.
Audio COTs are likely to now become easier and a standard COT may also be possible with a video consultation with the patients consent.
You are still likely to encounter cases that will give rise to case-based discussions, possibly even more so given the difficulties posed by the lack of ability to assess people in the same way you would have previously. You may find ticking the ethics competency or fitness to practise box becomes slightly easier during the pandemic due to the different challenges that you are likely to now face.
Stay on top of learning log entries. Continue to reflect on cases as you come across them. You may find yourself reflecting more than ever before at present, so use this to your advantage with regards to your eportfolio.
Although MSFs are still possible, PSQs are likely to be tricky but the current situation will be taken into account.
Refer to your trainer or local training programme guidance for more detail around specific requirements i.e CPR, PSQs.
Although the ability to do these will drop over the next few months, you are likely to still authorise occasional direct face-to-face assessments, so be mindful of any CEPS you need to do and complete these where you are able to.
Supporting your team
There has never been a better team to support your practice. Think about what issues your practice is facing and how you can support it?
If you have gaps in your clinics, can you help another team within your practice i.e reception, prescriptions? How is morale? Can you help to boost morale in anyway?
Many of your clinical colleagues maybe writing new protocols regarding newer ways of working. Could you help with this?
The clinical work will likely become more intense and can be tricky via telephone or video, so remember not to feel pressured into decisions you maybe uncomfortable with. If unsure, remember to ask for help and as you are within a training practice, ensure you have the ability to debrief after your clinics.
Key things to remember
- Look after yourselves and your families during this time.
- Keep on top of government guidelines regularly.
- If you develop symptoms, ensure you self isolate and follow the guidance. Do not work from home in this situation, ensure you look after yourself.
- If you have to work remotely due to family circumstances, do not feel guilty about this. Ensure you have the ability to debrief however with your trainer to appropriate supervisor.
- Ensure you exercise and relax where able.
- If you feel that you are struggling then there are many resources available that maybe able to help.
For more information on the resources that are available to support GPs and GP trainees see here.
- Dr Singh is a GP trainer in Northumberland