Educational Supervision

The updated list of Educational Supervisor allocation (click) has now been uploaded, as have their contact details. Please contact them now to arrange your formative review by the end of September.

28/8/10

The GPST trajectory for 3 years of training

This excellent document, with useful embedded links, details all the things you need to do and the deadlines for completion. A must read for all Trainers, Educational Supervisors and GP Trainees.

The GPST trajectory (click)

20/8/10

New Courses for GP Trainees

We have places available on all the following courses:

Contraception and HRT in the consultation - A guide for GP Trainees (September 20th 2010)

Consultation Skills Training – a two day ‘survival course’ for GP Trainees new to General Practice (February 17th & 18th 2011)

Managing emergencies in General Practice (March 31st 2011)

The Pennine Exit Course (March 14th & 15 2011)

 The Child Health Surveillance Course (May 2011)

These courses are open to all GP Trainees, not just those from the Pennine scheme.

14/8/10

Updated guidance for the new version of the e-portfolio

Newly released guidance for GP Trainees from the RCGP (click)

13/8/10

Say hallo, wave goodbye

The team at Pennine would like to wish all our ST3s the best of luck as they enter the world of General Practice. To help us improve our training please ensure that you have completed the feedback form (click) and sent it to Moira.

For GP Trainers we have a structured reference template (click) from our Tools for Improving Training webpage which ensures a global assessment of a GPSTs competencies. Furthermore, we have lots of useful downloads for Trainers and Practice managers to facilitate GPST induction (click).

2/8/10

CSA and AKT pass validity

AKT and CSA passes obtained after 1 August 2010 will no longer be subject to a three year validity limit.

Similarly AKT and CSA passes obtained between 1 August 2007 and 31 July 2010 by trainees in a specialist training programme will remain valid pending the award of a Certificate of Completion of Training (or Certificate of Eligibility for GP Registration).

Number of attempts permissible

From August 2010 a maximum number of four attempts will be permissible in both the AKT and CSA. 

Those who commenced specialist training on or before 1 August 2009 will be permitted to make an unlimited number of attempts at the AKT whilst they retain a national training number.  Further attempts will be permitted by those who have already sat the CSA for a third time provided that their national training number has been retained.

26/7/10

Changes to the 'summative' e-portfolio based ESRs

Version 5 of the e-portfolio has significant changes to the 'summative' e-portfolio based Educational Supervisor's Report (which take place in Nov & May).

E-portfolio vs 5 changes with screenshots (click)

26/7/10

Read the NHS White Paper 'Equity and excellence: Liberating the NHS'

Have a read of the new White Paper (click) which will change all our lives!

14/7/10

We need your feedback!

In order to help us support our Trainers and develop our training practices we need your feedback. So if you are currently in a GP placement please complete our feedback form (click) and e-mail it to Moira.

6/7/10 

Do you know your SAMAs from your LAMAs & SABAs?

If not have a look at the new COPD management guidelines from NICE (click). Essential reading for GPSTs in GP posts and those who have yet to sit the AKT.

28/6/10

Mustn’t Grumble

After the disappointment of the English performance at the World Cup and the dismay it caused I was reminded of a ‘memorable patient’. During my palliative care home visit she turned round to me and asked “Do you know the definition of lucky Dr Smith? It’s being able to go home at the end of visiting time from the Bexley Wing (The Oncology unit in Leeds).”

I always remember her and the perspective that consultation provided.

27/6/10

CSA and AKT failure – where do GPSTs go wrong?

Nick Whelan (of the Deanery Performance Review Team) gave an excellent presentation on the reasons why GPSTs fail the CSA and AKT.

So have a read of the synopsis of his presentation (click).

20/6/10

The CSA is changing (slightly)

The GPST experience of the CSA will remain the same, as will the marking schedule BUT instead of 12 cases + 1 trial case ALL 13 cases will count towards the exam! The pass mark will not be 8 passes but will depend upon the performance of your cohort - you will not know in advance what it will be.

17/6/10

GP recruitment is changing for 2011

The stage 2 assessment (MCQ) will now be held at local Pearson VUE centres. The stage 3 exercises will consist of three short simulated scenarios (doctor-patient, doctor-health care professional and doctor-relative) and a written exercise (The group exercise and the long simulated patient-doctor consultation have now been dropped).

17/6/10

ARCP Panels in the Y&H Deanery : the one-page summary

This summarises the process for the summer 2010 round of panels across the whole deanery (click).

In any round of ARCP panels, each trainee who is due a panel has one panel with one outcome.  The panel is a two stage process, beginning with a local (scheme) panel and concluding with a central (deanery) panel which takes place a couple of weeks after the round of local panels has concluded.  Each of the three areas (Leeds, NEYNL and Sheffield) hold central panels in their respective offices. 

Trainees who are given a satisfactory panel outcome by the local panel, or are out of programme, do not need to be further considered by the deanery panel.

7/6/10

Two excellent new sets of guidance from NICE

NICE have produced two excellent sets of guidance which are very relevant to primary care.

Lower Urinary Tract Symptoms in men (click) & Childhood constipation (click).

5/6/10

End of life treatment and decision making

This new guidance from the General Medical Council (click), based on best practice, will advise and assist clinician’s in providing the best possible care for patients who require end of life care.

The document also provides legal and ethical advice for the dilemmas associated with end of life care and is essential reading for all GP’s.

2/6/10

DAAG News Letter May 2010

Make sure you read the May News Letter (click). The Deanery Assessment Advisory Group (click) are the Y&H Deanery group who set the hoops through which you have to jump! They also provide a wide array of useful resources.

15/5/10

Preparing for Educational Supervision

It's that time again! Please make sure you arrange your summative RCGP Educational Supervision prior to May 29th.

Things you must bring to the Educational Supervision meeting:

• The completed COT or Mini-CEX competency mapping forms (click)
• The completed CBD competency mapping form (click)
• Your Half Day Release attendance spreadsheet (click)
• Also you must ensure that you have an e-portfolio entry detailing your reflections on your last post, as per Yorkshire Deanery NOE guidelines (click)
• Ensure you have updated your self assessment in the e-portfolio (the 12 competency areas)
• Your sick leave and complaints summary (click)

Please make sure you read the download on Preparing for Educational Supervision  (click) as this will help ensure that you get the most out of the review.

11/5/10

Dates to be entered in the Educational Supervision Form

Registrars please don't forget to accept your Educational Supervisors Report to enable the ARCP panel to read them.

Educational Supervisors, the three dates on the e-portfolio ESR form which have to be entered correctly to set the dates between which all the CBDs, COTs, Mini-CEX will count are as follows:

Top date = 4/8/10 end of CBD/COT/Mini-CEX capture period (yes the rules do seem different than from before!)

Bottom left = 3/2/10 start of CBD/COT/Mini-CEX capture period

Bottom right = day on which the review took place

11/5/09

PSQs and Summative Educational Supervision

If you are in GP placement (ST2 or ST3) please make sure that you have started collecting your PSQs in order to ensure that all 40 are uploaded prior to the Summative Educational Supervision deadline of the 29/5/2010. Also all your MSFs, CBDs, COTs, Mini-CEXs, CSRs and Naturally Occurring Evidence for this ST year must have been completed by this deadline.

The Pennine ARCP panel sits on June the 10th so make sure that all your e-portfolios are in good order and complying with our WBPA guidance.

As Pennine's ARCP panel is on June the 10th, why not read our tips on how to avoid a Deanery face to face panel review.

1/5/10

Clarification of ARCP panel OOHs expectations 2010

Some of you have spotted conflicting advice on the Y&H Deanery website regarding OOHs requirement. It says 6 x 6 hour sessions per six months in the NOE section and 6 x 4 to 6 hour sessions in the OOHs section.

Here is the clarification from the Deanery (click)

17/4/10

A new SystmOne OOHs guide

This new guide to using SystmOne in the OOHs centres (click) is now available.

17/4/10

Joint Injection Course

Please have a look at the flyer for this excellent joint injection course (click) being held in Bradford on May the 25th.

16/4/10

The National Training Survey is being launched from April 2010

Your response is important. You will receive (via e-mail from the PMETB/GMC survey team) a request to complete the trainer or trainee survey. Please take the time to do this!

Who needs to take part?

GPSTs and GP trainers.

Why bother?

It is your opportunity as a trainer or trainee to give your views of the training you deliver or receive. In turn this enables PMETB to ensure suboptimal posts are improved and good posts are recognised.

2/4/10

The PMETB and GMC have now merged

Following the merger of the Postgraduate Medical Education and Training Board (PMETB) with the General Medical Council (GMC) on 1 April 2010, the GMC is now responsible for regulating all stages of medical education in the UK. 

The content on the PMETB website has been integrated into the relevant sections of the GMC website.

The GMC Contact Centre on 0161 923 6602 (from outside the UK: +44 161 923 6602), will be able to answer your query or redirect you to the appropriate contact within the GMC.

1/4/10 (No it's not an April Fool's joke!)

CSA preparation for Trainers and GPSTs

Simon Hall and Mike Thomson from the Deanery have written an excellent review of how GPSTs and Trainers can use the CSA feedback in the event of CSA failure.

It is also a very useful document as a basis for understanding the domains the examiners are assessing.

You can find it in the CSA part of the nMRCGP section of the website with other resources or click on this link (click).

31/3/10

The ACCORD trials - changing targets for patients with Type 2 diabetes

The three trials collectively known as ACCORD compared intensive control with standard control of blood sugar, blood lipids, and blood pressure in 5000 people with type 2 diabetes and a high risk of cardiovascular disease. Results do not support more intensive treatment of blood pressure (sys lower than 135, Hba1c < 6.5% or lipids with a fibrate + statin.

Find out more (click)

29/3/10

Major changes to the way we investigate suspected IHD

• Suspected angina should be diagnosed with an Exercise Stress Test = True/False?
  
• All patients with suspected MI should be given high flow oxygen until the ambulance arrives = True/False?

If you answered True then you need to read the new guidance on suspected angina from NICE! Investigation of suspected cardiac chest pain (click)

25/3/2010

What must I do by when?

In addition to the RCGP minimum WBPA criteria (click) the Yorkshire Deanery demands other criteria:

Non WBPA MINIMUM criteria to be achieved prior to the end of the ST year

ST1

96 quality log entries (12 pages of the e-portfolio) and 18 SMART PDP entries

Reflections on post held, 2 Presentations, 6 x SEA

ST2

112 additional quality log entries (14 additional pages of the e-portfolio and an additional 18 SMART PDP entries - Running total = 26 pages of e-portfolio entries and 36 SMART PDP entries. Reflections on post held, 4 Presentations, 12 x SEA

ST3

144 additional quality log entries (18 additional pages of the e-portfolio) and an additional 18 SMART PDP entries - Running total = 44 pages of e-portfolio entries and 54 SMART PDP entries. Reflections on post held, 6 Presentations, 18 x SEA, 1 x two cycle audit

Please note that this is the minimum assuming that ALL the entries are quality entries. Have a look at the nMRCGP section (click) for more details

21/3/10

Patient safety, a useful audit and a great e-portfolio

Now that at least one detailed audit (2 cycles at least) is required by the Deanery for CCT identifying achievable 2-cycle audits is becoming a priority for GPSTs.

Recently the National Patient Safety Agency issued an alert (click) relating to Lithium prescribing and their guidance (click) lends itself to a GPST project which is both useful to the practice and patients.

Why not read more about our tips for audit before embarking on your project (click)?

20/3/2010

Updated CCT guidance

The Certificate of Completion of Training (CCT) confirms satisfactory completion of an approved programme of training and is one of the certificates which allows entry to the GMC Specialist or GP Registers. 

See the 2010 guidance on CCT from PMETB (click)

1/3/10

New PMR guidelines 

The recently published guidance for the management of PMR (click) by the British Society for Rheumatology features in this weeks BMJ editorials. This excellent guideline is very Primary Care orientated and certainly exposed a Johari blind spot!

On a related note, last week's BMJ editorials explored the risk of osteonecrosis of the jaw in patients taking low dose bisphosphonates (click), as used in Primary Care. Fortunately this seems to be low (1 in 10,000 to 1 in 100,000 person years of exposure).

27/2/10

Fit Notes

Sick note certification changes in the UK from April 2010 when Fit Notes will replace the traditional sick note. The Fit Notes will have a tick list of options on how the employer can help someone return to work and it currently (it may change over time) has four options that the doctor can choose from:

1. A phased return to work

2. Amended duties

3. A change to existing hours of work

4. Workplace adaptations

The doctor will also be able to write any comments in a comments box if he/she thinks that more explanation is needed. The Fit Note doesn't allow the doctor to confirm that the patient is fit for work (due to implications for employers' liability insurance) but allows the doctor to select:

• Unfit for work, or
• May be fit for some work, taking account of the following advice

The maximum period such a medical statement can cover will be reduced from six to three months (during the first six months of a health condition).

Med 4s, Med 5s, Med 6s and the RM7s are all being withdrawn.

Click here to read a summary or here for the detailed review with photos of the new notes

19/2/10

DAAG newsletter February 2010 - ARCP guidance

Please read and absorb the implications of this extract from the Deanery DAAG newsletter!

For the June ARCP panels we should be giving a clear message to educational supervisors and trainees that after two years of using workplace based assessment and the eportfolio, and time spent this year publicising our own need for certain “naturally occurring evidence” the time for leniency shown towards trainees with missing pieces of evidence should cease. The RCGP external assessors have given the message that deaneries have been giving too many satisfactory outcomes where the evidence has been incomplete.

You have all been warned.

Click here to read more from the DAAG newsletter

10/2/10

Financial Planning & the NHS Pension updated

Have a look at our updated web resources; The NHS Pension explained (click), Illness and death in service benefits (click) and Basic Financial Planning (click).

4/2/10

GP Revalidation - the CPD credit system updated

The new 2010 guide to revalidation has just been released (click). In this there has been a further clarification of the CPD credits system i.e. it's been simplified. Some cynics might say that each new version represents a dumbing down of revalidation due to political expediency!

The RCGP is using a learning credits system with a minimum of 50 credits in a year and 250 credits in a 5-year cycle to support a positive revalidation decision.

In essence 1 hour of education is one learning credit. However, if that education leads to changes for patients, the doctor or practice, the GP can claim two learning credits for each hour of such education. Credits are self assessed and verified at appraisal.

All GPs will, therefore, be expected to record their educational activity and award themselves credits based upon the hours involved and the impact of the education on themselves, their patients or the service in which they work.

Over a revalidation cycle a GP will be expected to demonstrate a broad range of general practice education.

30/1/10

Alternative to audit or QOF reflection for GPTS

Patient safety is becoming a priority issue at the strategic health authority
and as a consequence it is percolating down through the Deanery. At a recent
meeting with Adrian Dunbar he agreed that a good quality piece of work using a
number of cycles of the Primary Care Triggering Tool could be used in place of
the NOE requirement for audit or QOF reflection.

Find out more..(click)

25/1/10

Trainer re-approval is changing

The GP Trainer re-approval process which changed in 2008 is being altered again in 2010. The Practice visit is to be re-introduced in 2010/11, however, it will either be looking at specific areas and performances of the Practice or simply a random check to ensure that the Practice is maintaining accreditation standards.

Trainers will continue to attend the two day Teaching Quality Assurance Seminar (TQA).  This seminar forms part of the new GP Trainer re-approval process and provides time for review and discussion of teaching, trainer and practice development.

The good news is that re-accreditation will be occuring every five years rather than every three. Also the Practice visit will be Practice specific, rather than Trainer specific, so if you have more than one Trainer your Practice is still only assessed every five years.

15/1/10

Avoiding ARCP panel review

Read Adrian Dunbar's (Panel Chair for the Deanery) review of the reasons for panel referral during this round of panels (click) and try to avoid the same mistakes. Also have a read of the News entry from the 16/12/09 which explains some of the e-portfolio areas that are coming under closer scrutiny.

4/1/10

ARCP update

I have just finished sitting on an ARCP panel as the Deanery in Leeds. I always thought myself a hawk but I realised that now I’m considered a dove. As one panel member reminded me ‘doves get shot, plucked, stuffed and roasted’, which tells you about the shift in the level of scrutiny and the attitudes of panels to grey areas!

So in addition to the points highlighted last time (see the bottom of this page - click) the Deanery are specifically expecting GPSTs to follow their guidance for Natural Occurring Evidence (click)

This means that for those GPSTs about to have a panel review at ST transition they must have documented:

1. At least 6 SEA entries within the ST year.
2. A case study or presentation (e.g. HDR group work would count).
3. At the end of every post have an entry reflecting on the post (those who were in GP can use/upload the questionnaire which Moira sends out). But all docs at the end of every hospital post must have a reflection on post entry as per Deanery guidance.
4. By the final Ed Sup review in ST 3 completed an audit (going through the cycle twice) or a reflection on QOF performance.
5. The trainees must complete the self assessment section of the e-portfolio.
6. The Ed Sups must complete their review of competency prior to panel reviews irrespective of ST stage.

16/12/09

Reflections on the CSA from someone who passed

1. What was it like?
Quite intense – especially as I did the afternoon session and was locked up for 2 hours in a room with 50 other candidates immediately prior to starting. For this reason I would suggest doing the morning session or at least bringing something to eat and drink. The actors were not very 'giving' with regards to the history - especially compared to the mocks here and at Croydon (something we all felt was more than just exam nerves).
It was well organised and was actually quite realistic as the actors are on the whole quite believable and all the actors/assessors/staff are lovely and try to put you at ease.

2. What aspects of their preparation were worthwhile?
Without a shadow the best bit of advice I can offer is getting on the "CSA taster" course in the test centre itself. It makes such a difference knowing the set up etc. It is run just like the real
thing so it reduced my pre-exam stress. The Harrogate and Hull courses have also had good feedback.

You MUST also practice with a study group lots!! – a bit embarrassing at first but it really helps.  Another tip is to 'bite the bullet' and video your surgeries with a view to feedback from your Trainer during tutorials.

Knowing your NICE guidelines and urgent referral criteria also proves to be useful.

3. What aspects of their preparation were least useful?
Most of the case scenario books - they are written by people who have not helped set up or sit the CSA. They are often more complex and demand too much - makes you feel a bit scared pre-exam.
Doing 10min appointments surgeries at work: in the exam you don't write and often don't examine! So don't stress re 10mins appointments.

4. What advice would they have for Trainers and Trainees to help them in preparing for the exam?
Joint surgeries are very useful, an opportunity to pick up tips and compare your performance with your Trainer. Creating your own scenarios as we have done at HDR - makes you realise what is doable and expected. Also don't forget what items they provide for you, if they have provided a tuning fork on the desk in one of the scenarios you will be expected to use it!

GOOD LUCK!!!!

15/12/09

Microsoft Home User Program - Office 2007 for £8!

The Microsoft Enterprise agreement allows employees of NHS to participate in the Home User Program (HUP). HUP enables you to get a licensed copy of latest Microsoft Office desktop application to install and use on your home computer.  For each product eligible for the Home Use Program you are a licensed user with active Software Assurance coverage, you may order a single copy of that product to install and use on a home computer. You may continue using this HUP software while you are under our employment and as long as the software you use at work has active Software Assurance coverage.

To access the Microsoft Home User Program please follow the steps below:

a.               Access the Microsoft NHS resource web site http://www.microsof t.com/uk/ nhs/

b.               On the Left hand side you will see a link  to “Free and discounted software for NHS staff “ this link will take you directly to the Home User Program.

c.                Enter your corporate email address and click the green arrow.

d.               You will then be asked to sign into the Microsoft web site using your windows live ID, you can create one if you do not have one set up.

e.               The next page should show your corporate email address and a code number all you need to do is click submit. At this point an email will be sent to your work email which contains a link to a web page that enables you to continue the purchasing process. I suggest that you complete the first part of these instructions from work once you receive the mail from Microsoft forward it home and complete the process from there by clicking on the link and entering the on line shop. Note: this program code is assigned to your Trust for our sole use in accessing this site. You may not share this number with anyone outside your Trust.

f.                 Place your order on-line and you can choose to either download Office 2007 or purchase a disc.

13/11/09

Lest we forget

The NHS was born out of the hopes and aspirations of people living in post war 'Austerity Britain'. They and the country had suffered a huge personal and economic cost during WW2 which has shaped our country and our public services since. In this remembrance week why not have a listen to our link which tells the tale of some of the 55,000 aircrew who died in Bomber Command in WW2. 

http://www.youtube.com/watch?v=55QeB8_u_VQ (click)

7/11/09

Arrange your summative Educational Supervision session now!

The Deanery ARCP panels are being held in early December, so you need to have completed the minimum number of nMRCGP assessments and obtained your Clinical Supervisors Report (Yorkshire Deanery require this even if you are in General Practice) prior to your summative Educational Supervision which MUST take place before November 27th.

Things a Trainee must bring to the Educational Supervision meeting

• The completed COT or Mini-CEX competency mapping form.
• The completed CBD competency mapping form.
• Your Half Day Release attendance spreadsheet.
• Your sickness and complaints spreadsheet.
• Also you must ensure completion of your Clinical Supervisor's Report at the end of every post or prior to the summative (May & Nov) Educational Supervision meeting - whichever is the sooner.

Read more about the differences between the formative and summative Educational Supervision sessions (click).

31/10/09

Validity of curriculum matching

At Educational Supervision one of our ST1s asked how they can ensure their curriculum matching is valid. Fortunately the RCGP have a detailed webpage covering this issue which can be accessed via an existing Pennine download in the nMRCGP/e-portfolio section of the website which is......

The curriculum and curriculum matching  (click) - 2009

Utilising the broad principles of the GMC’s Good Medical Practice the curriculum defines the core knowledge, skills and attitudes that a GP Trainee have to attain by the end of their training in order to become a competent GP. It also allows you to assess whether your curriculum matching is valid. Just open the document and click on the statement headings and explore the domains of the 'statement' to find out what it means and how you might achieve it.

11/10/09

What do we mean by competent?

The team at Bradford have developed a what do you mean by competent download?  (click) which helps justify the grading of 'competent' or 'needs further development' in the 12 nMRCGP competency domains. So it can be of great use when validating log entries, e-portfolio based RCA and during CBDs. It also can help you think of ways in which the Trainee might have acted to reach the competent category, which is very useful when debriefing the Trainee afterwards and gives them more insight into potential "blind spots" in their consultation and case management skills.

10/10/09

Appointment length for GPSTs in ST3

A question has been raised following discusion with our Educational Supervisors about guidance relating to appointment length changes during ST3 and post surgery debriefs.

Here is the guidance I have recently added to the example of a GPST timetable from the induction webpage which can be found in the GP journey section of the website.

Also relating to post surgery debriefs, which is a Deanery requirement, many practices have adopted the simple strategy of the Trainer (or the GP covering the Trainer while they are away) having a blocked 10 min appt towards the end of their surgery. This ensures that de-briefs always occur and makes the process feel less punitive for the Trainer or covering GP!

Matt Smith

26/9/09

We now have a simple guide to SystemOne for OOHs

At Pennine all triage is performed by NHS direct and the clinical system they use is SystemOne. So if your going to NHD induction or have just done it prior to OOH triage, have a look at the download.

System One OOH Guide 2009 (click)

23/9/09

Roger Neighbour will be running a consultations skills study day for GPSTs in ST3 from the Y-H Deanery

Dr Roger Neighbour author of a number of landmark books including The inner consultation will be running a study day for GPSTs in ST3 on November the 11th at the Woodlands Hotel in Leeds.

‘Consulting beyond the models', will focus on:

• establishing rapport
• identifying cues, patients’ hidden agendas, building concordance
• ‘house-keeping’
• developing process awareness

The Deanery will be sending the booking details & costs soon, so clear this day and book early!

20/9/09

Contraception update

The BMJ have published a detailed review of VTE risk with different types of cocp (click) AND a detailed evidence based review of contraception (click).

11/9/09

New Guidance from the Deanery on SEA, audit etc requirements for GPSTs

Have a look at the new guidance from the Deanery on SEA, audit etc requirements for GPSTs which has implications for trainers, Educational Supervisors, ARCP panel members and GPSTs click here.

3/9/09

Arif Kazi - One of Pennine's PDs and the British Medics win the Football World Cup in Korea!

Arif (click) has just returned from Korea where he played in the Medics' Football World Cup winning side. Have a read of the press release and see the photos (click)

Congratulations from everyone at Pennine

13/8/09

CSA - Does prior knowledge of cases help you pass the examination?

It has come to the RCGPs attention that a number of CSA ‘live’ cases are being circulated through the AiT community. These have been created by trainees who have taken the CSA or trainers who have collected them, promoting them as being helpful in preparation for the examination. The purpose of this document is twofold:

• to warn you against rehearsing cases that you think are part of the case bank and likely to come up, and
• to guide you into thinking constructively about the type of cases you are likely to meet in the CSA.

The RCGP would like to point out that candidates are asked specifically NOT to reveal the cases they have seen, and that copyright of these cases resides with the RCGP, who reserve the right to refer anyone found to be fraudulently using RCGP cases to the GMC, as we regard this as a form of cheating.

See the RCGP guidance in full (click)

21/7/09

Tips and advice for OOH sessions - a super detailed review by one of our GPSTs

OOHs - a GPST's perspective (click) 2009 - A super detailed review of how to organise your OOH sessions and what to expect. Tips ranging from where to find the toilets or something to eat to where to park and what to expect from the OOH session and their various locations.

Thanks Fareed!

13/7/09

A glossary of medical slang used by patients in Yorkshire

A useful resource for non Yorkshire graduates! If you come across any that are in common usage in Yorkshire please e-mail me.

Yorkshire slang - a glossary of slang terms used in Yorkshire (click)

4/7/09

The Y&H Deanery advice on OOHs

Out of Hours News (click) 2009 - An updated explanation of how OOH sessions are organised and the Y&H Deanery's expectations of the number and type of OOH sessions to be completed by full time and less than full time trainees.

OOH record (click) 2009

A useful document (designed by one of our GPSTs and his Trainer - thanks Naim & Fiaz) to be used at OOH sessions which is completed and signed off by your supervisor at the end of the session. You can then scan it and upload it into your e-portfolio. It then enables your Trainer to log the competencies you demonstrated within the e-portfolio.

27/6/09

Have a look at the RCGP updated curriculum resources which help you address your educational needs

Version 3 of the RCGP Curriculum Map and Resources is now available (click). This tool enables you to search the curriculum and locate educational resources for general practice.

24/6/09

Additional paid medical work outside contractual obligations during GPST training

Recently the Deanery have clarified their position on additional paid medical work outside contractual obligations during GPST training.

Have a look at the Pennine Policy on ‘moonlighting’ i.e. additional paid medical work outside contractual obligations during GPST training (click)

20/6/09

Resources for Practice Managers

We've added a new webpage which provides useful up to date downloads covering all the employment aspects relating to GPSTs and the new training regulations.

Why not have a look and send the link to your Practice Manger?

http://www.pennine-gp-training.co.uk/resources-for-practice-managers.htm (click)

7/6/09

The Deanery Assessment Action Group (DAAG)

The Deanery Assessment Action Group (DAAG) have produced a newsletter detailing their advice following a survey of Educational Supervisor Reports and e-portfolios from the last round of ARCP panels.

So if you are a GPST or an Educational Supervisor, you need to read this!

The Deanery Assessment Action Group (DAAG) June 09 update (click)

It's a large file and takes about a minute to download

2/6/09

Updated NICE guidance on the newer drugs used in Type 2 diabetes

This short guideline describes the sequencing of treatment agents for the management of blood glucose control and gives guidance on starting insulin. Key changes to practice include the recommendations that DPP-4 inhibitors should be considered as a option when metformin and/or a sulphonylurea are not adequate. This guideline also reinforces the practice that human insulin (NPH) should be the first choice of insulin for most people who require insulin rather than analogue insulins. It also provides flow charts for managing hyperlipidaemia and hypertension in Type 2 diabetes.

Type 2 Diabetes updated management flow charts NICE 2009 (click)

31/5/09

Study Leave – Guidance for Practice Managers, Trainers and GPSTs 

Following recent discussions we have clarified our advice for study leave during GP posts. This is in line with guidance provided by other GPST schemes within the Yorkshire Deanery.

Study leave during GP placements (click)

23/5/09

Preparing for Educational Supervision

Things a GPST must bring to the Educational Supervision meeting:

• The completed COT or Mini-CEX competency mapping forms (click).
• The completed CBD competency mapping form (click).
• The COGPED OOH work booklet (if you're in a GP post).
• Your Half Day Release attendance spreadsheet (click).
• Also you must ensure completion of your Clinical Supervisor's Report at the end of every post or prior to the summative (May & Nov) Educational Supervision meeting - whichever is the sooner.

Please make sure you read the download on Preparing for Educational Supervision  (click) as this will help ensure that you get the most out of the review AND reduce the risk of ARCP panel referral.

17/5/09

Happy Birthday to the Pennine Website!

The Pennine website has now been live for one year and in that time we have had 5000 visitors who have looked at over 41,000 pages. Most visitors are from the UK but we have had visitors from 33 other countries, especially the USA, Saudia Arabia, India and Pakistan.

So what is everyone looking at? Out of our 65 webpages the top ten most visited pages are....

1. Our News Page

2. Tools for improving Training

3. Clinical - downloads matched to the curriculum, just click on the curriculum area on the left hand side of the webpage.

4. Missed HDR? Get the downloads - loads of great downloads!

5. nMRCGP - from tips about the CSA & AKT to physical examination videos

6. Updated chronic disease management - EBM last updated April 2009

7. The GP journey - from GPST induction, allowances, locuming to pensions

8. Educational Supervision - Tools for Educational Supervisors

9. Tips for WBPA - COTs, CBDs etc tips and tools for Trainers

10. GPST induction - useful downloads

16/5/09

Educational Supervision

GPSTs please make sure that your CSR has been completed prior to your Educational Supervision AND please don't forget to accept your Educational Supervisors Report by the 30th of May to enable the ARCP panel to read them.

Educational Supervisors, the three dates on the e-portfolio ESR form which have to be entered correctly to set the dates between which all the CBDs, COTs, Mini-CEX will count are as follows:

Top date = 4/8/09 end of CBD/COT/Mini-CEX capture period

Bottom left = 4/2/09 start of CBD/COT/Mini-CEX capture period

Bottom right = day on which the review took place

12/5/08

Diarrhoea and vomiting in childhood NICE 2009

Read this excellent and pragmatic summary (click) from NICE.

1/5/09

Support & Counselling for GP Specialist Trainees

Pennine and the Deanery have a policy for identifying and supporting GPSTs who may be in difficulty for a variety of reasons. Have a look at our new webpage which details 'who can help' and local & national resources for supporting doctors (click).

Also have a look at the download Trainees in Special Measures (click) - This explains the Deanery's policy of surveillance and support for GPSTs who are experiencing difficulties.

25/4/09

A guide for mentors of intending Trainers

After IS1 all intending trainers should have an allocated mentor, someone who is an experienced trainer and is able to help them and their practice prepare for training and support them during their first six months of training.

Have a look at our guide for mentors of Intending Trainers (click)

25/4/09

CSA performance indicators updated

The RCGP have produced an excellent summary of both the positive and negative performance indicators for the CSA domains.

Have a look at our updated CSA performance criteria download (click)

12/8/09

The European Working Time Directive and its implications for Trainers and GPSTs

The EWTD has implications for both Training Practices and GPSTs.

Have a look at the EWTD guidance for GPSTs (click)

10/4/09

The GP curriculum is changing

The new curriculum will come into force from August 2009.  However, to give curriculum users ample notice of the changes the RCGP has posted the revised version already, together with a change log. Most of the changes are to update existing information, but there are also some changes to the learning outcomes and these have also been listed separately so that they can be referred to easily.

Please be aware that trainees who are working towards a Certificate of Completion of Training (CCT) will continue to train under the curriculum that was in force on the date their training programme commenced.

Updated RCGP curriculum (click)

8/4/09

The NHS complaints system has been updated

Have a look at the changes that have come into place since April 2009

NHS complaints procedure MDU 2009 (click)

NHS complaints - local resolution in detail MDU 2009 (click)

8/4/09

Mock video consultations to aid teaching COT and consultation skills

Useful for Trainers’ Workshops to develop Trainers' COT teaching and feedback skills. Also great for Trainers to facilitate tutorial sessions with their GPSTs without them being distracted by the worry of their performance - see our videos of mock consultations (click).

29/3/09

The National Dementia Strategy has been launched

The main outcomes are 17 recommendations coalesced around three areas - raising awareness, early diagnosis and improving the quality of care.

The National Dementia Strategy (click)

14/3/09

InnovAiT now available at a reduced rate for Trainers

The monthly InnovAiT journal from the RCGP rotates though the new curriculum over a three-year cycle. Regular features include:

• clinical and non-clinical themed articles linked to specific curriculum topics
• peer reviewed AKT questions linked to articles that appear in each issue
• key GP topics
• practical guidance and advice from a GP trainer
• nMRCGP preparation for AiTs
• practical guidance on learning needs from an educationalist
• news and updates

A great resource for Trainers and only £35 for the next year!

CLICK HERE  to obtain this reduced rate.

12/3/09

Getting more out of Case Based Discussion - Tips for Trainers

We have added another 'question maker' for Case Based Discussion. Why not have a look at our Tips for Cased Based Discussion (click)?

9/3/09

A great resource for Trainers and Programme Directors

We have put together over 16 HDR sessions which can be used by Programme Directors or Trainers for their education sessions or tutorials.

Why not have a look at our education sessions ready for download (click)?

8/3/09

Using the e-portfolio as a training resource

The Bradford GPST scheme have been using the e-portfolio as an educational tool in a way that has been stimulating to both Trainers and GPSTs. It also allows the Trainer to mark the discussed e-portfolio entries as ‘read’ and identify competencies, learning needs and help the GPST with their PDP.

Have a look and see how they do it - Using the e-portfolio as a training resource (click)

7/3/09

Diabetes and driving

Have a look at the Feb 2009 DVLA guidance (click) and the excellent Diabetes & Driving download (click) from Diabetes UK which provides advice on hypos, safe driving etc. 

28/2/09

Physical Examination videos for the CSA & General Practice

Have a look at these UK Teaching Hospital You-Tube guides to brief but competent examination technique - Ideal for the CSA and day to day general practice.

22/2/09

Our Registrars' recommended 'good reads' has been updated

Now we have over fifty recommended 'good reads' which are divided into medical, medicine related and non medical sections.

Why not take a look? Click on recommended 'good reads' to find out more.

14/2/09

Surviving the AKT

Have a read of the tips from our GPSTs who have just sat the AKT this week.

AKT tips 2009  (click) -  Our Trainees' tips on how to prepare for the AKT.

31/1/09

Have a look at the InnovAiT archive

All our GPSTs who have used InnovAiT have found it helped with both the AKT and CSA, so why don't you have a look at the InnovAit archive (click)

30/1/09

Free prescriptions for cancer patients

It has been announced that from April 1st cancer patients will be able to receive all their prescriptions for free, even if the medicines are not related to treating the disease or its side effects, saving them around £100 a year. The certificates will mean patients will be entitled to free prescriptions for five years even if they are declared free of cancer before then and they can be renewed as many times as necessary.

Forms can be collected from GPs and cancer specialists during appointments and those received before March 24th should be processed in time for the April 1st implementation date!

28/1/09

NHS Constitution for England is published today

This Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively.

Why not have a look at the NHS constitution download (click)?

21/1/09

Doc are these home BP monitors any good and how do I use them?

How often have I heard this in the last few months! Now there is an answer in this week’s BMJ.

Current guidelines suggest using a mean of seven days of monitoring, with two measurements of blood pressure a day (morning and evening) and the first day’s readings discarded. Upper arm (brachial pressure) monitors are preferred to wrist (radial pressure) monitors because few wrist monitors have been clinically validated and they are more dependent on arm position.

Most home measurements of blood pressure are lower than those taken by a health professional in the office—a meta-analysis found that they differed by 6.9/4.9 mm Hg and the difference varied with age and treatment.

Europe has settled on the diagnostic threshold of 135/85 mm Hg for hypertension using home measurements. Once BP is controlled then home monitoring (for one week) only needs to be repeated 9 to 12 monthly.

See the BMJ article in full (click)

4/1/08

Guidance on the new SEA, audit/project and reading e-portfolio domains

New guidance from the Yorkshire Deanery for GPSTs and Educational Supervisors on the new e-portfolio domains which were added shortly after publication of the excellent e-portfolio pearls document.

Guidance on the new SEA, audit/project and reading e-portfolio domains (click)

9/12/08

Updated guidance on Registrar sick leave from the Yorkshire Deanery

Have a look at the new guidance (click).

1/12/08

HDR attendance

HDR attendance is now under scrutiny by the Yorkshire Deanery and regular audits are being conducted by the Deanery to establish Pennine's performance, as well as that of other GPST schemes in Yorkshire and Humberside.

Please can you start keeping a personal record of your attendance using the new HDR attendance download (click) and bring it to your Educational Supervision meetings. Not only does it calculate your % of attendance but it allows us to identify reasons for non attendance, such as post or workload issues, which we can then address.

6/12/08

Updated Chronic Disease Management Guidelines

The six monthly update of our pragmatic, primary care orientated, evidence based guidelines has been completed and signed off. Why not take a look at the CDM guidance page (click) with all the updated downloads?

25/10/08

Curriculum - self assessment rating scale

This helps Registrar's identify their learning needs within the curriculum and goes into much greater detail than the e-portfolio 'curriculum coverage' section. A useful way of identifying knowledge gaps and using it to plan learning.

Also it's a great way for Trainers to co-ordinate teaching when 'non Trainers' are involved in Registrar education within the Practice -Curriculum - self assessment rating scale (click).

19/10/08

e-portfolio log entries - ARCP panel expectations

We are now getting more clarification about the standards ARCP panels will be expecting from e-portfolio log entries from the Deanery. Adrian Dunbar from the Deanery has outlined...

Panels will be looking for evidence of description, interpretation, reflection, action (change) and further learning plans with breadth and depth of coverage in all of the e-portfolio learning log domains. Assessments are only half the picture and naturally occurring evidence (log entries) will provide balance and enhance assessment. This multiple sampling of evidence provides triangulation and justification for ARCP panel outcomes.

14/10/09

CBDs & COTs - Sharing best practice

At Pennine we are adopting an approach developed by Bradford VTS which has proven to work very well, for both Registrar and Trainer. Our Registrars now have to complete a CBD or COT questionnaire with each potential submission. This questionnaire details the competencies they feel they have achieved and how they demonstrated them.

This helps focus the COTs and CBDs ensuring that the Registrar and Trainer make the most of this formative and summative process.

See our nMRCGP webpage dedicated to CBDs and COTs (click)

4/10/08

Less Than Full Time Training

Due to the drive to increase training capacity the Yorkshire Deanery can not guarantee LTFTT to new applicants and will be offering 50% LTFTT working as the primary option in hospital posts. This allows 'slot shares' and maximises training capacity. Currently there is still some flexibility in the % LTFTT in GP posts, although this may change. There is an 'exceptional cases'  funding stream, primarily aimed at facilitating sick doctors returning to work, which will enable a few doctors to have tailored LTFTT.

20/9/08

Benign and malignant skin tumours

Have a look at an excellent PowerPoint presentation put together by one of our Registrars which has loads of great pictures and useful information. Please click here for the presentation.

8/9/08

InnovAIT magazine - useful for Trainers as well as Registrars

InnovAiT is a journal which all GP Registrars receive on a monthly basis from the RCGP. It rotates through the whole curriculum for the nMRCGP on a three year cycle.

Each issue covers two clinical themes, and one non-clinical area alongside a news section highlighting important new policies, research and guidelines affecting GPs. In addition to this and editorials, the Journal has two regular columns: ‘From the Trainer’ providing guidance to supplement that provided by the AiT’s real-world trainer, and a column on exam tips from a recently qualified GP. Each issue also features ‘applied knowledge test’ questions and answers. 

So don't forget to open the packet and have a look!

18/8/08

Less Than Full Time Training

The guidance on the minimum number of Work Place Based Assessments has been changed from August 2008 by the RCGP!

The requirement for MSF and PSQ prior to each six month review in ST1 and ST3 will be changed so that for less than full time trainees MSF and PSQ will be presented at the review that represents the mid and end point review for ST1 and ST3 respectively. This ensures that there is sufficient time for appropriate feedback and any necessary change in behaviour.

The schedule with respect to DOPs, Mini CEX, CBD and COTs remains the same. RCGP 8/08

See an example of a schedule for 50% LTFTT (click) or go to the LTFTT part of the RCGP website (click).

15/08/08

Basic financial planning and the NHS pension scheme explained

Whether you're starting or finishing your training scheme it's essential to get to grips with NHS sickness & pension benefits and basic financial planning. So, have a look at our new web pages which cut through the confusing terminology of financial planning (click) and the NHS pension scheme (click).

26/7/08

Making the e-portfolio work for you

An excellent summary irrespective of where you are in your training, detailing the do and the don'ts for making the most of your e-portfolio.

Also a 'must read' for Trainers, Educational Supervisors and Programme Directors organising their induction courses!

Click e-portfolio pearls to download.

22/7/08

Pennine now has a password protected confidential forum for Registrars and Trainers.

It has a Buy & Sell thread, recommendations of courses, books and resources as well as discussions relating to Training and medicine.

Please sign up to the invitation you will receive by e-mail, as we need a critical mass of people to make this a 'goer'. If you have not received an invitation then e-mail Matt Smith (click)

NB - please note that if you don't want to be sent e-mails from the group but still want to be a member that can fully participate this is an option which you can select at sign up or after sign up by editing your preferences.

Our forum is a Yahoo group called pennine-gp-training which can be found at http://uk.groups.yahoo.com/group/pennine-gp-training/ (click).

30/6/08

Educational Supervision - the different reviews explained

Things are a lot clearer after our joint visit to the Deanery last week, please see the newly re-written 'Educational Supervision - a summary' download found on the Tools for Educational Supervisors page of the website.

The May and November meetings, the six monthly RCGP statutory meetings, are of critical importance with respect to possible ARCP review. These tend to be more quantitative, looking at whether they are on track for nMRCGP in terms of their assessments, PDP and the breadth and depth of their e-portfolio log entries. These are recorded in the 'Review section' of the e-portfolio & the educational supervision form is uploaded as a 'Professional conversation'.

The March and September supplementary Yorkshire Deanery reviews are more qualitative, looking at how they're settling in, the educational environment, educational theory and how it applies to them and their e-portfolio, advice on their PDP and how they might demonstrate the outcomes. These are uploaded as a 'Professional conversation' BUT not entered into the formal e-portfolio 'Review section'.

17/5/08