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The 1st GP job takes a little
while to adjust to, but then it is definitely ideal to get the audit out of the
way. I felt the MCQ could be done at any time really. Regarding videos,
presumably you do get better with practice so I feel they can be left until the
2nd job to complete, but the more practice in the 1st GP job, the better!
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I think the 2nd GP job is very
much dominated by MRCGP, so the more you get done early, the more time you’ve
left towards the end to learn how to practice well. I feel computer skills
should be taught formally somewhere in the curriculum. I have none, and wish I
had!
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Basic Life Support/ALS need at
beginning 2nd 6/12. CHS need at beginning 2nd 6/12.
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Training folder for GPR to
follow around all training. To include aims/training request for each 6 months.
Using MRCGP syllabus as guideline provide hospital days within
syllabus/structure. At times too vague – time wasted !
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As regards to other milestones
I think it would be good to put a set time for completion of a video to be
submitted for SA as it would be a good idea to have this watched or marked by
the peer group as per the official marking scheme.
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Consults on their own –by end
of 2nd week is general practice to be 1st on call (with cover) – within 1st
month of 1st attachment, within 1st week of 2nd attachment.
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These are very rigid I think
there should be a degree of latitude to account for different GPRs' situations
e.g. sick leave, maternity leave.
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Participate in practice
significant event audit by 3 months
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Write multidisciplinary care
reports. Prepare own assessment of learning needs.
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Sounds a bit like more
paperwork! What will it replace?
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Audit – timescale set by
summative assessment process – unnecessary duplication to list as milestone
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Easiest way to implement in
Sheffield would be to have an "end of 1st attachment" form to be filled in by
1st trainer.
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I think that these milestones
are paternalistic and too presumptive. Everybody learns at a different pace, so
I think milestones can be dangerous. I think that it feels that there are enough
‘tasks’ to complete already (i.e. SA) without additional things to worry people.
Part of learning is the fun of discovery. When everything is ‘mapped out’ there
is a danger of feeling as though you are just someone else wearily plodding the
path.
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This feels like Medical School
and box ticking. For the part of the best of VTS is setting my own agendas,
deciding for myself what to learn, where to go. As it happens, with the help of
my trainer, I have achieved many of the above milestones, but I felt ownership
for them and I worked harder to achieve them. It was/is exciting. Just reading
the milestones fills me with apathy. Sorry not to be more enthusiastic.
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I think it is important to
provide guidance without making the whole process to dictatorial.
These milestones suggest what
is normally likely to be appropriate.
They are intended to help
trainers and registrars to know what is likely to be expected of them if they
are to make the best use of the registrars time on the scheme. They are not
intended as a rigid scheme, or another hoop to jump through.
It is right and essential that
each registrar negotiates with their trainer and their course organiser to get
the training opportunities that they need. (It is also important that work is
not left until the second six months of training which could reasonably be
attempted in the first 6 months, causing problems for the registrar and their
trainer).
