The Working and Learning Week

It is sometimes difficult to get the balance right between learning by seeing patients in a formal surgery setting and learning through other opportunities. The details set out below illustrate how you might plan the learning programme over a typical week with a doctor who is in your surgery on the standard four-month placement.

The working/learning week for a F2 doctor is 40 hours divided into 10 sessions. The F2 is not expected to do out of hours work during their general practice rotation. They are not expected to work beyond 7am-7pm.

Morning and evening surgeries will often be of varying lengths and lunchtime meetings count towards their hours.  Free time during the day, not used for meeting is own time.  Practice location will have a bearing on the F2 doctor’s schedule.  Ideally they would not have long gaps in the working day but can be encouraged to complete an audit/quality improvement project or e-learning for example.  Visits count towards their working hours.

6 -7 Surgeries

• - These will usually start at 30 minute appointments for each patient and then reduce to 15- 20 minute appointments as the F2 doctor develops their skills, knowledge and confidence.
• - The F2 doctor must have access to another doctor, though this does not have to be the trainer in the practice.
• - The F2 doctor does not need to have their own consulting room and can use different rooms so long as patient/doctor safety and privacy are not compromised.

1 x session for de-briefing

•   - The F2 doctor will receive most of their teaching through de-briefing of their clinic contacts.
•   - De-briefing should occur after each surgery and no later than 24 hours later. The F2 must have access to supervision during surgery time if needed.
•   - The de-briefing must ensure patient safety and encourage the F2 to reflect on what went well, what could be better and how this links in with their PDP and the curriculum.

1 x session on project work or directed study

• - Your F2 may want to undertake a project or audit during their time with you. They should have protected time to do some research, collect the data, write up the project and present their work to the practice team.

Average 1 x half day release     

• - Arranged by Foundation Training Programme Director

Tutorials

Tutorials are not obligatory but F2 doctors should ideally receive some regular teaching, either within the practice or as part of a local GP educational programme.

Associate trainers supervising ST doctors can give tutorials.

• - Tutorials can be given either on a 1:1 basis or as part of a small group with their learners.
• - Any member of the practice team can and should be involved in giving a tutorial.
• - Preparation for the tutorial can be by the teacher, the learner or a combination of both.

Chronic disease management

• - It is important for F2 doctors to realise how much ‘acute illness’ is due to poorly controlled chronic disease and social circumstances.
• - It is important to expose them to chronic disease diagnosis and management.