Provisional August 2022 Grampian Rotations Announced....

Provisional rotations for the Grampian GP Training Programme have now been published on the North of Scotland GP Training Blog. These are only provisional rotations but give you a good idea of what is going to be on offer. The GP Practices for the Grampian Programme are located in Aberdeen City and throughout Aberdeenshire.

https://scotlandgptrainingprograms.blogspot.com/p/grampian-3-year-program.html

Where is the Joy in General Practice for you?

I never thought I would find myself working for something as cheesy sounding as The Joy of General Practice. And I didn’t expect to then be working where I am right now. Therein lies the essence of a career as a GP – the opportunities are endless and varied, though very much dependent on our commitments elsewhere in life, not to mention the need at times for a wee sprinkling of courage.

As GP trainees we all have ideas of what we think we are looking for from general practice. Very often those ideas are based on our experiences to date, which can be limited. Training practices are often quite rightly seen as exemplars of practice – well organised, well staffed, and with a supportive environment. The reality of the post training world can be quite different – struggles to provide cover, overwhelming workload, challenging personalities and a finger-in-the-dyke approach out of necessity. Why is that? How can we spread the positive experience of most training practices to help and enhance those where the biggest challenges lie? Do we just continue feeding the well run practices with trainees who have experienced little else, while leaving other practices to struggle?

We all like to feel comfortable and there are times in our working life when that is what we need. The last 20 years as a partner and trainer in a comfortably ticking along training practice has been that for me, and I am grateful for the experience, stability and patient connection that I have had. Before arriving there, varied locum and overseas experience gave me fantastic perspective and memories to last a lifetime - my own wee bit of courage took me off to rural Canada immediately after GP training with no regrets. It has left me with a longstanding itch to keep exploring the breadth of what being a GP actually means.

The Scotland Support Team of the Joy of General Practice project has at its heart an opportunity to scratch that itch and once again provide new challenges, while at the same time allowing me to both share and broaden my experience. I would have loved this kind of organised opportunity when I finished my GP training more than 20 years ago to see what was out there, but there’s now a different dimension in doing it at the other end of my career. Like any newly qualified GP I have to prove myself in different places with different people, learn new systems, adapt to different philosophies and hopefully help where help is needed. The added value may come from my own past experience, though that could be a hindrance if not carefully applied. Time will tell. So far, it has been all of fun, frustrating, eye opening, challenging and rewarding – what General Practice should be, in my view.

There are some newly qualified GPs who have joined the Joy team and I look forward to catching up with them. I hugely admire their courage in putting themselves forward for situations that may well be outwith the comfort zone of their training practices. They will be rewarded for that courage by finding an ability to turn their hand to anything, anywhere. This will in time make it easier to find work that gives a level of comfort, stability and challenge that really suits where they are at in their lives. If it also enables and empowers the development of practices without the structures and standards offered by Training Practice accreditation, then we may ultimately help Scottish general practice as a whole towards a better place.

Who knows, we all might even find a wee bit of joy while we’re at it too.

Sandy Rough

October 2020

https://www.srmc.scot.nhs.uk/joy-project/rediscover-the-joy-of-general-practice/

RCGP North of Scotland Grant and Macleod GPST of the Year Award 2020

"Coming towards the end of my GP training it was satisfying when my ES told me anumber of weeks agp that he had felt fit to nominate me for the North of SCotland GP Trianee of the Year awards. 

Amongst all of the many, often daily, changes to work adn training over the last few weeks the memory of our breif discussion had been lost.

When asked to call one of the Training Programme Directors recently my immediate thought therefore was: "there must be something wrong with my e-portfolio!"  To be told I had actually won the award was surprising and, honestly, slightly embarrassing. I am very aware of some of the exceptional personal and professional accomplishments of prior winners and also those of my contemporaries in GP training in the North. 

Generally I felt that I had simply being doing my job, hopefully mostly proficiently, for the last 3 years and to be recognised as having actually been doing better than that was unexpected but satisfying.

Being told of the award and approaching the final weeks of my training has given me cause to reflect (it is an award related to GP training of course...). 

I have been lucky to have had exceptional posts throughout my programme based in Caithness and Orkney. Each was unique, rurally focussed and provided valuable experience that will stand me in good stead in the future. 

A man cannot build his house on sand however and these rotations were supported by excellent educators that certainly deserve mention for enabling me to feel supported at work, learn and undertake some of the extra work that has led to the award: Drs. Idris Thomas, Alison Hughes and Huw Thomas. 

Additional support and education provided by staff at the Deanery has also been much appreciated. I have also had the pleasure of working with innumerable other colleagues over the last three years in a variety of settings and without their team working, good humour and guidance I do not think my training could have be so successful. 

In particular it has been an honour to be part of my training practice team, Dounby Surgery, for nearly 18 months. I have learned the art of General Practice in some way from each and every person who works there and to them I am eternally grateful - thank you. 

I think my advice to future or new GP trainees embarking on a training programme in the North would be three fold. 

Firstly, see every day as a potential learning opportunity even if it appears to be a routine day in surgery. There is always something presented to you that you haven't seen before or is presenting in a different way.

Perhaps another member of the team might approach you with a query that you aren't quite sure how to advise on. Using these moments of uncertainty to trigger further discussion with your supervisor, background reading and yes reflection can make every day valuable and stimulating as you develop as a doctor. 

Another factor that I think has been fundamental to an enjoyable and successful time in training is fostering an effective partnership with your trainer early on. I can see how it might be easy not to do so early in training while in hospital posts but GP training is quite short and utilising every month as effectively as possible will make for a smoother journey overall. 

Generally, I have found that those that are trainers are highly enthusiastic and keen to impart knowledge and wisdom. Utilise this to benefit your own development and recognise that often as a trainee you can actually have a similar effect on your trainer. 

Having a good understanding and mutual agreement about your priorities and objectives with each other can also be useful in allowing you to achieve my third piece of advice. As a trainee you will often be full of energy and ideas that can be hugely beneficial to the setting you are working in and potentially further afield. 

Finding time to undertake some additional work outside of routine clinical work can be satisfying, maintain enthusiasm and give some broader perspective on the system within you are working. 

Of course, it can be tiring when trying to juggle this with exams and keeping up with e-portfolio but quite a lot can achieved with not a significant additional time investment and often this can be negotiated with your supervisor within the working week. I have been involved in a variety of different antimicrobial stewardship quality improvement projects and have also sat on the health board Antimicrobial Management Team. It is educational to understand a bit of the "bigger picture" regarding how healthcare systems operate within which you are working.

Choosing to do rural GP training in the North is certainly a decision I'd recommend to anyone considering a career in General Practice. The experience has been varied, stimulating and challenging, with opportunities to explore my own interests alongside routine work. I definitely feel well prepared to begin work as a thoroughly well trained newly qualified GP. 

I would like to express my thanks again to all of those who have been involved in and supported my training in numerous roles. Thank you also to the local RCGP faculty for sponsoring the award. "

 Dr Jack Cunningham

GPST3

Dounby Surgery

Dounby, Orkney 

Planning for Induction

Despite the current Covid-19 Lockdown, plans are well underway for welcoming new GPST1 trainees to Grampian.

The Deanery team are currently exploring options for a virtual induction programme in the event that social distancing measures are still in place in August.

General Practice has always been a flexible and adaptable speciality and we are confident that we will have a comprehensive programme ready to welcome the next generation of GPs.

ENT Core Workshop

Grampian GPSTs taking part in a full day ENT core workshop. The session, which was co-ordinated by the ENT department at ARI, included short lectures on common Primary Care ENT problems and a series of practical sessions and demonstrations of examination techniques and manoeuvres.

The trainee got a lot from the session as you will see from their feedback:

"Comprehensible, concise, practical"

"Excellent visual aids"

"Time to practice manoeuvres at the end"

"Presentations were relevant GP targeted topics"

"Enjoyed the enthusiasm of all the speakers"

"Good practical session"

"Good question and answer session"

"Learned how and when to refer various ENT conditions"

"Useful information about how common ENT conditions can be treated in the community"

Protecting Vulnerable Groups

GPSTs on the Grampian Programme had the opportunity to participate in an interactive session focussed on protecting vulnerable groups. The session was led by Jacqui Mackintosh, Joint Training Co-Ordinator for Learning and Development within NHS Grampian. Trainees had an opportunity to discuss and reflect on a number of clinical cases with an Adult Protection theme.

New Start to GPST Group Work

Last week saw the new Grampian Programme ST1s attend their first group work session. The new ST1s (some of whom had already been in to the department for PBSGL training) were welcomed by some members of the deanery team, their GP group facilitators, and their ST3 colleagues.

The certainly looked just as happy at the end of the session as they did at the start!