General Practitioner Registrars Research Articles

B.A.R.D in the Practice – A Guide for Family Doctors to Consult Efficiently, Effectively and Happily

Forewords by Mayur Lakhani, Mike Pringle and Philip R Evans Respectively Chairman of Communications and Publishing, Royal College of General Practitioners, London; Head of School and Professor of General Practice, University of Nottingham; Former President of WONCA Region Europe. This groundbreaking book describes a completely new approach to the medical consultation, focusing on four key points: Behaviour, Aims, Room and Dialogue (B.A.R.D.). This practical approach has gained support from the Royal College of General Practitioners and reflects the way real family doctors consult in the real world, to the benefit of both the practitioner and the patient. Practical suggestions are made throughout the guide, with training exercises to aid in application. B.A.R.D in the Practice provides important reading for all general practitioners and general practitioner registrars.

Variations in the ability of general medical practitioners to apply two methods of clinical audit: a five‐year study of assessment by peer review

Clinical audit has a central role in the NHS clinical governance agenda and the professional appraisal of medical practitioners in the UK. However, concerns have been raised about the poor design and impact of clinical audit studies and the ability of practitioners to apply audit methods. One method of making informed judgements on audit performance is by peer review. In the west of Scotland a voluntary peer review model has been open to general practitioners since 1999, while general practice trainees are compelled to participate as part of summative assessment. The study aimed to compare the outcomes of peer review for two methods of audit undertaken by different professional and academic groups of doctors. Participants submitted a criterion audit or significant event analysis in standard formats for review by two informed general practitioners (GPs) using appropriate instruments. Peer review outcome data and the professional status of doctors participating were generated by computer search. Differences in proportions of those gaining a satisfactory peer review for each group were calculated. Of 1002 criterion audit submissions, 552 (55%) were judged to be satisfactory. GP registrars were significantly more likely than GP trainers (P < 0.001) and other established GP groups (P < 0.001) to gain a satisfactory peer review. GPs in non-training practices were less likely to achieve a satisfactory review than registrars (P < 0.001) and colleagues in training practices (P < 0.001). Of 883 SEA submissions, 541 (65%) were judged as satisfactory, with all groups gaining a similar proportion of satisfactory assessments, although GP registrars may have outperformed non-training practice GPs (P = 0.05). A significant proportion of GPs may be unable to adequately apply audit methods, potentially raising serious questions about the effectiveness of clinical audit as a health care improvement policy in general medical practice.

The sexually transmitted infection foundation (STIF) course

General practitioners (GPs), GP registrars, practice nurses, trainees in obstetrics and gynaecology, general medical and infectious disease doctors—anyone who might need to assess a patient's risk for sexually acquired infections. I did it in my third year on a general medical rotation. I was considering a career in genitourinary medicine and felt it would be a good introduction to the topic. It's a two day course consisting of lectures and workshops. A precourse …

Membership of the Royal College of General Practitioners (MRCGP)

MRCGP signifies the achievement of a high professional standard in family practice set by the Royal College of General Practitioners (RCGP). It enables general practitioners not only to enjoy the benefits of the professional organisation of their discipline but also to have an influence in the development and management of the medical profession as a whole through participation in college activities. During my general practitioner registrar year in the 1990s. To achieve a high standard of professionalism in general practice and to equip myself for academic practice in family medicine. My preparation started 12 to 15 months before the exam and included self study, attendance at a weekly half day release course, and a revision course. I studied about 5 to …

Sexual health care training needs of general practitioner trainers: a regional survey

ObjectivesThe National Strategy for Sexual Health and HIV aims to facilitate improved patient access to sexual health care, primarily in general practice. This study aimed to identify sexual health care...

The hospital component of training for general practice: the experience and aspirations of general practitioner registrars in the Eastern Deanery of England

(2005). The hospital component of training for general practice: the experience and aspirations of general practitioner registrars in the Eastern Deanery of England. Education for Primary Care: Vol. 16, No. 1, pp. 21-30.

Adding to academic extensions

Editor—As academic general practitioner (GP) registrars, we agree with Rachel Hardwick and Sinead Regan that an academic GP registrar extension provides a solid base to begin a career as an academic GP.1 Our experience of the scheme is that it offers more than …

Medical students' and GP registrars' accommodation needs in the rural community: insight from a Victorian study.

Medical education in Australia is currently entering a new era, including support for the significant extension of medical students and general practitioner (GP) registrars' training programs in rural communities. This commitment to rural medical student and general practitioner recruitment and retention has made the provision of accommodation in rural communities a vital issue. This study has found that approximately half of all medical students on placement with rural GPs are currently accommodated with their GP supervisor or with other practice staff. This is a burden for many GPs and when the anticipated increase in the frequency and length of rural placements occurs what is currently a burden will become unsustainable. The changing gender and cultural demographics of medical students and rural general practitioners will also contribute to stresses on this accommodation system. It is important to have a systematic approach towards more appropriate and sustainable models of accommodation for both medical students and GP registrars.

The Greencard system for general practitioner registrars in Scotland

The Greencard system for general practitioner registrars in Scotland

Selecting general practitioner registrars: the West Midlands model

Selecting general practitioner registrars: the West Midlands model

TIPS ON...Choosing a practice as a general practitioner registrar

TIPS ON...Choosing a practice as a general practitioner registrar

Competency based selection system for general practitioner registrars

Competency based selection system for general practitioner registrars

Meeting the training needs of GP registrars in child abuse and neglect

AbstractA questionnaire survey undertaken among general practitioner registrars in North Thames in 1998 revealed significant deficiencies in their child protection training. A minority expressed confidence at the prospect of dealing with child protection cases in the future. A new, interactive training package was subsequently developed and delivered to a sample of GP registrars in Northeast Thames in 1999. Preliminary evaluation confirmed that the new training material was sensitive to the needs of recipients and levels of perceived confidence with participation in child protection work were increased. Further work is needed to develop the package and to oversee its successful incorporation into general practitioner vocational training. Copyright © 2001 John Wiley &amp; Sons, Ltd.

Audit and summative assessment: a completed audit cycle.

To develop and test a system for delivering a completed audit cycle for summative assessment of general practitioner registrars in the United Kingdom. A trainer-based questionnaire on criteria for a completed audit cycle, followed by two marking exercises of audit projects submitted by general practice registrars. Training practices in the West of Scotland between 1997 and 1998. Trainers and registrars in the above practices. 116 (89%) agreed that two collections of data were an essential or desirable part of an audit project. All 57 registrars who started in August 1997 successfully completed an audit cycle, seven (12%) after resubmission. Using two rather than three independent assessors to screen the projects, the marking instrument was shown to have a sensitivity of 95% (95% confidence interval (CI) +/-3.9%) and a specificity of 77% (95% CI +/-7.5%). All assessors found the new system easier to mark and 47 registrars (87%) found completing an audit cycle as or easier than expected. Evidence from the pilot project has shown that a general practice registrar's ability to review and critically analyse a piece of his/her work, with appropriate management of any necessary change, can be tested feasibly by means of a completed audit cycle within the registrar year. The process retains adequate levels of sensitivity and specificity and requires fewer assessors for marking the projects.

A year as academic general practitioner registrars

A year as academic general practitioner registrars

Domestic violence a comparative survey of levels of detection, knowledge, and attitudes in healthcare workers

The objective of this study was to compare the knowledge, attitudes, responses and levels of detection of domestic violence among a variety of healthcare workers in different specialities. Self-administered questionnaires were sent to community and hospital based healthcare workers in Oxfordshire working in primary care, obstetrics and gynaecology, mental health and accident and emergency. These comprised all principal general practitioners and general practitioner registrars, 50% of practice/district nurses and health visitors in each practice, and all healthcare workers in obstetrics and gynaecology, community mental health teams and accident and emergency in one trust. The amount of domestic violence detected in different healthcare settings was far less than indicated by anonymous surveys and crime figures. Knowledge about many of the issues surrounding domestic violence was inconsistent and there were fundamental deficiencies. The attitudes of healthcare workers to domestic violence were generally sympathetic and supportive. Women, nurses and community mental health workers reported significantly better knowledge and more positive attitudes than other respondents. Gender, role and speciality were independently associated with more positive attitudes and the latter two were independently associated with good knowledge. The response that healthcare workers make when they uncover domestic violence is confused and often inappropriate. In conclusion, most healthcare workers accept that domestic violence is a healthcare issue but lack fundamental knowledge about the issues surrounding domestic violence itself and appropriate agencies that can offer help. They also lack skills in identifying and discussing this issue with patients/clients. A large, unfulfilled training need has been identified. Public Health (2001) 115, 89–95.

Domestic violence: a comparative survey of levels of detection, knowledge, and attitudes in healthcare workers

The objective of this study was to compare the knowledge, attitudes, responses and levels of detection of domestic violence among a variety of healthcare workers in different specialities. Self-administered questionnaires were sent to community and hospital based healthcare workers in Oxfordshire working in primary care, obstetrics and gynaecology, mental health and accident and emergency. These comprised all principal general practitioners and general practitioner registrars, 50% of practice/district nurses and health visitors in each practice, and all healthcare workers in obstetrics and gynaecology, community mental health teams and accident and emergency in one trust. The amount of domestic violence detected in different healthcare settings was far less than indicated by anonymous surveys and crime figures. Knowledge about many of the issues surrounding domestic violence was inconsistent and there were fundamental deficiencies. The attitudes of healthcare workers to domestic violence were generally sympathetic and supportive. Women, nurses and community mental health workers reported significantly better knowledge and more positive attitudes than other respondents. Gender, role and speciality were independently associated with more positive attitudes and the latter two were independently associated with good knowledge. The response that healthcare workers make when they uncover domestic violence is confused and often inappropriate. In conclusion, most healthcare workers accept that domestic violence is a healthcare issue but lack fundamental knowledge about the issues surrounding domestic violence itself and appropriate agencies that can offer help. They also lack skills in identifying and discussing this issue with patients/clients. A large, unfulfilled training need has been identified. Public Health (2001) 115, 89–95.

The Beach doctor

Debashis Singh talks to Dr Nick Imm, a general practitioner registrar and doctor on the set of the film The Beach

General practice registrar responses to the use of different risk communication tools in simulated consultations: a focus group study

Objectives: To pilot the use of a range of complementary risk communication tools in simulated general practice consultations; to gauge the responses of general practitioners in training to these new...

Psychiatric training for family doctors: what do GP registrars want and can a brief course provide this?

About 40% of British General Practitioners (GPs) train formally in a psychiatric post as part of their general practice training, but such training may not fully meet the needs of future GPs. A specific course in psychiatry for family doctors has run in Manchester for more than a decade. Semi-structured interviews conducted with GP registrars before attending the Manchester course in psychiatry with questionnaire follow-up afterwards to ascertain (a) the training 'wants' of GP registrars and (b) whether the course was providing them. GP registrars most frequently wanted training in communication skills, how to access the resources that are available to GPs, the detection of psychiatric illness, drug treatment and the management of aggression. The course was successful in satisfying the first three but failed in the last two. There was trend for those who attended Manchester Medical School, which scored significantly higher on number of topics covered at undergraduate level, to perceive a greater need for training than those who attended other medical schools. However, there was no evidence to link self-perception of greater need with having already worked in general practice during postgraduate training. More attention needs to be paid to how to address the specific mental health skills training requirements of GP registrars both within the attachment in psychiatry and during the practice year. Preliminary research is required to devise teaching packages before they are entirely satisfactory for GP education.