How GP training is delivered

General practice placements provide the core experiential learning environment for future professional and career development.

The current structure of GP training over three years incorporates experience in both general practice and hospital posts specifically selected as being suitable for GP training. The GP training model is for all training programmes to be increasingly constructed with 24 months spent in general practice posts and 12 months spent in specialty posts (24/12)⁸. Each post is referenced to the curriculum and 13 capabilities.

General practice experience might also be gained through an integrated training post (ITP) providing experience in a combination of general practice and other relevant posts, including outreach posts based in the community, specialty posts, usually based in hospital, and integrated care. An ITP can also include a non-specialty element such as research or leadership.

Learning opportunities include tutorials, informal learning, case discussions, meetings and quality improvement.

Reference

8. This is indicative – the Statutory Education Bodies (SEBs) in the four devolved nations have flexibility in how they approach this.

Hospital rotations approved for GP training are chosen to reflect exposure to problems encountered as a GP. Outpatient clinics can be valuable for seeing patients under supervision. Non-primary care environments provide experience of cases encountered as a GP but with a more concentrated exposure in specialist departments. This offers training in managing acutely ill patients and allows GP registrars to become familiar with the patient's journey under specialist supervision.

Hospitals also provide opportunities for GP registrars to attend a wide range of multidisciplinary team meetings to gain different perspectives on integrated care and team working.

Detailed information on methods of supervising training progression can be found in Section 4 of the Conference of Postgraduate Medical Deans (COPMeD) Gold Guide to postgraduate foundation and specialty training in the UK.

Clinical supervisors are responsible for day-to-day supervision in the clinical setting. They integrate learning with service provision by enabling GP registrars to learn by taking responsibility for patient management within the parameters of good clinical governance and patient safety and by providing constructive feedback during a training placement.

Educational supervisors monitor GP registrars’ progress over time to ensure they are making the necessary clinical and educational progress. The supervisor collates evidence of a GP registrar’s performance in a training placement, providing feedback to the GP registrar and agreeing action plans to ameliorate any concerns or issues identified.

The educational supervisor provides essential educational continuity in the assessment of overall progression towards the Certificate of Completion of Training (CCT) in general practice. The educational supervisor monitors the quality of evidence for learning through the portfolio and provides real-time and summarised feedback on workplace-based learning. An educational supervision review usually occurs annually and assesses all naturally occurring and formal evidence of achievement to make recommendations to the Annual Review of Competence Progression (ARCP) process. The educational supervisor will:

• ensure that the GP registrar is receiving appropriate support and teaching to have a good understanding of the RCGP portfolio and what is acceptable progress
• review portfolio learning log entries, provide formative feedback for reflective practice and review the GP registrar’s PDP
• assess formal evidence, such as the clinical supervisor’s review and patient and colleague feedback, against the RCGP curriculum competences
• meet the GP registrar to review the evidence against the 13 specific capabilities and make recommendations on training progress towards the CCT
• have an understanding of the relationship between WPBAs and the educational supervisor’s ARCP report
• identify the initial steps in managing GP registrars with problems and signpost them to appropriate additional support and resources where necessary.

All supervisors undergo an annual appraisal, which includes an appropriate element of educational appraisal.