GROWING INTO GENERAL PRACTICE
It's well worth starting with a big thank you for enabling me to take part in this wonderful conference! Not only was it a very sociable event, but also highly informative and in all parts relevant to me on the verge of starting my GP registrar year this August.
The venue was excellently chosen, very centrally located in the heart of Leeds with quick access to the pulsating life of the city centre and the local shopping mile. The accommodation, catering and layout of the conference rooms were formidable throughout. I'm sure this was part of the reason everyone got along so well. This culminated in the ‘best out-of-hours session’ on Thursday night with a good meal followed by extraordinary entertainment. Resident O&G Professor James Drife combined medical jokes and anecdotes with stand-up comedy and poetry to warm us up for some exuberant dancing well into the night.
The conference itself headed off with a welcome and introduction from Andrew Thomson, BMA GPR subcommittee chairman, Hamish Meldrum, BMA GP committee chairman and RCGP council chairman Mayur Lakhani. Together they gave an excellent overview over recent and expected changes (including improvements in the sluggish uprising of the PMETB) and job prospects weaved in with medical ethics and politics.
Hamish Meldrum delivered an in-depth SWOT analysis on being a GP with advice on how to make the best of the opportunities the specialty offers (work WITH the government; listen to public and colleagues; keep to principles, NOT progress; don't make career decisions too early; don't be put off by disillusioned GPs; and keep positive).
Mayur Lakhani added further advice (declare an ambition for general practice and take a leadership role; aim for clinical excellence and the highest standards; and ensure continuity of care).
Each day offered two 1-hour so-called parallel sessions looking at relevant topics of the GP career.
One session by David Wrigley, a Lancashire GP partner, concentrated on ‘taking the plunge’ into partnership and outlined sources of information on local practice infrastructure, on the financial implications, the importance of the partnership agreement and the many potential stumbling stones to look out for, such as parity, and differences of PMS/GMS contracts.
To end the first day's programme, a very interesting look into the mirror of interpersonal relations was given by three Glaswegian actors, later supplemented by volunteers from the audience who simulated true doctor–patient scenarios. Different situations showed how easily things can go mightily wrong and how difficult it is to establish a rapport, direct our empathy and control our judgement within the limited time of an encounter in everyday surgery. It was astonishing to learn that the majority of what we're saying is conveyed through body language and tone of voice with a meagre 7% left for the actual content of what is said.
Tom Earnshaw, a young Cheshire GP, was next to step up as the first of two speakers focusing on planning of training. Overall, Tom stressed the importance of not letting one's educational needs be submerged by (perceived) service commitments. Tom propagated a structured approach to the practice, it's staff (keep the receptionists on your side!) and equipment, financial and contractual plans, annual and study leave (giving advice on courses he found useful). An educational plan should be in place that is reviewed every 3 months. Tom also stressed the importance of planning for the individual exam components (study groups, start shooting videos as soon as possible) and certification, keeping in mind crucial deadlines and, again, submitting VTR forms as soon as possible.
Kate Adams, London sessional GP, then focused on training options after CCT qualification. She advocated on-thejob learning by regular case discussions and possibly sitting in with other GPs at the surgery. Kate also touched on elearning options and attending teaching sessions organised by the deanery.
After lunchtime I attended my final parallel block, this time on sessional GPs. This concentrated on potential catches regarding working time, pensions, annual, study and maternity leave depending on the contractual setting of salaried GPs (GMS versus PMS or APMS — with the latter two locally negotiated rather than based on a national contract) and freelance/locum work. The speaker, who was excellent, and whose name I sadly did not catch, also introduced the concept of retainer and returner schemes.
The conference closed with RCGP president Roger Neighbour giving us in-depth information on the individual modules of the ‘old’ MRCGP exam. This was highly relevant to myself and others in the early stages of their GP registrar year, but less interesting for those who would be sitting the new exam. This, as none of its parts are fully developed as yet, was not introduced. Neither was the current process of summative assessment mentioned (apart from the apparent ease of passing it). This would have been useful from my perspective. The advice given from an examiner's perspective on preparations and what to expect will surely prove useful to me.
- © British Journal of General Practice, 2006.