General Practice Rotation

We Phase-III students are now well into our second Specialist Clinical Placement (SCP) of eight in 2017. After six weeks learning all about Musculoskeletal Health, my clinical partner and I are now on the General Practice (GP) block through the end of March. It’s been an overall wonderful experience so far, and we both hope it continues to be. Every clinical-partner pair in this block is assigned to a local GP surgery, most of which are local to the medical school and South Warwickshire. Our practice is a very diverse one, and we have worked with five or six different GPs so far – and we’re only two weeks in! We of course had GP placements during our second year (Phase II) as well, and we rotated through three different practices over the course of our 30-week Core Clinical Education block.

There are some similarities to our consultations in Phase II but it’s also different in many ways. First of all, our time slots are a lot shorter. We’ve generally only got fifteen minutes per consultation (much shorter than 20 minutes – or sometimes 30 – during CCE). Secondly, we know so much more this time round! It’s amazing to think of how much we’ve learned in such a short time period. And finally, and most importantly, we are much more actively involved in the entire consultation – from history to management and safety-netting (ensuring that more-serious conditions are accounted for when discharging a patient). I feel like we are taken very seriously by our supervising doctors these days; this gradual increase in responsibility (and accountability) will help us well when we qualify.

We also spend time observing the consulting styles of different GPs at the practice, which is extremely valuable for our development from students into doctors. It’s really important to see how different people handle different situations with patients, and it’s also a vital part of our medical education to learn how to be flexible and adaptable. I cannot count the number of times that a consultation has come to an end and I’ve been amazed by the way a GP has dealt with a tricky topic or adapted a message to a specific situation; I know that this can come with years (and sometimes decades) of practice, but it really useful for us to observe these skills so that we can develop them for ourselves.

And of course, the GP block isn’t just sitting in on consultations with live patients. We have a lot of skill-building exercises and off-site teaching as well. Our block gives us two days per week at the medical school. Once per week we have teaching in very small groups, where we spend the day talking to simulated patients who present with a specific set of problems. For instance, the theme this week was “difficult consultations”, where we had to deal with very sensitive diagnoses and figure out the best way to discuss them with the (simulated) patient. My session had an actor playing a woman who had just tested positive for an STI, and I had to discuss the diagnosis and possible causes with her. It was a little awkward to discuss these issues for the first time, but I’d much rather it be awkward with an actor than with a real-life patient. Broaching sensitive subjects with patients, and bringing up topics that they might not want to hear, is of course a skill which is not used only in general practice; these are skills that are useful to doctors of all disciplines.

John

Luke Pemberton : 24 Feb 2017 15:16 |  Tags: John Mbchb Patients Student Warwick Wms |  Comments (0) |  Report a problem