All 4 entries tagged Gp

Being introduced to general practice

Along with all other Phase II students, my clinical partner and I spent a day last week being introduced to general practice by spending some time floating around the GP surgery to which we had been assigned. This introduction involved shadowing various professionals around our allocated practice and trying to get a handle on what each of them does.

Although I had seen GP surgeries from the patient’s perspective a fair number of times, being on the other side was very eye opening. It certainly changed my perspective about what GPs and their colleagues do and how complex running a practice can be behind the scenes. Needless to say, there’s a lot more going on there than meets the eye.

Most of the visits I’ve ever had to a GP surgery have been of the quick, ten-minute, in-and-out kind: I describe my problem to the doctor, and he or she gives me advice, a prescription or a letter. But of course there is much more to it, and our introduction showed us a little more of how complex that is.

We spent some time observing the receptionists (a missing member of staff for any number of reasons can mean that they’re really run off their feet – especially in the morning), got an introduction from the dispensary nurse (our practice also functions as a pharmacy because it’s so rural), shadowed each of the nurse practitioners for an hour or so apiece and even had a view from the waiting room – and all of this was before lunch!

There is a common misconception that GPs only deal with coughs and colds, but this couldn’t be further from the truth. We saw all sorts of minor procedures, including cleaning and redressing of wounds, taking bloods, vaccinations and lots of other things which aren’t really complex enough to warrant a hospital visit – plus, the nearest hospital was ten miles away, which is s significant distance for the less-mobile among us.

During lunch, my clinical partner and I each followed a different doctor on their home visits, and then we each observed about two dozen consultations apiece in the afternoon. The presenting complaints were as varied as can be imagined – and there was not a single cough or cold among them! If you like variety, thinking quickly and the surprise of not knowing what condition the next patient will present with, then general practice might just be up your street.

In the New Year, spending time at the GP surgery will form a key element of our core clinical education – we will be there at least once a week for each of the thirty weeks of the CCE segment. I’m already looking forward to it. The professionals in the office were very welcoming, the practice is run very efficiently and the idea of completing this portion of my education is very exciting.

John

Megan Earle : 20 Nov 2015 14:56 |  Tags: Gp John Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Venturing out into GP Land…

The lectures in Advanced Cases 1 have been tailored to achieve two main objectives: firstly ensuring we have the knowledge to understand multisystem and chronic diseases that we will be seeing on a regular basis in hospitals, and secondly, to understand the links between primary and secondary care.Our lectures in AC1 have been complemented by our placements in hospitals and last week we had our first adventure out into the mythical place that is GP Land.

Our community placements in Phase 1 taught us a lot about care in the community and the services available to different patients but last week was the first time we’ve actually been in a GP practice.In preparation for this we have had lectures this past week about the history of General Practice, from when General practitioners were brought into the NHS and regulated for the first time to the more recent creation of Clinical Commissioning Groups and GP Federations.

Throughout all these lectures there has been a common theme that has been emphasized, that as a GP you are often the first and last person that a patient comes to see.Patients will present to their GP with the initial signs of a problem and it is the GPs job to formulate a diagnosis and management plan.Even if that plan involves referral to secondary care that patient will eventually be discharged back to primary care and be managed by the GP long term.The opportunity to formulate a diagnosis and be able to follow up that patient over time is something that really appeals to me so I was very much looking forward to spending time in General Practice.

The GP practice I have been assigned to is a small practice in quite a deprived area with a large immigrant population, so the practice also has a full time interpreter.There are high drug and alcohol abuse levels in the local population and the practice is also the nominated service for a Parole Hostel, which brings with it a unique population with their own challenges.

While all this sounds a bit scary at first I think this presents a unique opportunity to work with a very diverse population with a variety of physical and mental health conditions as well as giving me real insight into the complex interplay with social aspects of our life.This has really put my Social and Population Perspectives theme from Phase 1 to good use! Working in a hospital you always enquire about social circumstances during a history but actually have very little time or power to be able to actually do anything about it.This is different for GPs who can take a more holistic approach.Come January we will be taking histories and examinations from real patients while on our GP placements which is equally scary and exciting!

The GP society at Warwick is very active and runs events throughout the year about different topics related to General Practice.Their next event is a night dedicated to GP special interests.Many GPs have a special interest, which is an area that they have additional training or knowledge in. At the practice I am based at, one of the partners had been in surgical training prior to becoming a GP, so he performed minor operations at the practice as part of his special interest area-often unannounced much to the nurses horror!

Even one day in GP land has shown me that it’s not all coughs and sniffles (although there are lots of tea and biscuits!) and there are lots of opportunities for medical students to learn about how diverse this area of medicine can be.

Joanne

Megan Earle : 17 Nov 2015 09:47 |  Tags: Gp Joanne Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

A day in the life of a GP!

A few weeks ago I spent a day shadowing various healthcare professionals at a GP surgery. The majority of my GP experience comes from my own visits so I was looking forward to seeing what really goes on, and getting to spend time with other members of the team.

During the day I spent time at reception, with the nurse, in the dispensary department, going on home visits and sitting in with the GP for their afternoon clinic. Getting to experience so many different aspects of the practice was so interesting, and enabled me to see a wide range of patients.

In reception you would have the regular patients who loved to have a quick catch up, the patients who didn’t have time to wait for the receptionist to answer their questions, and then everyone in between. As the morning got underway the surgery got busier and busier – the phone rang incessantly and more people had follow-up appointments to book. I got to see how the electronic system worked and how every clinic was coded and ordered.

When I spent time with the nurse I mainly saw a variety of injections – whether it was for a new-born, contraceptive needs or elderly vaccinations. The nurse was great at communicating with patients of all ages – and I got to see how best to deal with a screaming infant who did not want their MMR jab, even with the bribery of stickers and sweets!

The dispensing part of the surgery was really fascinating. My GP at home doesn’t have one so it was great to learn how they work, and which patients are eligible to use them. It was also interesting to see all the different ways prescriptions can be ordered – email, phone, paper... And then just how real polypharmacy is – some patients would have boxes and boxes of tablets. The pharmacist highlighted how it is just as important for them to check the different medications as the doctor, sometimes they can suggest a better alternative or a possible reduction when they are going through a prescription.

Having the opportunity to go on a couple of home visits was great. Neither of the patients really needed to see the doctor for anything important, they were both more of just a chat, but it showed how elderly patients in particular appreciate seeing a figure they trust and can open up to. Conversely, it also showed how sometimes such patients can take up a lot of time, and increase the pressures put on GP’s schedules.

Finally, sitting in on the afternoon clinic! I loved seeing again the real mix of patients that attended. Sometimes the doctor could guess what the presenting complaint was going to be, but other times it was completely random. It also gave me the chance to see what questions I would ask, or what areas I would examine and how that differed to what was actually done. I learnt a great deal and went home with a list of things to look up!

All in all I really enjoyed my day and am looking forward to my GP placement later on. I liked it a lot more than I was expecting, and therefore it made me re-think my preconceptions for various other specialities.

Megan Earle : 18 Nov 2014 12:01 |  Tags: Generalpractitioner Gp Mbchb Patients Rachel Warwick Wms |  Comments (0) |  Close comments |  Report a problem

Summer's out, let the hard work commence!

So we are already two weeks into the second year and it’s feeling like the summer was ages ago. Although, this term our timetable is much nicer than it was last year, so we can’t really complain! We no longer have our Friday sessions at University Hospitals Coventry and Warwickshire for anatomy, and now have a full day in hospital on a Monday. We also have a lot more free time during the week which allows us to go over the days lectures, do the Self Directed Learning work that has been set, and basically work at a much more relaxed pace.

The first week back mainly consisted of lots of holiday discussion. Most people wanted to make the most of our final long student summer and so went on fun, exciting holidays. Some people worked at jobs back home in order to have enough money for this next year (the NHS bursary can be great for some, or a real pain). For others it was just simply a time to relax and get away from studying for a while. A few lucky students went to Grenada for an anatomy master-class and spent five weeks doing dissection in the Caribbean. But whether people backpacked across Asia, or simply lounged on the sofa catching up on TV, I think everyone came back feeling more ready and prepared for another year.

Our second year starts with a 12 week block called Advanced Cases 1. This block is intended to build on what we learnt last year, adding more detail and information, and assisting us in understanding more about what is involved within the healthcare setting. It is also to help get us ready for after Christmas when we will be on placements. Our Mondays in hospital, for example, are split between bedside teaching (similar to what we had for half a day last year), procedural skills, and clinical learning opportunities. The clinical learning opportunities are to help give us the chance to spend time with various healthcare members and departments within our hospitals and GP surgeries, including management areas. Last Monday we had our first day and I had a great time first shadowing a matron and then spending my afternoon in the mortuary. It was fascinating finding out what matrons actually do – it was a lot more about ensuring the best opportunities and care for patients than I had realised. It was also really interesting to see what exactly goes on in a mortuary, and to understand how important it is to have a good relationship with all staff members to guarantee the best care, during and after life.

All in all I think this year will definitely bring new challenges and difficulties, but now that we have done the hard part of laying down the ground work, it should be much more enjoyable. Not that first year wasn’t – but I think after already having three years of a lecture based course I am looking forward to getting onto the wards, and hopefully we can start seeing what we have learnt and begin applying it!

Megan Earle : 09 Oct 2014 13:08 |  Tags: Gp Healthcare Mbchb Rachel Summer Warwick Wms |  Comments (0) |  Close comments |  Report a problem