Abstract
I'm pleased to announce that the Postgraduate Certificate in Medical Education is mine. I am now a fully fledged GP trainer—and my, what a feeling!
What is unique in GP training is the one-to-one trainee—trainer relationship that facilitates learning for registrars and is something that I feel could enhance secondary care training too. In this article, my current F2 and I try to reflect personally on the trainee—trainer relationship and how secondary care could learn from it, and conversely, how primary care may learn from current hospital medicine training. So, without further ado, let me introduce you to Adam Briggs, an enthusiastic academic F2 with an aspiration for hospital medicine, with whom I have had the privilege to serve for 4 months.
From the trainee
As an F2 coming in to a general practice rotation with the intention of pursuing a career in hospital medicine, it was important to ask myself how I would best make use of my 4 months in primary care. The trainer is intrinsic in ensuring that such a trainee's experience is a positive and educationally fruitful one. To achieve this takes input from both the trainer and the trainee: a motivated trainee should agree a set of learning objectives at the beginning of the 4 months with the trainer setting a teaching agenda to address these.
My experience of hospital teaching has so far involved (ostensibly bleep-free) group clinical or theoretical sessions as well as opportunistic ward-based teaching from the SHOs or Registrars. Although of variable quality, the group teaching sessions have, in my experience, been largely relevant and useful. General practice, however, is the first speciality where I have had protected one-to-one ‘consultant’ taught teaching sessions. I appreciate that this may be impossible to guarantee in a busy hospital job and in my GP practice I don't necessarily get the group sessions.
Those trainees choosing to pursue a career in general practice or any other specialty need to ensure that they make the most of their one-to-one training opportunities. This type of educational interaction, on top of any group sessions or opportunistic learning, is invaluable and not always found across the medical specialties.
The other difference that I have noticed in my limited experience is that in general practice, I feel more isolated without the social cohesion that is achieved by going to the pub with colleagues after work or having a coffee over lunch to gossip. Perhaps it is those weekly group teaching sessions that help to fuel this sense of togetherness among trainees and trainers and allow the planning of social events. Perhaps general practice could learn from its hospital-based cousins that there is a role for striking a balance between one-to-one sessions and group discussion.
From the trainer
The one-to-one relationship in training facilitates a more personal relationship. Teachings and tutorials can be more learner focused and ‘tailor made’ to the needs of the individual trainee. Looking back to my hospital training jobs, I see how I could have benefited from a one-one tutorial once a week to identify, discuss and address my individual learning needs. As my current F2 reminds me, a hospital consultant may not have the resources to offer this to all his trainee's and perhaps we have become too accustomed to the abundance of GP trainers in the community. Furthermore, do primary care trainees lose something from the lack of group teaching that our hospital colleagues embrace so widely?
Shared learning and teaching have many benefits and perhaps we could use it more frequently in primary care. In my practice, all trainees have a group teaching as well as their personal tutorial each week, which bridges that gap somewhat. Furthermore, should we put more emphasis on opportunistic teaching during surgeries with interesting cases? This happens invariably on ward rounds but requires more effort during surgery with resulting delays. The one-to-one apprenticeship role GP trainees have is certainly something to be cherished … but one must always look for ways to improve.
That's all folks, until next time!