Training for general practice.

  • Great Britain. Joint Committee on Postgraduate Training for General Practice.
Date:
1982
Catalogue details

Licence: Open Government Licence

Credit: Training for general practice. Source: Wellcome Collection.

    9/80 (page 7)
    Suitable hospital experience is regarded as an important part of postgraduate pre- paration for general practice. The concentration of clinical material, and the ready supervision by senior colleagues, can rapidly enhance clinical skills and help bring about professional maturing, with a general gain in competence and confidence. In addition, while it is true that most patients’ illnesses can be contained by general practitioners and successfully managed without recourse to hospital in-patient or out-patient facilities, it is equally true that most people can expect to be admitted to hospital at least once if not several times within a lifetime; and so first-hand knowledge of hospital procedures and of what hospitals can offer is of importance to general practitioners. At the same time a perspective on the relationship be- tween general practice and specialist services is achieved from the hospital standpoint. Criteria for selecting posts Since it is manifestly impossible for every relevant hospital specialty to be included in an individual training programme, selection is inevitable; but the nature of the specialty is not the only criterion. A particular post in a specialty conventionally regarded as highly relevant to general practice might in fact provide an undue pro- portion of narrowly technical or repetitive work, while another post in a more specialised discipline may show valuable features of patient care, or have a vigorous teaching programme. The points to which particular attention is paid are: as Nature of clinical experience: its range, amount, quality and continuity; whether ambulatory as well as in-patient Supporting services: adequacy of nursing, investigation and rehabilitation — Supervision and responsibility: a gradual increase in responsibility under the supervision of the consultant and senior colleagues — Educational aspects: an active programme, involving personal teaching by the consultant and his registrar; departmental audit and patient-management review ; interdisciplinary meetings; clinico-pathology conferences; library facilities — Liaison with community-based services: home nursing, social work depart- ments, and especially general practitioners. The trainee’s work-load is expected to be such as to give sufficient experience yet allow adequate time for patient care and for his own learning. Within the discipline concerned, the range of work ought to be as wide as possible, and not confined to a highly specialised area such as neonatal care, or to only a single aspect of the service such as in-patient gynaecology. A sequence of short-term rotations, for instance two months each in ENT, Eyes and Skins, may be a good way of covering a number of ‘“‘minor”’ specialties; but longer continuity of care is also desirable. Supervision should be adequate, and as the trainee progresses through the post he should be allowed increasing responsibility. Help should always be available from senior colleagues.