Year 5 medicine placements supervisor information

The students are preparing to become foundation year doctors. Experience in general practice will enable them to become more autonomous and confident in assessing and managing patients.

What is the structure of Year 5?

Placement blocks will be for four weeks at an average of three days per week, total 12 days per block. This may be across all seven days of the working week and may include periods outside of normal office hours (e.g. night shifts, weekends).

The student will attend one day on campus per week. This will be Monday or Thursday and confirmed to you at the start of the academic year. Students can work with any member of the team whom you feel appropriate.

All students will do at least a four-week block in primary care with the possible option of doing a further block. They will also do compulsory blocks in front door medicine, assistantships, research and mental health. The students also have a choice of specialty blocks. These placements focus on an area of career interest or in a subspecialty to which students may have not had exposure to date.

The focus while in general practice is on collaboration of learning, and preparation for practice. It is therefore expected that students will see their own patients within a 'student surgery'. All patients then being reviewed by a supervisor.

If you would like further information about procedural skills, please email the Year 5 Workplace-Based Skills Facilitator at Burnley.

What are the aims of the Year 5 GP placement?

Building on their experiences in general practice gained in years one to three. The students are expected to develop their skills across the broad range of primary care presentations.

The primary focus should be on seeing patients in a student surgery, with patients booked in directly with the student. Due to the new ways in working in primary care, we understand that this may initially take the format of a supervised telephone or video consultation.

The student is expected to undertake:

History-taking
Examination (where appropriate)
Formulate differential diagnoses and a management plan.

Then present this to their supervisor, who would then review the patient themselves. We also encourage the students to document their findings.

Students should not prescribe independently. Where time allows though, please encourage the students to think about what they might prescribe in different scenarios. They can use the online BNF where required.

Students may perform examinations unsupervised, with the exception of intimate examinations where they should have a suitable chaperone. However these examinations should be repeated/confirmed by their supervisor.

Once a procedure has been signed off as competent by our Skills Team. The student may then perform this procedure supervised. This is in keeping with the student practising within their level of competency. They should be supervised by a person with appropriate experience and competency in the procedure. For example a GP or suitably-trained practice nurse when carrying out venepuncture or IM injections (excluding immunisation).

Our policy is that students are not permitted to undertake any invasive procedures on each other. For example taking blood, even under the direct supervision of a GP.

If you would like further information about procedural skills, please contact the Year 5 Workplace-Based Skills Facilitator:

We recognise the breadth of activities going on in general practice as important learning experiences for students. Therefore variety is encouraged in a student’s week to give them a real feel for modern-day general practice.

As a starting point, you might consider booking clinic with the student for six out the eight sessions per week. With the other two timetabled sessions used for other primary care related activities. These activities will vary practice to practice, but might include;

Shadowing other members of the primary care team
Home visits
MDT meetings
GSF meetings
Minor surgery
Contraceptive clinics

Please ensure that the student is safe and well supervised in these sessions. We encourage students to partake in home visits however request that these are supervised. No student should undertake home visits alone.

What are the core capabilities and learning outcomes expected?

The Year 5 programme is structured around 20 core capabilities and a series of learning outcomes. All are based closely on the foundation year one programme. This is to enable students to transition smoothly into postgraduate learning after graduation.

All medical students graduating from UK universities from the academic year 2024–25 onwards will need to pass the Medical Licensing Assessment (MLA) as part of their degree before they can join the medical register.

From 2024 the MLA is embedded within the MBBS programme, so that students graduating from the course will have met the requirements of the MLA. The Applied Knowledge Test is sat at the end of Year 4, and the Clinical and Professional Skills Assessment is sat at the end of Year 5.

Students will have already spent considerable time in general practice settings in years one to three. They should be familiar and comfortable with the concepts of comprehensive primary care and ways of working. By the end of Year 5, it is expected that they should be able to meet all of the core capabilities and learning outcomes below:

Core capabilities

Has worked effectively to establish themselves in clinical practice in their role at the level of a final year medical student including:

Recognises, assesses and initiates management of the acutely ill patient
Recognises, assesses and manages patients with long term conditions
Obtains history, performs clinical examination, formulates differential diagnosis and management plan
Requests relevant investigations and acts upon results
Prescribes safely
Demonstrates understanding of the principles of health promotion and illness prevention
Manages palliative and end of life care

Has established him or herself as a member of the healthcare team including:

Works effectively as a team member
Demonstrates leadership skills

Has been able to adapt practice to suit the clinical setting in each placement including:

Communicates clearly in a variety of settings
Recognises and works within limits of personal competence

Has demonstrated the ability to learn in the workplace

Keeps practice up to date through learning, teaching and reflecting
Demonstrates engagement in career planning

Has demonstrated the knowledge, skills and behaviours necessary to apply:

The professional duties
Principles and responsibilities set out in good medical practice
Generic professional capabilities framework
Other professional guidance and statutory legal requirements

Acts professionally
Delivers patient centred care and maintains trust
Behaves in accordance with ethical and legal requirements
Makes patient safety a priority in clinical practice
Contributes to quality improvement

Is competent to perform the core procedures mandated by the General Medical Council (GMC)

Performs procedures safely
Is trained to assist at cardiac arrest

Learning outcomes

Recognise red flag symptoms for the community block core clinical presentations and describe appropriate actions which should be taken
Describe the circumstances when home visits may be appropriate and appreciates the challenges that may be inherent in assessing a patient in a non-clinical setting and how these may be addressed
Describe the role of the primary healthcare team in a community setting and how this functions effectively to maximise patient care

Understand how services are provided out of hours in a community setting
Understand the concept of "safety netting", the indications for this and develop the communication techniques to undertake this
Develop the communication skills to conduct a consultation in a limited timeframe and how to overcome the challenges inherent in this
Develop the communication skills to conduct a consultation via telephone for either an acute or follow-up appointment
Describe the techniques for conducting a consultation or assessment when remote from the patient, recognising the limitations
Reflect on the limitations of the medical professional to effect change and acknowledge the emotions this may generate
Interpret a hospital discharge letter and understand what actions are commonly required post-discharge in the community
Demonstrate an understanding of how patient records are kept in primary care and the use of systems such as EMIS
Utilises clinical reasoning skills to deal with undifferentiated presentations
Utilises prioritisation skills to determine appropriate management strategies for patients presenting with multiple problems
Reflect on why some patients may attend frequently and consider strategies for managing expectations
Recognise the issues of uncertainty and risk inherent with working in a primary care setting; develop strategies and resilience appropriate for dealing with this
Discuss how issues such as poverty, unemployment and housing impact on health and wellbeing; describe sources of advice or help for patients with such problems
Understand how healthcare services in the community are structured and resourced
Construct clear, timely referral documents to clinical and non-clinical colleagues – using the SBAR approach
Demonstrate understanding of clear communication with other HCPs about prescribing including accurate use of nursing authorisation charts.
Recognise ethical dilemmas in Primary Care and suggest appropriate management options
Reflect on patient centred care in relation to multi-morbidity including implication of over diagnosis, under diagnosis, treatment burden and iatrogenesis
Appraise the benefits and limitations of continuity of care
Explain what is meant by the term Medically Unexplained Symptoms
Describe the difference in assessing patients in an Out of Hours setting vs in core GP hours
Formulate a plan for continued self-reflection and learning including identification of PUNs and DENs
Demonstrates the ability to recognise situations that finds stressful and proposes a plan to maintain own resilience
Identifies options and local pathways for social prescribing
Demonstrates an understanding of the role of general practice within the NHS , including the role of GP as independent contractor and basic primary care business models.
Reflects on the role of primary care within the NHS and compares with different models of healthcare abroad
Reflects on the role of GP as gatekeeper
Recognises the role of QoF (Quality and Outcome framework) and local Quality Targets in patient care and implications around achievement of these target for primary care business models
Cites relevant primary care research

Some of the above core capabilities and learning outcomes will also be covered in campus-based teaching.

Year five FAQs

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What are the expectations of the Year 5 GP supervisor?

Students will be given your name and practice in induction week. We encourage students to make contact with you. However students also appreciate GP practices making contact with them with reporting details and any preparatory material prior to the start of the placement. For example a practice student handbook.

The student should be made aware of their supervisor for each session. They should be supervised by an appropriately experienced clinician. The supervisor for a particular session might be different to their overall named supervisor.

Meeting forms

Two formal meetings are required in the four-week GP placement with the student’s named supervisor. These are the induction meeting and an end of placement meeting.

The initial meeting should include:

Any induction required
Introduction to relevant staff
Discussion of the timetable
A plan for the sessions and any specific agreed learning objectives

The end of placement meeting includes completion of the end of placement form. Wherever possible, feedback should be sought prior to the end of placement meeting from the wider Primary Care Team regarding the student’s performance.

All forms are completed as an e-form within the student’s e-portfolio - Pebble Pad. The student will either bring a tablet PC to the meetings and will access the forms on that, or via any desktop PC. Forms are always accessed via the student’s account. Supervisors do not need their own direct access to Pebble Pad.

What assessments am I expected to undertake?

Students must undertake:

Four Mini Clinical Evaluation Exercises (Mini-CEX)
Four Case-Based Discussions (CBDs)
Nine Direct Observation of Procedural Skills (DOPS)

In total across the three blocks of the year. It is advised that one CBD and mini-CEX be in GP and therefore it is helpful if these assessments can be facilitated.

A Workplace-Based Skills Facilitator is available to assist students with this process and to identify and train assessors in the clinical areas. Facilitators will also monitor students’ progression against their WBA requirements. They may liaise with you as a GP supervisor if there are any concerns. This might enable some particular sessions to be run in the general practice setting that addresses particular learning needs.

As a GP supervisor, it is not a requirement to formally assess DOPs. Out of the DOPS in Year 5, it is likely that only phlebotomy could be reasonably achieved in GP. However, we know that many like to do so.

Students undertake a range of other assessments with the university, which include:

Clinical logs
Prescribing logs
SSC and elective reports
Reflective reports
Multi-source feedback
OSCE examinations
Portfolio review
Exit reviews

Suggestions of timetables

Whilst we recognise that no two GP practices are the same, it can sometimes be helpful to have a starting point on which to base your student’s timetable. Please see the timetables below for some inspiration.

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Week one - induction
Time	Day one	Day two	Day three
9am - 10.30am	Welcome and induction	Observe HCA/phlebotomy clinic	Observe GP clinic
10.30am -12 noon	Observe GP Clinic and complete initial meeting with named supervisor	Observe HCA/phlebotomy clinic	Observe GP clinic
12 noon - 1pm	Lunch	Lunch	Lunch
1pm - 2.30pm	Home visits	Spend time with prescription team and discuss recall system	Spend time with practice management team
2.30pm - 5pm	Observe "on the day" appointments. Shadow on call GP	Observe practice nurse clinic and time to ask questions	Spend time with clinical pharmacist (or other allied health care professional)

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Weeks two - six
Time	Day one	Day two	Day three
9am - 12 noon	Student clinic	Undertake clinic with HCA (phlebotomy, ECGs, BP, NHS health checks etc)	Student clinic
12 noon - 1pm	Lunch	Lunch	Lunch
1pm - 2.30pm	Home visits with visiting clinician	Home visits with visiting clinician	Home visits with visiting clinician
2.30pm - 5pm	Student clinic	Observe clinics with allied services	Student clinic

Medicine placement FAQs

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If a student is unable to attend placement what should the student do?

If a student does not attend placement as planned - what should the practice do?

What do I do if I have concerns about a student's attendance?

If you have concerns about a student’s attendance, please issue a professionalism development opportunity via completion of an event form. The event form system has options for wellbeing and safety, and professionalism lapses.

Choose whichever one you feel is most appropriate for the situation as you understand it. This will then be dealt with by the Professionalism, Wellbeing and Safety Tutor or Lead for Professionalism who will take appropriate action.

What do students need to do prior to placement?

Please be assured that all students will have had a DBS (Disclosure and Barring Service) check by the University prior to being allowed to attend placement. The student will have a copy of this, and we ask they have this available if you need to check.

The students also must complete the E-Learning for Health module for their year group. This includes safeguarding adults and children level 2 and resuscitation.

What should the practice do prior to placement?

Students with a disability

Influenza and Coronavirus vaccinations

Student feedback

Student feedback is essential as it enables us to monitor and improve what we do. We are also required to submit such data to our regulatory body, the General Medical Council.

In phase 2, student feedback gets collected via four methods:

Clinical module evaluation form – students will get asked to complete this at the end of every clinical module or sub-module. Questions will cover all aspects of the module including campus day and placements (including GP).
Module evaluation questionnaire – these get administered at the end of the academic year. The questionnaire covers all aspects of the programme over the entire year.
Staff student liaison committee – this meets each term and issues are brought to the meeting by the student representatives.
Unitu – this is an online platform that allows students to raise issues and propose solutions for the school to consider.

All feedback can be anonymous if desired.

Feedback is part of students’ professional responsibilities and is not an optional activity. Students are encouraged to give constructive feedback rather than just critical.

Students will be informed about any actions taken based on feedback via the Staff Student Liaison Committee and through the twice yearly “you said, we did” sessions.

If there is any important feedback relating to a GP placement, a GP Tutor from the Work-Based Learning Team will discuss this with the practice involved.

You will receive a copy of the feedback from the students after each placement which should be useful for planning of future placements.