Year 5 medicine placements supervisor information

Each of these blocks is eight weeks long. In the community care block, weeks one and eight are spent on campus undertaking primary-care teaching. Weeks two-seven are spent on placement in GP practice. During these six weeks, students attend the practice for four days (eight sessions) per week. The final day is for self-directed learning.

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.

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 the Skills team in the School of Medicine. 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. e.g when carrying out venepuncture or IM injections (excluding immunisation).

The School of Medicine 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 five Workplace-based skills facilitator:
Stephen Gowland-Mahon 

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 and no student undertakes home visits alone.

• 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.

Week one - Induction

Weeks two-six