PGME Blog - April 2015

Welcome to April. I will start by updating you on news from outside the Trust. We have just had the preliminary list of names of FY1 doctors for August. Confirmation of allocation to tracks will follow in the coming weeks. Recruitment to Specialty Training, including General Practice has not been reported yet, but round 1 re-adverts for unfilled posts and then formal round 2 will proceed in many specialties. 

Many of you will be aware that Malcolm Brown, the Associate Dean for this patch has stepped down. He has been replaced by Shirley Remington who is an Anaesthetist. Shirley will be commencing in post this month and will support us in our educational quality assurance processes for HENW. Just a note to add to this - at the time of writing, we have not received the written report and recommendations from the monitoring visit on February 3rd. 

The ARCP season is nearly upon us for most of our trainees. For FY1 doctors, please note that there are just 8 weeks of this final post in the rotation, before the Horus portfolio is closed down for the ARCPs, which take place in early June. All portfolio entries and reports must be completed by 22nd May.  This is to give time for the ARCP meetings and then make the necessary recommendation to the GMC for full registration. Please support your trainees in demonstrating all the necessary competencies and also support them with the necessary Clinical and Educational Supervisor reports for this deadline. Many other ARCP processes take place at this time of year and in the same way are dependent on the supervisor reports, which our educators write on behalf of their trainees. Thank you for this important work which evidences the high standard of education which we provide. 

Work is progressing to ensure that all our Educational and Clinical Supervisors achieve full GMC recognition by 1st August. Those of you who have started to use the MyL2P system will notice that educational responsibilities have been significantly highlighted in the appraisal process. Because we have had a mix of appraisal systems over the last 2 years, we will be seeking a declaration from educators about their educational CPD since August 2013. More communication on this shortly. 

Supporting educator CPD is a priority for us. We have three opportunities for internal CPD coming up, with half-day Educator Updates on the afternoon of Friday May 22nd at BGH and both morning and afternoon on Monday July 13th at RBH. The programmes will be similar for each of the three sessions. There are still some places left. Please book with Matt Hay in PGME. There are of course many other opportunities to demonstrate CPD as an educator, with personal study and reflection on important events (including supporting ARCP and recruitment processes) as examples. 

There are in addition a number of external courses to develop Consultants and Specialty Doctors as Educators. We are about to complete our second cohort of trainers through the educator module provided by the team from University of Chester. We plan to run a further cohort shortly, now renamed as ‘Chester Module Zero’. 

I will keep you all posted with developments over the next few months, which promise to be among the busiest of the educational year. 

Malcolm Littley, Associate Medical Director (Medical Education)

PGME Blog - March 2015

Most of you will have heard something about the outcome of the HENW visit on 3rd February through divisional and directorate meetings. If not, the key features were some excellent progress in surgical specialties around supervision, support and trainee experience. Anaesthetics were described as cohesive. The foundation programme was highlighted as innovative and developing well. There was evidence of good experience elsewhere, remarked upon by GPST’s in Paediatrics, Acute Medicine and O+G. In medicine there were positive comments about dermatology and respiratory medicine.

We were made aware of on-going difficulties in the emergency pathway, especially in acute medicine. The Surgical Out of Hours Service is working better, but there was a concern that some trainees may be asked to work beyond their competency when managing patients in the sub-specialties. An action plan to address both of these issues has already been implemented. The full report from the visit should be available by the end of the month. 

Moving forwards, we must all be aware that although our ward inpatients require a high level of input from our trainees, there must be time set aside for all trainees to attend outpatient clinics and other educational opportunities. The balance of non-ward work required to achieve this is gradually rising, both in foundation and specialty training. For instance, in medical specialties, core trainees will be required to attend not just one clinic monthly to meet ARCP requirements, but from August, they will need to attend one clinic weekly. In foundation, there are some new requirements also, where many posts will require one outpatient clinic weekly to broaden exposure to community-facing opportunities from August. This affects foundation tracks where a specialty is repeated during the 6 posts of foundation training. 

And what of trainers. We are now planning further educator updates and opportunities to network with colleagues in support of full recognition of educator status for August 2015. We will be circulating dates shortly (provisionally May 22nd and July 13th). It is vital that all current educators demonstrate evidence of Educator CPD to support full recognition in August. 

I have been asked why our training posts are not always filled completely each year. There are a number of reasons. For higher trainees, there is incomplete recruitment in some specialties due to shortages, which becomes worse as the year goes on and trainees are appointed to consultant posts. It has also become apparent that foundation trainees do not always go directly into specialty training, preferring a period of flexibility to travel, work outside the UK or do something completely different. In 2011, 71% of doctors completing FY2 year went on to specialty training. This has fallen progressively so that in 2014, the figure was down to 59%. 

Figures like this strongly support the case for workforce change. Trust staff will be attending workshops on developing Physician Assistant roles. Also, we continue to train advanced nurse practitioners to fill a range of specific roles. All of these will help us to protect trainee time and deliver excellent postgraduate medical education. 

Malcolm Littley, Associate Medical Director (Medical Education) 

PGME Blog - January 2015

The beginning of the year has seen the trust very busy with emergencies, but education and learning have continued unchecked and in many cases with renewed vigour. We are now well advanced in our preparations for the Health Education North West monitoring visit on 3rd February. Please ensure that trainee doctors are released from clinical duties to meet with the visiting team and that all departments can also release adequate numbers of consultant supervisors for their sessions too. Much work is going on behind the scenes to support this. My special thanks to the PGME team who are working beyond the call of duty preparing everything for the day. In addition, they are doing this while preparing for the induction of new trainees who commence work in ELHT on Wednesday 4th February.

The HENW visitors will be looking at many aspects of what we do and we should all be proud of the high standards seen across ELHT. Many consultants have undertaken educator development to meet new requirements. Examples include internally organised supervisor updates, sessions on reflection for appraisal and education and a cohort of educators undertaking modules with Chester University. The latter have been supervised locally by Professors Della Fish and Linda deCossart. This is an important year for medical education. In August, we hope to see the full recognition of all of our clinical and educational supervisors, having undertaken CPD related to education and demonstrating this through reflection and appraisal.

I will close by commenting on some of the excellent work being done by trainees in the field of quality improvement. The public nature of this piece prevents me from ‘naming and faming’. However, we have some real stars who have contributed to such diverse areas as negotiating better access to practice summaries of patients on EMIS, supporting the development of the clinical support nursing team (reducing educationally unproductive tasks) and developing smart-phone apps to support safe clinical decision making by trainees. There are many other examples and I will highlight these in future communications.

Malcolm Littley, Associate Medical Director (Medical Education)

PGME Blog - December 2014

Welcome to the first Postgraduate Medical Education blog for ELHT. The aim is to keep everybody up to date with news and developments in the field. We will concentrate on medical education, but conscious of the place of workforce planning in good educational experience, we hope to broaden the remit in the future. 

Top of the list has to be the forthcoming Health Education North West monitoring visit to the trust on 3rd February 2015. HENW inspect the quality of our education provision. Preparation is well under way. The timetable has now been sent to us and duly circulated. It is really important that trainees are released to speak to the visiting teams. Equally, it is vital that consultants then attend the sessions to give their views and hear some feedback. Some departments have already had mini-visits, where we have used some of the formal monitoring visit tools to reveal issues which we can act on quickly before the official visit. These mini visits have been extremely useful and very motivating. 

We continue to expand the boundaries of education. On November 18th a leadership development event for senior trainees was held, where they had the opportunity to attend a ‘Meet the Execs’ session with trust executives. Both groups learned a good deal and we will be repeating the event early next year. 

On 9th December, we held our annual Poster Presentation afternoon in the learning centre at RBH. This is an opportunity for trainee doctors to present research, case studies or audits that they have undertaken recently. The posters are primarily prepared by foundation doctors. In previous years the standard has been very high and judging the winners has been a real challenge. This year, the trainee doctors organised the event themselves. 

As we join the age of social networking (a few years late!) it only remains to tell you that we are also setting up a twitter account. The aim of this will be to keep everybody up to date with events and developments. It will of course be somewhere to provide feedback – the essence of learning. 

Seasons Greetings.

Malcolm Littley Associate Medical Director (Medical Education)