What you should expect from your
Your registrar year is a steep learning curve and a lot will be demanded of you. But what should you expect from your trainer? Dr Tanvir Jamil discusses
The trainer is 'the catalyst in the dynamic of learning' (Stott). Your trainer is going to be your role model and these are some of the qualities you should look for:
• A desire to help
• Time, energy and enthusiasm
• Up to date
• Learning attitude
• Patient centred
However, just watching isn't enough; what should you expect from your trainer?
Assessing your needs
In the first weeks of the registrar year your trainer would have conducted an interview to look at your past medical and personal experiences, what and how you have been taught and what you have learned.
They would have asked you specific examples of good practice, team working, lessons from mistakes and your strengths and weaknesses. They may have also used tools to assess your learning style1,2. This interview will help you and your trainer plan the year.
Your trainer will get together with you regularly to plan the curriculum for the year. The first six months will mainly be the trainer's agenda – that is, the basics they feel you should know. The latter half of the year should almost entirely be dictated by you – the areas of medicine you feel unsure about, such as ENT, ophthalmology, palliative care, practice management, etc.
Your first 10 to 14 days of the year should have been spent sitting in with all members of the practice. You should sit in with all members of the team including the local pharmacist. It's often a good idea to sit in towards the end of your registrar year as well. By then you'll be experienced enough to be able to pick up individual nuances and styles more easily.
Most trainers will arrange debriefing by different partners after each surgery for the first few weeks. Regular debriefing only usually lasts about one month – unless your trainer wants to keep a closer eye on your consultations.
Otherwise the occasional debriefing session can be held during your year together as a part of random case analysis.
You should feel supported and feel able to call up any partner for advice or to see patients you are having problems with. You should never be left without adequate cover.
If you are alone in the surgery there should at least be a partner you can reach by phone. Your trainer should ensure there is adequate time for reflection during the day.
You need time to talk to other staff, look at the PUNS and DENs you've collected and try out some of the new consultation techniques you have discussed with your trainer.
You should have at least two hours of protected time a week with your trainer. This will give you time to look at problem cases, random cases, review the week, talk about your day-release work, update on summative assessment and MRCGP preparation.
You should expect your trainer to be prepared for the tutorial. If you are looking at a particular subject, your trainer should make explicit the objectives of the tutorial.
A regular joint surgery with your trainer is also a great way to observe and practise techniques, and allows them to give you immediate feedback. Try also to arrange tutorials with different partners, practice manager, nurses and health visitors.
Expect teaching and learning to be done every day, whether it's in your room, common room or corridor. Try to meet most of the clinical staff on a regular basis, such as after surgery for a coffee. Your practice should also have regular clinical meetings for you to attend, such as journal clubs, significant analysis, practice business meetings, staff meeting, PCT meetings, etc.
Your trainer will monitor the kind of patients you are seeing to ensure an adequate case mix and may ask specific patients to see you when they or other partners are away.
They may arrange for you to take over the care of palliative patients. The partners in the practice may also ask you to pop in and look at interesting rashes or signs.
During your year, don't expect to cruise. No matter how good you are, your trainer should stretch your abilities and take you out of your comfort zone.
Expect to get regular feedback on how you are doing. This will happen informally for most of the year, but you should have a
formal assessment at six months and 11 months.
This should be a 360-degrees type of feedback from all staff at the practice. Your trainer should also expect feedback from you.
Tanvir Jamil is a GP trainer in Burnham, Buckinghamshire