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The Primary Care Unit

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Opportunities for teaching medical students in Primary Care

Some feedback from recent students:

  • ‘A lovely practice with excellent teaching and opportunities as a student’
  • ‘****** provided possibly the friendliest environment I have ever encountered in my medical training so far.’
  • ‘The doctors were excellent teachers and clinicians. They were also very welcoming and keen to help us meet our learning objectives.’
  • ‘This was a fantastic attachment - the whole practice made us feel very welcome, and I gained a huge amount of experience’
  • ‘This was the best attachment of my course so far. Thank you everyone!’
  • ‘My experiences at this practice made me reconsider my rigid "no way I'll be a GP in future" view, and I would definitively consider this career option’


Introduction

The primary care course for medical students at Cambridge University is coordinated by the GP Education Group (GPEG), part of the Cambridge University Department of Public Health and Primary Care. We are a group of GPs, supported by an excellent administrative team and we work closely with GP teachers and with secondary care colleagues in the Clinical School. Our role is to support GP undergraduate teachers working in Cambridge University teaching practices throughout the region and to ensure that Cambridge medical students, whatever their career plans, get the very best learning opportunities in primary care.

Cambridge University has a traditional course for medical students, divided in to pre-clinical and clinical components. Students studying medicine at Cambridge University spend their first 3 years (pre-clinical) reading for a degree in Medical Sciences. Successful completion of this degree allows them to enter the Clinical School, where they spend 3 years studying clinical medicine before qualifying as FY1 doctors.


The Clinical Course

The Cambridge University Clinical course is divided into four sections, a 3 week Introductory Course and three subsequent 'Stages'.

  • Stage 1‘Basic Clinical Method’ - This lasts 8 months and aims to equip students with a firm grounding in basic clinical method, including history taking, communication and examination skills.
  • Stage 2‘The Life Course’ - This lasts 15 months and takes students through a series of speciality attachments.
  • Stage 3‘Preparing for Practice’ - Lasts 11 months and allows students to develop their skills and confidence through senior Medicine, Surgery and General Practice, preparing them for more independent practice as FY1 doctors.

The clinical course was completely redesigned in 2005 and is based around 14 curricular themes. A key and innovative feature in the design of the course is the integration of teaching across specialities (including integration across primary and secondary care).

 

How the doctor approaches practice What the doctor is able to do The doctor as a professional
Pathology and core science Clinical Communication Skills Personal and professional development
Ethics and Law Patient investigation The multi-professional workplace
Clinical problems Therapeutics and patient management  
Clinical decision-making and judgment
Practical procedures
Public Health Learning, teaching, evaluation, research
Individual in society  
Chronic disease and disability


The Primary Care Course

General Practice is represented throughout the pre-clinical and clinical courses, and the redesign of the curriculum in 2005 has allowed a very significant expansion of teaching in primary care. This has been strongly supported by our teaching colleagues in secondary care and has been very well received by students.

PfPA

During their pre-clinical studies, students concentrate on the theoretical underpinning of medicine, but they do begin to explore the social context of medicine and the importance of effective communication skills through the Preparing for Patients course (PfP) which extends throughout the 3 years of their medical sciences degree. The first part of this course (PfPA) takes place early in year 1. Students visit local general practices on two afternoons to interview patients about their health problems and to reflect on the process of the patient interview.

Introductory Course

Mid September

At the start of their clinical course, students spend a couple of weeks on an ‘Introductory Course’ to clinical training. Much of this time is spent in the lecture theatre or clinical skills lab, but students do get some early clinical experience at this stage including a half day spent in a local GP surgery. Students are placed in pairs and are merely asked to sit in on one surgery and watch what is going on. They are given tasks to consider during consultations, relating to their communication skills training and to the role of the GP

Stage 1 – Basic Clinical Method

October – March

During Stage 1 students rotate through a series of medical and surgical attachments in Cambridge and in regional hospitals. During these attachments they learn the basic skills of medicine. Eight Fridays are spent in a GP surgery (roughly every other Friday).


Students usually visit general practices in groups of 4 (although some smaller practices opt only to take a pair of students). During their time in the GP surgery students are given the opportunity to practice basic examination of the cardiovascular, respiratory, gastrointestinal, neurological and musculoskeletal systems with specially invited patients and are given the chance to refine their history taking skills (based on the Cambridge Calgary Model) with a GP tutor in a teaching surgery. They also begin to learn a bit about our speciailty. Teaching is linked to the topics students are studying during their Stage 1 Medical and Surgical attachments.

Stage 2 – The ‘Life Course’ (Current course)

July – May

During Stage 2, students rotate through a series of five 8 week specialty blocks

  • Women’s Health
  • Growth, Development and Childhood Illness
  • Neurology, Rheumatology and Orthopaedics
  • Psychiatry
  • Major Adult Diseases (principally cardiovascular medicine and surgery and infectious diseases)

The last fortnight of 4 of these blocks (all except Major Adult Diseases which is mainly taught at Papworth Hospital), is spent in primary care. Each of these primary care fortnights follows a similar pattern. Eight days (Mon-Thu) over 2 weeks are spent in a GP surgery, and on the Fridays students return to the Clinical School for seminar teaching. These attachments give students both experience of primary care and expose them to the linked specialties from a primary and community care perspective.

Students are usually allocated to practices in groups of 4 (although some practices prefer to take 2 students). Teaching practices currently take the same group of 4 students for all 4 blocks of the Stage 2 course.

As well as seeing patients, sitting in on surgeries and taking part in normal practice activities, during the Stage 2 GP attachments, students are expected to undertake an audit project and a series of case-based community projects facilitated by GPs within the practice. The self-directed time allocated to these projects enables flexibility and allows 4 students to work in a practice whilst minimizing disruption.

Stage 3 – Preparing for Practice

End August – End October

This is the senior GP attachment and students are allocated to their teaching practice for 4 consecutive weeks. Students come to the practice in pairs and resources are provided for them to stay in Bed and Breakfast accommodation if the practice is outside Cambridge. There are 2 possible 4 week GP blocks and practices can take students for both blocks if they wish.

During this stage students are expected to develop their confidence and skills prior to becoming FY1 doctors. Whilst students in Stage 2 will continue to require considerable supervision, it is expected that by Stage 3 they should begin to work in a more autonomous way and take more responsibility for patient care and their own learning. You teach primary care as a speciality, with students acting as closely supervised “pre-FY1 doctors”. Although much of the learning in Stage 3 is opportunistic, GP teachers are asked to deliver some teaching in the primary care management of common ENT, Ophthalmology and Dermatology problems.


Who can teach on the primary care course?

In order to ensure that our student doctors experience an excellent attachment we have a defined set of Teacher and Practice Standards that teachers on the primary care course and their host practices are expected to be able to demonstrate (see Appendix). These standards have been produced with our GP teachers. We will provide, through our Teaching the Teachers meetings, the necessary information and opportunities to gain skills in order to meet the standards. Formal qualifications are less important than a desire to help students to learn and a willingness to reflect on experience so as to keep learning oneself.

Our standards are appropriately less demanding than those laid down by the Eastern Deanery for GP registrar training, but are explicitly related to them to make dual accreditation as simple as possible, since many practices enjoy teaching in more than one area. Before being accepted as a Cambridge University Teaching Practice, you will be visited by a member of the GP Education Group to discuss what we have to offer and to ensure that your practice is able to meet our standards.


Support for GP teachers

The GPs and administrative team in GPEG provide support for all of our GP teachers. We ensure that teachers are well informed about the curriculum and we run a formal programme of support entitled Teaching the Teachers or TTT.

This programme has three aims:

  1. To keep primary care teachers informed about curricular developments and changes.
  2. To enable primary care teachers further to develop their educational abilities.
  3. To enable us to use the experience and expertise of our GP teachers in course and curriculum development (the current primary care curriculum was developed following a series of meetings with our GP teachers and we continue to welcome ideas and initiatives from our teaching faculty)

The content of the programme is evolving and responsive to identified needs.

We are easily contactable by phone or email and are very happy to discuss issues with GP teachers and to visit practices when required.


MEDPORTAL

The Clinical School has its own ‘intranet’ called the Medportal. This contains a wealth of information for students and teachers regarding the Clinical Course and is increasingly becoming the essential repository for all teaching resources. Much of the site is password protected, but all GP tutors are issued with a password allowing them full access.


Interested in teaching?

We are always keen to hear from GPs who are interested in finding out more about opportunities for involvement in undergraduate teaching. Please feel free to get in touch by telephoning the GPEG office on 01223 330364 or the admin team on 01223 762516

Or by email:

This e-mail address is being protected from spambots. You need JavaScript enabled to view it , Director of GP Studies

This e-mail address is being protected from spambots. You need JavaScript enabled to view it , AssistantDirector of GP Studies

This e-mail address is being protected from spambots. You need JavaScript enabled to view it , Assistant Director of GP Studies

This e-mail address is being protected from spambots. You need JavaScript enabled to view it , Assistant Director of GP Studies

This e-mail address is being protected from spambots. You need JavaScript enabled to view it  Cambridge Graduate Course GP co-ordinator 

Last Updated on Tuesday, 10 September 2013 10:20  

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