Sharing the Load – building career support expertise for ...

Sharing the Load – building career support expertise for doctors in Wales

Our Start-up Challenges

Demand for career supportCapacity of careers team (1.5)Geography of WalesBalancing service delivery with service

development

The helpers we have engaged

Career Leads in Specialty Schools: development event in March 2009

Foundation Programme DirectorsPostgraduate Centre ManagersCareer network contactsMentoring Group

Strategy Group

2 University Careers ServicesDeanery CareersUndergraduate Curriculum LeadsAssociate DeansFoundation and Specialty ProgrammesWorkforce planningBMA reps (students, Foundation,

Specialty)

Foundation Workshops3 generic curriculum-based career sessions Contain key, up-to date information Blended e-resources in development to complement

F2F sessions Gets us in front of Foundation Doctors

242 F1 and 179 F2 to date“Excellent, very useful”“Brill, more stuff like this”

Educational Supervisors

2 hour workshop, 2 CPD points, 71 to dateTalks and Grand RoundsNew E – Learning module“How to”…Downloadable information resources and

handouts on Deanery website

Unanswered questions…

Is all this communication one or two-way?

Are we reaching everybody?Are we “spraying and praying”?Are we making any difference?How can we evaluate the

decentralised career help others are giving and receiving?

Incorporating tasters in Foundation Year 1 with a redesign of the rota

1st July , 2009

Background

• Tasters envisaged as an important part of FP

• Tasters traditionally taken in FY2

• Recently suggested that there may be greater benefits in tasters being taken in FY1

Difficulties at Trust-level

• Service delivery

• Co-ordination (trainee, Clinical Supervisor, Taster Supervisor, Medical Education Team)

• Responsibility

• Timing (FY2, pre-ST1 interview)

Homerton approach

• Changes to GMC requirements for the content of pre-registration programmes allowed opportunity to restructure

• Restructuring gave the opportunity to incorporate tasters in FY1

The Posts

• All Homerton FY1 posts were restructured as follows:

• Acute Care (3 months)

• General Medicine (3 months)

• General Surgery (3 months)

• General Medicine (3 months)

Block 1 Block 2 Block 3 Block 4

Acute Care General Medicine (Pharmacology) General Surgery (Lower GI) General Medicine (Cardiology)

Acute Care General Medicine (Endocrinology/Diabetes) General Surgery (Lower GI) General Medicine (Cardiology)

Acute Care General Medicine (Endocrinology/Diabetes) General Surgery (Upper GI) General Medicine (Respiratory)

Acute Care General Medicine (Endocrinology/Diabetes) General Surgery (Upper GI) General Medicine (Respiratory)

Acute Care General Medicine (Rheumatology) General Surgery (Upper GI) General Medicine (Care of the Elderly)

Acute Care General Medicine (Gastroenterology) General Surgery (T&O) General Medicine (Care of the Elderly)

Acute Care General Medicine (Gastroenterology) General Surgery (T&O) General Medicine (Care of the Elderly)

Acute Care General Medicine (Rheumatology) General Surgery (Urology/Breast) General Medicine (Elderly/Rehabilitation)

General Medicine (Cardiology) Acute Care General Medicine (Pharmacology) General Surgery (Lower GI)

General Medicine (Cardiology) Acute Care General Medicine (Endocrinology/Diabetes) General Surgery (Lower GI)

General Medicine (Respiratory) Acute Care General Medicine (Endocrinology/Diabetes) General Surgery (Upper GI)

General Medicine (Respiratory) Acute Care General Medicine (Endocrinology/Diabetes) General Surgery (Upper GI)

General Medicine (Care of the Elderly) Acute Care (with Surgical Specialty Taster) General Medicine (Rheumatology) General Surgery (Upper GI)

General Medicine (Care of the Elderly) Acute Care (with Surgical Specialty Taster) General Medicine (Gastroenterology) General Surgery (T&O)

General Medicine (Care of the Elderly) Acute Care (with Surgical Specialty Taster) General Medicine (Gastroenterology) General Surgery (T&O)

General Medicine (Elderly/Rehabilitation) Acute Care General Medicine (Rheumatology) General Surgery (Urology/Breast)

General Surgery (Lower GI) General Medicine (Cardiology) Acute Care General Medicine (Pharmacology)

General Surgery (Lower GI) General Medicine (Cardiology) Acute Care General Medicine (Endocrinology/Diabetes)

General Surgery (Upper GI) General Medicine (Respiratory) Acute Care General Medicine (Endocrinology/Diabetes)

General Surgery (Upper GI) General Medicine (Respiratory) Acute Care General Medicine (Endocrinology/Diabetes)

General Surgery (Upper GI) General Medicine (Care of the Elderly) Acute Care General Medicine (Rheumatology)

General Surgery (T&O) General Medicine (Care of the Elderly) Acute Care General Medicine (Gastroenterology)

General Surgery (T&O) General Medicine (Care of the Elderly) Acute Care General Medicine (Gastroenterology)

General Surgery (Urology/Breast) General Medicine (Elderly/Rehabilitation) Acute Care General Medicine (Rheumatology)

General Medicine (Pharmacology) General Surgery (Lower GI) General Medicine (Cardiology) Acute Care

General Medicine (Endocrinology/Diabetes) General Surgery (Lower GI) General Medicine (Cardiology) Acute Care

General Medicine (Endocrinology/Diabetes) General Surgery (Upper GI) General Medicine (Respiratory) Acute Care

General Medicine (Endocrinology/Diabetes) General Surgery (Upper GI) General Medicine (Respiratory) Acute Care

General Medicine (Rheumatology) General Surgery (Upper GI) General Medicine (Care of the Elderly) Acute Care

General Medicine (Gastroenterology) General Surgery (T&O) General Medicine (Care of the Elderly) Acute Care

General Medicine (Gastroenterology) General Surgery (T&O) General Medicine (Care of the Elderly) Acute Care

General Medicine (Rheumatology) General Surgery (Urology/Breast) General Medicine (Elderly/Rehabilitation) Acute Care

Acute Care General Medicine General Surgery General Medicine

Acute Care posts

• Two posts not required for service delivery (Psychiatry and O&G) were reallocated to Acute Care

• Eight trainees allocated to a six-trainee rota• Fixed-leave rota designed• Two trainees off in three week blocks• Blocks labelled as ‘tasters’• Fifteen working days to be allocated as six (or

seven) days leave and nine (or eight) days taster(s)

Co-ordination

• Trainees requested to submit a taster co-ordination form

• Trainees supported in organising placements

• Trainees asked to complete a taster evaluation form

0

5

10

15

20

25

30

35

2005-06 2006-07 2007-08 2008-09

F1 taster outcomes

F1 Tasters (Total =32/33)

0

2

4

6

8

10

12

14

16

18

Gatwick HUH RLH Barts Kings IH

F1 tasters locations

0

1

2

3

4

5

6

7

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Avi

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Tr

avel

Med

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F1 taster specialties

F1 tastersspecialties

0

2

4

6

8

10

12

14

16

ExtremelyUseful

Very Useful Useful Not veryuseful

Not usefulat all

How useful was the opportunity to undertake a taster in your F1 year?

0

2

4

6

8

10

12

14

16

18

20

Yes No

Would you encourage trainees to do tasters in their F1 year?

Career InnovationsUK Foundation Programme

London 1 July 2009

Dr Anil GargFY2 Programme Director

Worthing Hospital

Dr Karen ClarkeGP Tutor

Claire KrostFoundation Manager

Career Innovations

Career Advice Session

for

Foundation Year 2Dr Anil Garg

FY2 Programme DirectorWorthing Hospital

Dr Karen ClarkeGP Tutor

Claire KrostFoundation Manager

Foundation Year 2

25 traineesHospital career choice:10

Primary Care Career choice:8Undecided:2 Travelling:2

Half day session 9:15 – 12:30

Objectives

• Better understanding of what to expect in 4 weeks• Process of application • How to approach interviews• Practical understanding of interviews• Learn the basics of interview scenarios• More confidence with interviews• How to approach answering ST mock interview questions

“What do you expect to gain from the session?”

Objectives

“Interview training as paramount”

2008 Survey of Careers Support in the STFS. 5.5

Fun & Games

• All the group to gather

– What Quality they would like in their colleague – 1 each.

– Work in pairs : chosen speciality and why?

Interview Process

General Practice & Hospital Specialities

is

Different

Fish Bowl

Fish Bowl Exercise

ObserverObserver

Observer Observer

F2 colleague has received a complaint from a patient.You know he drinks too much and have witnessed him make a mistake. The nurses do not bother to ask him to do things.

Discuss with your F2 colleagues how you are going to approach this problem.

‘Speciality’ Duel

‘Speciality’ Duel

How did you manage your last crisis?

What do you think of EWTD?

2 InterviewersI interviewee Rest ObserversFeed back real timeAfter each trainee

10 min each

‘Speciality’ Duel

How did you manage your last crisis?

What do you think of EWTD?

Swapped Interviewee&

Interviewer

What did you learn from the session

• Putting myself in the hot seat• Various ways of approaching a question• What interviewers are looking for• Techniques and strategies for GP selection• It was excellent to practice group discussion as that’s

hard to practice

Few weeks after the ‘Interviews’

Few weeks after the ‘Interviews’

Finally

Do we tell them about what they want to know rather what they need to know.

????

Thank you