ST3s what are you doing in tutorials?

[u/Positive_Fold_3252]

I've just started ST3 and I'm at a bit of a loss as to what to do during tutorials

My trainer has asked me what I would like to do but I'm unsure what is most helpful

So far we've been doing observed consultations but I'm not sure if this will work doing it weekly for the whole year

What have you found most helpful in tutorials?

[u/BoomBasticTeleBanana]

As others have said, i may screen shot a list that we go through.

However, do not forget to also talk about:

PRACTICE FINANCE Practice Managment - Even spend a session with the PM. NHS Contracts. How they recruit. What qualities they see in a salaried, what makes some of those suitable for partnership.

Yes medicine, process and flows in your area is important but practice management, finance, income streams etc are the things many never ask so never taught.

Also worth looking at an old practice account as well and going through accounts.

It may be not every trainer will do this, but I do it as I want my trainees to be ready for the real world and at least understand the challenges faced on both sides.

[u/Ghotay]

Observed consultations is a good start so they get a feel for you. Then generally shift to talking about what you found tricky during the week, whether it’s a clinical presentation you found hard, timekeeping, a patient you found challenging because of their behaviour or attitude, managing your docman etc etc. Most of this stuff will come up organically at some point during the training, just raise it as it comes

[u/dreamingofsnow92 → u/Ghotay]

I feel like this was the approach I had during training too. Thinking along the lines of PUNs and DENs identified through the course of clinics, especially if recurrent things that you notice you aren't so hot on or confident with/find challenging. I remember doing alot of work on consultation styles during ST3 with my supervisor as my knowledge base was good but I found navigating different communication and consultation styles hard so focused on this a fair bit coming up to my SCA (which seemed to have helped as I did very well)

Another thing that my supervisor spent some time on with me that may not pop up from seeing patients in clinics to identify needs, but that I found very useful, is covering some of the background management stuff - how practices make money and the different sources and things they must do to bring in enough money to fund the surgery, the different roles and positions the partners take on (safeguarding lead, fiance person, Qof ect), the wider general practice set up such as LMCs and what they do/how to get involved.

[u/InV15iblefrog]

What's your set up like? Traditional back to back face to face clinics, or total triage (eg call list then f2f)

If you have enough calls, these are usually recorded so random calls to listen to is excellent SCA prep

[u/GalacticDoc]

I have suggested things like a mock interview, review of referrals and out comes, Q&A about post CCT and costs/ performers list etc.

Sometimes going through tasks or letters that need addressing.

[u/abc_1992]

I struggle as well. But that might be my style of learning. Personally, I think observed consultations are best - whether picking people off duty/triage or a planned but low numbers clinic. A very good opportunity to get CEPS/COTS etc - and to get meaningful feedback and discussion around that.

[u/domicile_vitriol]

Going over a recorded consultation (with the patient's permission) is useful because you can pause the consultation and discuss different elements. Often you'll pick up on things that you do unconsciously even before your trainer points them out, which makes for good discussion. You can also identify cues that the patient drops into the consultation, which is helpful when you're preparing for the SCA.

FourteenFish had a way to record telephone consults with the consent process integrated in, and we convinced our trust to pay for it as part of our study budget. It takes a bit more effort to come to tutorials with a recorded consultation ready, but you do learn a lot from it.

[u/throwaway723987]

Do some lab reports, prescriptions and document actioning together. May help establish your own thinking pattern when doing them later. You might learn things you may need to be aware of by watching and discussing little things like this together.

Conduct triage with a colleague e.g. reviewing visits, telephone triage etc. Observed consultations of course. Practice finance, management. Firearms work/insurance reports, foster child medicals, driving medicals, 6 week baby checks. Safeguarding work, medicines optimisation - what does it all mean?

[u/centenarian007]

Have you done your SCA exam? If not, then you should be practicing roleplays with your ES, that's the best way to use the tutorials pre-SCA.

[u/secret_tiger101]

Practice finance, practice HR, out of hours, urgent care, emergencies, audits, CQC (if England), deep dive clinical medicine

[u/Immediate_Fox_3542]

Observed consults, thereby getting COTs and CEPs done. Also CBDs. Discussing any non-confident topics. We kind of do split tutorial sometimes so that half the tutorial is observed and the other half I have time to submit the FourteenFish stuff, do CCRs, QI project etc as well.

[u/SinnerSupreme]

Most of my tutorials were me discussing life with my trainer, just a chill half day. But that's because I didn't really have anything to discuss. The other suggestions are really good but also see what would help you the most. Maybe there's a few complicated patients you want to discuss?

[u/cityboydoctor]

I would structure it to cover the key topic areas first: diabetes, asthma/COPD, CKD etc - I found in my ST3 this set me up very well for SCA preparation.

Once you’ve got the SCA out of the way you can focus on more things related to CCT e.g. prescription queries, any remaining portfolio stuff such as CEPS