doctors in difficulty
TRANSCRIPT
Doctors in DifficultySimon Carley
‘Any trainee who has caused concern to his/ her educational
supervisor(s) about the ability to carry out their duties, which has
required unusual measures.
RecogniseReviewReferRehabilitate
Task 2
What would alert you to a DiD?
The disappearing actLow work rate
Ward rageRigidity
Bypass syndromeCareer problems
Insight failureInappropriate attitudes
Lack of engagement (with CS/ES)Lack of initiative/professional engagement
EWS Regulator
EWS Regulator
Warning Signs
EWS Regulator
Warning Signs
REGULATOR
PerformancePunctualityaPPearance
Task 3
What are you going to do about it?
Trigger event
Investigate Decide
Does it matter?
Can they normally do it?
Why are they not doing it
now?
Trigger event
Investigate Decide
Is this health?
Is this performance?
Is this conduct?
Is this environment?
Is this health?
Is this performance?
Is this conduct?
Is this environment?
OccupationalHealth
Clinical assessment
Disciplinary
MedEd team investigates
Is this health?
Is this performance?
Is this conduct?
Is this environment?
OccupationalHealth
Clinical assessment
Disciplinary
MedEd team investigates
OccupationalHealth
Clinical assessment
Disciplinary
MedEd team investigates
PlanDocument
Share
Poor performance is a symptom
not a diagnosis
Documentation and witnesses
http://www.gmc-uk.org/Final_Appendix_5_Trainees_in_Difficulty.pdf_53816759.pdf
Guidance
Meetings
Task 4Exercise
Dr X is an PGY4 & has been with you for 4 months.
He has not participated in any educational assessments to date and finds it very difficult to find time to meet with you. Appointments are made but he often cancels these at short notice. Your initial meeting went well but you have not formally met with him since.
He has phoned in sick again today and your colleague points out that this is his 4th episode of sickness since starting this placement.
You you have had a few minor concerns about his practice but no major clinical concerns. He is slow at seeing patients and the nurses find him frustrating. He has told them that he is doing the best he can, but the patients are complex.
He failed his last set of professional exams.
Dr Y is an PGY2 and you are his educational supervisor for the last 4
months.
You had a good start with this doctor.
He came with good recommendations and have a great
portfolio but their performance on your team has been poor. They are
not engaged, often late and you have had several reported episodes
of them becoming angry with members of the nursing staff and
junior members of the team.
Dr V is a PGY2 doctor. He has been with you for 3 weeks and has just
finished nights in medicine.
You have several complaints about this doctor from nurses and middle grades.
They say he is incompetent and lazy.
Last night he tried treating an SVT on the ward with Adenosine. On review the patient had a sinus tachycardia secondary to a pyrexia (missed by
him).
The middle grade and ward sister tell you that he should not do nights
again.
Dr Z is a new locum doctor
You are contacted by the nurse on duty last night.
She noticed that Dr Z had a large empty syringe of antibiotics in
her pocket. When questioned she said that he had drawn the
morphine up for a patient earlier in the shift but as they did not
need it all he had kept it and used the remainder on another 2
patients.
This is Dr Z’s 1st job in the country.
RecogniseReviewReferRehabilitatewRite it all down