learning medicine in the community

Learning Medicine in the Community in Third Year

Getting the most from Community Clinical Placements

Dr. Philip Burns

Philippa Lindsay

Dr. Mark Perry

Dr. Sarah Smithson

Professor Val Wass

Dr. Kurt Wilson

www.manchester.ac.uk/CBME

http://www.manchester.ac.uk/CBME


Why Learn in the Community?

o90% of care takes place in the community

oLess patient time in hospital

o Inpatients are more illoChronic diseaseoFewer hospitalsoTomorrows Drs – GMC

Why Learn in the Community?o Approx 20% of Manchester

clinical curriculumo Boundaries between primary

and secondary care are becoming blurred – hence health education zones (HEZ)

o Intermediate care, changing professional boundaries

o 50% of you will become GP’s

Do GPs see much serious illness?

Yes or No

Do GPs see serious illness? In a typical yearo 10 myocardial infarctionso 5 strokeso 2 new lung cancerso 1 new breast cancer o 1 new prostate cancero 20 deaths (1 suicide every 4

years)

What are you here for?o Not just to pass exams!o To become a competent F1

doctoro To become equipped for

lifelong learningo To become (or remain) a

competent communicatoro Vocational courseo One curriculum

Why is the community different?

o Patients…as individuals o …familieso …communitieso Time. Continuityo Complexityo Uncertaintyo Variety o Populations

Opportunities? Top Ten Tips


o Turn up!


o Turn up!o Patients: ‘pick-your-own’,

do searches


o Turn up!o Patients: ‘pick-u-own’ -

searcheso Check consent

/confidentiality



searcheso Check consent /confidentialityo Use the whole team



searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the

lines



searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the

lineso Ask questions – challenge!


o Turn up!o Patients: ‘pick-u-own’ - searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the lineso Ask questions – challenge!o Find out how the practice

learns


o Turn up!o Patients: ‘pick-u-own’ - searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the lineso Ask questions – challenge!o Find out how the practice learnso Write things down – use your

notes


o Do stuff !


o Do stuff !o Do one


o Do stuff !o Do oneo Do another…Ask for

feedback


o Do stuff !o Do oneo Do another…Ask for feedbacko Do another


o Do stuff !o Do oneo Do another…Ask for feedbacko Do anothero Do another…GET IT WRONG


o Do stuff !o Do oneo Do another…Ask for feedbacko Do anothero Do another…GET IT WRONGo LEARN FROM IT


o Do stuff !o Do oneo Do another…Ask for feedbacko Do another…GET IT WRONGo LEARN FROM ITo Tell your GP what you need –

learning objectives from PBL! – what sort of patient will you need next week?

o Any Problems: ask for help early!

GP tutor / hospital dean

Finally… assessment headaches!

o Does your tutor know YOU want honours?

o Demonstrating excellence: initiative, organisation +

feedback

Community SSCs

Explore new horizons…but plan early!

Send in a proposal!Sportseliteexercise Rxschoolscampaigns

Everything else!OccupationalHealth Law, CharityBusiness

Culturedrama,voice,writing,media

galleries,music,dance,film

.

Disabilities rights, groups, university,deaf/visual impairment,learning dis. OT/mental health

Some other opportunities!

Charity...hospices, Age Concern, Rape Crisis Cancer Research,

Occupational Health...benefits agency, fitness for work

Law...prison health, forensics, probation, rehab, victim support

Community Sign-ups

oOver to Jac

Community Sign-ups

oWhat are they?

oWhy do we need them?

o What areas do they cover?o Podiatryo Dermatologyo Pharmacyo Palliative Careo Diabetic clinicso Ophthalmologyo Out of hours serviceso Homeless Teamo Intermediate Careo Cancer support serviceso Chronic kidney disease teamso Nutritional Therapyo Active livingo Audit Trainingo Suturingo Breast Unito Nursing and Residential Homeso Musculoskeletal Teamo Epilepsy and neurological service

o How do we sign-up?

o Only open to NME students

o Attend 6 placements

o Attend 100% - compulsory

o What do we do when we get there?

o Portfolio cards

o Dress code

o Feedback

o Over to Kurt

Compliments, comments and concerns

o We want to hear your compliments and comments regarding community experience

o Please let the base hospital community administrator teams know

o We want to help you address concerns

o First speak to the team at your practice

o Stuck? Speak to your base administration team and where necessary, the GPEF

We want to hear your thoughts!!

• CBME Complaints/Concerns/Compliments procedure

• MedLea Evaluation • Pop-up reminder • Focuses on all elements of the year

• Only 63% of active practices were given an evaluation report in 2007/08

• Student response rate • 2007/08 was 69% (657 responded out of a

possible 956)• 2008/09 was 23% (220 responded out of a

possible 941)• Remember: put your practice and GP

tutor name on the community part.

Contact us

www.manchester.ac.uk/CBME



learning medicine in the community

Education