Post-Certification Career Planning

Life after the MRCGP Examination. Kevin Hurrell. Head of KSS Post-Certification GP School

GP Deanery• The Quality Assurance of

GP Training and Continuing Professional Development in Kent Surrey and Sussex.

• Including support for doctors throughout their career in general practice.

GP Vocational training schemes• 3 year programmes (4

soon)• 16 months in general

practice• Day release and learning

sets• MRCGP assessments• Training programme visits• 800 Trainees

The Post-Certification GP School• The whole world is now in

your hands.

• 30-40 years hard graft

• 2,400 GPs in 3 counties

• A new Paradigm for CPD

Workshop Aims:

•WHAT…..do you want to be doing in 10 years?

•WHO…..do you want to be working with?

•WHEN …..do you make your moves?

•HOW…..do you get what you want? …..stay safe, sane and secure?

Audience questions:• 1. How to get your CV ready/up to date for Job

applications2. Practical advice on commissioning, what commissioning skills we need to develop now and how to develop them.3. Career Options. Where else can we work other than GP surgeries/hospitals?4. During interviews what questions should we be asking prospective employers?5. What are the things to look out for in a contract? How do you ensure you get a good contract?

I I know..know..

So much So much to to

considerconsider

‘Salaried’

‘Part-time’

‘Revalidation’

‘Appraisal’

‘Unemployment’

‘Portfolio careers’

‘Private providers’

‘Commissioning’

‘QOF’

‘PCTs’

‘Work-life balance’

‘Colleagues’

‘Complaints’ ‘GPwSI’

‘Access’

‘Marriage’

‘Health’£££

WHAT DO YOU WANT?

•Have you really thought through your career options?

•Have you shared your ideas, dreams and aspirations?

•How hard are you prepared to work?

Choices to be made:

•Full time. Part time. Portfolio.

•Salaried. Partner. Both?

•Property sharing?

•PMS . GMS. aPMS. OOH. Agencies.

•Opportunities aplenty………

Who will you be working with?

WHEN?

• How do we manage change?

• Do opportunities find us out…or do we find opportunity?

• What does ‘networking’ really mean?

• Can you say ‘no’ as well as you can say ‘yes’?

How….do you ‘find opportunities’?• Group discussion

• How can you network?

• How do you present yourself?

• What do you need to ask?

Looking ahead…..NHS Appraisal• Experience as ST3• Linkage to ESR• Additional competencies:• Financial skills• Conflicting obligations• Multiple agendas

• Adult learning as independent GP

• Helps shape your career• Encourages ‘proper PDP’• A new paradigm for CPD!

www.revalidationsupport.nhs.ukThe purposes of medical

appraisal for revalidation• To enable doctors to discuss their practice and performance

with their appraiser in order to demonstrate that they continue to meet the principles and values set out in “Good Medical Practice” and thus to inform the responsible officer’s revalidation recommendation to the GMC.

• To enable doctors to enhance the quality of their professional work by planning their professional development.

• To enable doctors to consider their own needs in planning their professional development.

• To enable doctors to ensure that they are working productively and in line with the priorities and requirements of the organisation they practise in.

Revalidation• Started 2012• Strengthened appraisal• More governance• 5 year cycle. 3 at first• 50 CPD credits per year• Multi-source feedback• Clinical audit• Declarations

Deanery business:

• Support the Responsible Officer

• Including RO for doctors in training

• Leadership training for appraisers

• RCGP Revalidation Facilitators

“Of course, long before you mature,most of you will be eaten”

GMC Principles for CPD

• Improving healthcare and promoting a healthier society

• Encouraging individual responsibility for participation and recording of CPD activities

• Improving professional effectiveness and work satisfaction

• Ensuring CPD covers all areas of Good Medical Practice and all GPs keep up to date

• Encouraging reflection upon a great range of clinical activities, planned and opportunistic

• Encouraging patient and public involvement• Ensuring annual appraisal monitors CPD and

produces appropriate PDPs• Providing a continuing measure of assessment of

performance where possible

Appraisal mapped to GMP

Domain 1- Knowledge, skills and performance

Attribute 1: Maintain your professional performance

Attribute 2: Apply knowledge and experience to practice

Attribute 3: Keep clear, accurate and legible records

Domain 2- Safety and Quality Attribute 1: Systems to protect

patients and improve care Attribute 2: Respond to risks to

safety Attribute 3: Protect patients from

risk posed by your health

Domain 3- Communication, Partnership and Teamwork

Attribute 1: Communicate effectively

Attribute 2: Work well with colleagues and delegate effectively

Attribute 3: Establish and maintain partnerships with patients

Domain 4- Maintaining Trust

Attribute 1:Show respect for patients

Attribute 2:Treat patients and colleagues fairly and without discrimination

Attribute 3: Act with honesty and integrity

GMC supporting information principles

• General information – providing context about what you do in all aspects of your work

• Keeping up to date – maintaining and enhancing the quality of your professional work

• Review of your practice – evaluating the quality of your professional work

• Feedback on your practice – how others perceive the quality of your professional work

www.revalidationsupport.nhs.uk

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GMC supporting information requirements

•There are six types of supporting information:

•1. Continuing professional development•2. Quality improvement activity•3. Significant events•4. Feedback from colleagues•5. Feedback from patients (where

applicable)•6. Review of complaints and compliments

www.revalidationsupport.nhs.uk

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Assessing continuing competence as independent practitioner

Shows How

Knows How

Knows

Does

KnowledgeSkills Clinical Communication Organisational AttitudesValues

Miller GE (1990) The Assessment of Clinical skills/Competence/performanceAcad. Med,65:563-67

Suggested template for ST3 appraisal•After ARCP but before CCT•One to one with own trainer, build on ESR•Ensure understanding of NHS Appraisal

and Revalidation as 5 yearly cyclical programme

•Revisit weaker areas of curriculum and then use either appraisal toolkit or RCGP portfolio

•Stress the individual’s responsibility for continuing CPD

•Look forward, set priorities, produce PDP.

What makes up a good PDP?

Layered cake and icing: The 5P Paradigm• Personal: Wants and needs of the individual Work on weaknesses before developing special interests.• Practice: Wants and needs of new practice How will you choose your working place? What will you do

to integrate? Where will you be in 5 years time?• Patients: Wants and needs of patients How will you identify and respond to patients’ views and

needs? Do you have sufficient knowledge and skills?• Populations /Political: Wants/needs of

local/national NHS What do you know of QUIPP? How will you keep up to date

with new service pathways? Have you any commissioning ambitions?

Small group work

Try to produce simple PDP for your next year.

Try to produce a layered cake:•Personal needs•Practice needs•Patient needs•Population needs•Political needsCompare / contrast PDPs within the group

Best practice

•Both ST3 and trainer keep copy of brief summary of appraisal discussion and PDP

•ST3 can make reflective statement in e-portfolio learning log and link

•Trainer can use document for own appraisal and for trainer reaccreditation (with reflection!)

•Trainee’s exit questionnaire can be completed soon after.

Quality CPD: The GP Tutor Role• Appraiser Learning Sets• Protected learning Time• Some CPD Provision• Support for CCGs• Support for Sessional

Doctors• Support for federated

training model• Commissioning Awareness

= New Paradigm for CPD.

• CPD for the doctor is mindful of:

• Personal needs• Patient needs• Practice needs• Population needs• Political agenda

Job opportunities:

• Trainee representative for local faculty.

• Trainee representative for Deanery Committee

• Sessional Doctor Learning Set Member and Convenor

• Foundation Supervisor• GP Trainer• Programme Director• GP with Special Interest• OOH work• Prison doctor• Armed forces

• GP Tutor• Mentor• Appraiser• Lead Appraiser• Commissioning lead• Commissioner

Supporting ‘Grassroot GPs’• Sessional Doctor Learning Sets• GP Tutors for CPD & PLT• ‘Remedial support’• NHS Appraisers• Revalidation Facilitators• LMC and RCGP Links

• MENTORS

KSS Mentors

• Peer to peer• Confidential Support and

Guidance• Practice and professional

issues• Free to all GPs working in

NHS• Protected time• Single or series of

meetings• Lots of capacity!

1. How to get your CV ready/up to date for Job applications2. Practical advice on commissioning, what commissioning skills we need to develop now and how to develop them.3. Career Options. Where else can we work other than GP surgeries/hospitals?4. During interviews what questions should we be asking prospective employers?5. What are the things to look out for in a contract? How do you ensure you get a good contract?

Checklist:

Why Reflect?“A goal without a plan is just a wish” Antoine de Saint-Exupery

“If you don’t know where you’re going, any road will get you there.”The Cheshire Cat, Alice in Wonderland

Be a curious GP….

• Keep asking questions

• Keep looking for opportunities

• Think in terms of clinical leadership and responsible followship!

• GOOD LUCK!