Dr M Feldman

Medical school [ 5 yrs ]

Foundation year 1 – typically 6 months surgery, and 6 months medicine

Foundation year 2 – 3x 4/12 of ◦ Various specialties ◦ May include a spell in GP

Entry onto training scheme◦ Knowledge test

◦ Assessment centre Consultation Group work Written test

Scheme consists of 3 yrs◦ 2 yrs in hosp then one in GP◦ Increasingly 18 months in hosp then 18 months

gp◦ Selection of specialties

A&E Hospice O&G Paeds Care of elderly Medicine Rheumatology +GP ( ITP) Dermatology +GP ( ITP )

Training practices

◦ Specially approved

Premises

Trainers – one year course now

Standards –

Notes

Library

Accommodation

Teaching assessed

nMRCGP◦ Applied Knowledge Test – often taken in 2nd year

◦ Work Based Assessment Patient satisfaction questionnaire Multisource feedback Consultation observation tool Direct Observation Procedures Case Based Discussion Eportfolio log diary Educational Reviews

nMRGGP

◦ Clinical Skills Analysis 12 Cases like a real surgery –

10 minute consultations

Work in teams

Average practice about 5900 patients

About 1800 per GP

35% partners are female

60% GP registrars are female

Activity Full time GP / Week

Surgery consults 102.3

Phone consults 18.8

Home Visits 6.4

Care home visits 1.9

Clinics 1.5

Most British full time GP work either 8 or 9 sessions per week

Typical sessions are 2- 2.5 hours long with 12 – 15 booked patients

Average time per consult 11.7 mins

Average time per home visit 26 mins

Working from own premises

Working from health centres

Polyclinics – to come

Most GP self employed – partners We employ

◦ Nurses◦ Nurse assistants and phlebotomists◦ Receptionists◦ Admin staff and practice managers◦ Occasionally counsellorsWe rarely employ

Midwives (5%)Physiotherapists ( 3%)

Almost all increase in clinical contact due to extra nursing input

Average income GP 2007 about

◦ £100 000 = Euro 124000 – partner

◦ £70 000 = Euro 86,800 – salaried gp

◦ Currently dropping due to government clawbacks◦ Need for GP’s to fund staff increase◦ Our practice approx Euro 248 000 staff bill

excluding doctors