Welcome to the February 2011 edition.

CEO Welcome

NCGPT CEO John Langill

Before I say anything else, can I just offer a warm welcome to our new cohort of 34 registrars who started their first GP and Hospital terms in mid-January. I enjoyed meeting many of you at the workshop in Angourie and hope that you have all settled in well at your practices. Everyone here at NCGPT is pleased you chose to train with us and we look forward to working with and supporting you over the next few years!

Welcome also to all the hospital-based doctors who started their 10 week terms in our new Prevocational GP Placement Program (PGPPP) posts. I just popped my head out of my office to ask Bruce (our PGPPP Program Manager) how you are all going….his response was “exceptionally well!”. We hope that your experience in general practice is rewarding and that, if you are not already, you might consider pursuing a career in GP.

Finally, welcome back to all of our continuing registrars, procedural trainees and overseas trained doctors. All up, NCGPT will be working with almost 200 doctors at various stages of their training in our programs this year. Together, you are all making an enormous contribution to the GP workforce in our region and our communities are much better off for it. We are very glad you are here!

2011 looks set to be a busy and exciting year for NCGPT. On behalf of the entire team thanks for entrusting your training to us. Personally, I think we have the best team of medical educators in the country and as our training programs continue to grow so does the team. We now have 11 GP educators across the region and they are backed up by a strong administration team. That means our educators can concentrate on what they love to do….teaching and supporting you!

Enjoy the rest of the articles in the POST and I’ll look forward to seeing you throughout the year.
 

John Langill

NCGPT CEO

Education Update with Christine Ahern

Director of Training Christine Ahern with new registrars at a recent HDR.

Amidst floods and cyclonic events, our training year managed to start with good numbers of new registrars arriving at practices in a timely manner and attending orientation days in each region. Welcome and well done!

With the increased numbers this year, the challenge for the medical educators and NCGPT staff is to maintain our up close and personal approach to training, and our first real test came on orientation day. We hosted seventeen new registrars in Ballina, seven in Coffs Harbour and six in Port Macquarie. Evaluations from the day showed that we are still right on the mark when it comes to topic areas. Some constructive suggestions for change included more trainers and computers for the software training session in Ballina, and perhaps some flowcharts for some referral pathways.

This aligns well with the requests we are getting from supervisors to incorporate more computer training into our early registrar workshops. We will do our best to incorporate these and other suggestions into our next orientation and basic workshop.

Let’s move into this year with gratitude for the relative calm of our region, and thoughts for colleagues elsewhere affected by severe weather conditions. Remember that we are here to support and advise and look forward to another productive year.
 

Farewell to Katherine Dent – RLO extraordinaire!

RLO Katherine Dent

After two years as one of NCGPT’s Registrar Liaison Officers (RLO), Katherine Dent ran her final RLO information session at the GPT1 workshop in Angourie earlier this month. Katherine has done an incredible job as our RLO and we have been lucky to have her in that role to support our registrars. We will miss her energy and positive outlook on, well, just about everything! On behalf of the team and all of your peers, thank you!

But of course, all is not lost! Kirsten Patterson and Michael McKeough are continuing as RLOs and we are currently talking with one of our first term registrars to start as our third RLO.

You can reach Kirsten and Michael via email.

Michael McKeough - mrmckeough@hotmail.com

Kirsten Patterson - kruffles@hotmail.com 

SLO Update with John Vaughan

Supervisor Liaison Officer John Vaughan  

Welcome to the new year and to all our hard working supervisors in NCGPT. It promises to be a fantastic year with a strong new group of registrars who are based in our RTP and the launching of PGPPP's in some of our practices as well as the medical students who come from different universities to sample life in general practice with us.

The numbers of all of these eager trainees will no doubt increase over the next few years which will provide both a stimulating and interesting time for all of us. I trust everyone has settled into the pulse and beat of day to day life as the key deliverers of primary care in the region.

There has been an offer from the NGPSA (National General Practice Supervisors Association) to have us join this rejuvenated organisation. Bearing in mind Groucho Marx's comment that he would not join any club that would have him I still think that it would be a benefit to make this organisation as strong as possible so that it can advocate for supervisor concerns. Having said that, we have decided to accept on your behalf, but give you the option of opting out if that is your choice. Membership is free and it will provide a voice for us in negotiating in an increasingly changing landscape for supervisors.

I will also be attending an SLO conference in Melbourne in mid March where interaction between SLO's from around the country will occur and concerns of supervisors will be raised directly with representatives from GPET - the funding organisation for RTP's. 

I would be more than pleased to hear from any supervisors who have particular concerns prior to this meeting so that I can raise them at this forum. Feedback from the meeting I hope to provide via the North Coast Post.
 

If any of you do decide to opt out of the NGPSA please email seano@ncgpt.org.au .
 

Best wishes to you all and happy teaching
John Vaughan
SLO
 

New AGPT Leave Policy

GPET has just released a new AGPT leave policy. This policy only applies to those registrars who enrol in or commenced AGPT after 1 January 2011. This policy DOES NOT APPLY to registrars who are enrolled in or who have commenced AGPT prior to 1 January 2011.

Click here to view the new policy

RSO Update with Sue Gramza

Registrar Support Officer Sue Gramza

Welcome to 2011 at North Coast GP Training. I had the pleasure of meeting all of the GPT1 registrars in Angourie , and what a lovely group you are!
I mentioned at the workshop about having a social day in each node and wanting ideas on what you would like to do…..So please email me on sueg@ncgp.org.au with any suggestions. A couple of you mentioned building a billycart for the Bangalow Billycart race day..I’m not sure if you were serious, but if so, we need to get started on building our billycart, so therefore we need someone who is handy with a hammer etc… (Check out  http://www.bangalowbillycart.com.au/ )
 

We held an exam preparation workshop at our Ballina office earlier in February and we are holding a Mock OSCE exam preparation on Saturday 16th April, again at our Ballina office. This is for anyone who has enrolled to sit the RACGP Exam in Term 1, 2011.
NCGPT are running a Practice Managers workshop on 2-3 April in Coffs Harbour, this will be a very “Hot” event….so I hope to see all of our practice managers there.
 

2011 GPT1 Workshop

Our new registrars at the GPT1 Workshop in February

(Click on the photo to see who's who)

What a wonderful group of registrars again!

The GPT1 workshop was packed full of information, a variety of speakers and topics and twenty seven enthusiastic and enquiring registrars. What a fantastic mix.
 

All the usual “suspects” were covered – dermatology, chronic diseases, smoking cessation, “consulting skills” and “diagnostic uncertainty” to name just a few. I can reassure those registrars who have requested sessions on contraception, mental health, sexual health and drug and alcohol that these topics (and many more) will be covered comprehensively at the life stages workshop and half day releases throughout the year. Check your education calendar for dates (www.ncgpt.org.au/events )  and if you feel you require teaching on any of these topics earlier, as Hilton has already suggested , ask to make this a topic for one of your in-practice teaching session.

Other requests were for more free time and physical activities between sessions. This was the most ambitious workshop to date in terms of content, and we will certainly take this suggestion on board and in future incorporate more space between sessions – especially on the third day. Other fantastic suggestions for topic areas will be considered in our major program restructure, planned for later this year. Keep your eye on the education calendar because if you can negotiate release time with your practice, we welcome attendances at half day releases even in GPT3 terms.

Christine Ahern

Director of Training

Click here or on the group photo for an enlarged image and corresponding names to see who is who !! 

GPT1 Workshop Feedback

Medical Educators Deb Kors and Hilton Koppe at the recent GPT1 Workshop

Medical Educator Hilton Koppe received a thank you email from a new registrar who attended the GPT1 Workshop.  (email used with permission)

It was indeed an excellent workshop. I understand that it is impossible to teach everything general practice involves in 3 days of workshop but the most important topics were beautifully covered.

The best thing I liked was demonstrating and talking about practical things and I noticed that when I walked in the surgery on Monday morning I had an air of confidence with me in contrast to 2 weeks ago when I was literally shaking. I was still the same person having no clue what was going on with the patient but I could handle the situation well as I was able to rule out possibility of serious problem, remained honest with the patient made sure no harm was done to the patient and had an appropriate follow up plan. 

I would like to thank the whole team of medical educators for giving me that confidence.

Hiltons' response, “feedback like this makes all the effort worthwhile.”

2011 AGPT Registrar Guide

The 2011 AGPT Registrar Guide is now available both online and in hardcopy. If you would like a copy please contact seano@ncgpt.org.au at NCGPT.

To view or download from the GPET website visit: 

www.agpt.com.au/NewEvents/Update/article.shtml?article=2898230

PGPPP Update with Kayte Evans

NCGPT Medical Educator Kayte Evans and PGPPP Doctor Nan Gu

PGPPP Orientation , January 2011

Despite floods and potholes big enough for a semi to fit in, the trip down to Coff’s to orient the first wonderful cohort of PGPPP’s for 2011 was well worth the effort. We all arrived tired and late on the Monday night, 17th January after a days work and 4.5 hours on the back road via Casino to Coff’s for myself and Medical Educator Nicola Foster. Linda from Lismore and Willeke from Tweed had endured the same drive alone and on a strange road. The Novotel was a welcome sight and we met over a very late dinner at 9.00pm. Diane and Alyssa had also done the long drive from Port Macquarie in the other direction.

The program was a good mix of presenting styles. We took a bit of time over the introductions including talking about a significant grandparent or older person in their lives which was a good ice breaker. This welded the PGPPP’s into a group that bonded well over the next two days. The Trivial Pursuit and GP Etiquette sessions went well . We also had an interesting session brainstorming differences between hospital and GP practice.

The Tuesday afternoon was a bit tricky as Tim Francis, our other ME and also a GP anesthaetist, was unable to attend as he was tied up with emergencies. A quick bit of ad libbing on the Red Flags section by Nicola and I filled the gap. Hands on Best Practice and Medical Director training covered the IT stuff. Learning plans and learning styles can be a bit tedious but they was valuable feedback for us. I hope the PGPPP have found them useful in working with their supervisors.

After a long day, we were glad to head down to the beach and then feast on the wonderful seafood offered at the hotel. Linda even had energy to belt out a few kilometers at the gym

Thanks to Tim’s arrival the next day, we had great sessions on consulting skills in various forms including introducing oneself and confidentiality issues in the medico legal section. Tim’s Paediatric ABC was a hit, with fresh stories from his experiences in Macksville ED the previous day. Our GP stories, concluding with the consulting skills questionnaire ( with prizes ) was a good way to wrap up.

One of the worst fears of the PGPPP’s (what a name , we need to think of a much more palatable and memorable title ) is feeling foolish in front of the patient due to lack of knowledge. Reassuring them about setting in place safety nets, and that they are free to ask their supervisor or other GP’s if not sure is very important. It has been a good start for the 2011 Prevocational GP Placement Program ( another mouthful) which has doubled in numbers this year and so far we have had good feedback from them all.

(See the following article for some of this feedback)
 

PGPPP Karma

PGPPP doctor Stella Tang

Recent PGPPP participant Stella Tang was so impressed and enlightened by her experience at Toormina Medical Centre that she decided to put pen to paper to inspire other JMOs to undertake what she now believes should be a core rotation. 

Karma by Stella Tang

The first day of my PGPPP rotation I found myself wondering if I made a HUGE mistake in choosing this rotation…the last 2 years of my hospital training I have been disciplined into an efficient and effective discharging machine particularly moulded by the likings of my consultant and their speciality. The words “follow up with your GP…”, “that’s something your GP can look into”, “discuss that with your GP, it’s not an emergency problem…”, “Your GP can refer you to…, “ it’s all about coughs and colds and medical certificates” flashed before my eyes…and I began to wonder if this was Karma.

As inconceivable as it may be to some, I found myself being drawn into the complexities and value of community based teaching in my placement at Toormina Medical Centre (TMC). It is a wonder why GP rotation isn’t a core rotation as it is the only one “speciality” that treats the patient as a ‘whole’ not just in bits. It is the integral hub that interacts with all these specialities (the ‘bits’). It’s the speciality that witnesses a patient’s journey from birth to death and the speciality that has the privilege to treat an entire family spanning across generations at any one given time.

Our core population in healthcare is ageing day by day as our advances in medical intervention continue. This means that our patients not only have multiple morbidities, but require complex care that demands medical prioritisation of their chronic conditions. How can someone learn this without the exposure and the appropriate guidance? 

My time at TMC provided broad base teaching and insight into how our health care system worked. It encompassed more dedicated one on one teaching by passionate mentors on a vast range of medical subspecialties than any other medical terms I have experienced. This is surrounded by a familial environment of comradeship and up to date medical practice in weekly clinical “grand-round” meetings of case presentations, in addition to access to quality nursing and allied health services on site (diabetic educator, podiatrist, psychotherapist, mental health nurse). This was a term that developed not only my confidence in patient management but also fine-tuned my clinical and interpersonal skills in diagnosing, interpreting and managing common medical problems. 

This rotation was not only rewarding, as you saw the outcome of your decisions through continued and ongoing patient care, but also emphasised the importance of establishing a good work and life balance. The freedom it provided with organising your own patient load, having devoted lunch breaks and the regularity of working “normal” office hours was a stupendous luxury after the last 2 years of unrostered overtimes. All in all I cannot fault this rotation and regardless of what “specialist” training you strive to endeavour to…“holistic” patient care is what good medicine is about, and good medicine is what good doctors practice.

After all…there’s Karma …