Work Observation
Advice for Practices
Introduction
It has been a concern of the North East Scotland Faculty of the Royal college
of General Practitioners that there are too few students who commit to a
career in General Practice. Driving this concern is the limited number of
General Practice placements in Foundation programs. However there may be
other contributory factors including access to high quality General practice
experience at all stages of education and learning.
With increasing numbers of medical schools explicitly giving extra points to
students who have undertaken work observation or shadowing placements in
health care environments it seems likely that the number of students
approaching practices will increase. Medical Schools consider that while work
experience is not essential, it does present an advantage in the selection
process. At present there is no data to support the assumption that
undertaking work experience has any bearing on a candidates’ success but
there is a consensus that undertaking such placements is indicative a
commitment to becoming a doctor. In addition the Faculty Board considers
that anything it or its members can do to raise the profile of general practice
and/or to engage early on in a prospective doctors training will result in
greater interest in general practice as a career.
The BMA advises that doctors should support the development of formal
schemes rather than one of individual arrangements. To this end the Faculty
has produced this document to give a thorough background and advice
together with pro-forma confidentiality agreements, sources of further
information etc to help practices consider the key issues and to offer advice
as to how placements could be best organised
These guidelines are specifically about work observation (shadowing). They
are not for voluntary work or other jobs in the healthcare sector potential
medical students may organise.
RCGP Work Observation Advice for Practices
What is Work Observation?
Work observation is when a prospective medical student, often, but not
always, a sixth former, spends some time observing a doctor's work. It is often
called 'shadowing'. The term work observation will help participants to have
realistic expectations of how their time will be spent and to understand that
they can only observe doctors' work. They will not be able to participate in any
clinical work. Periods of work observation typically last for up to one week. In
some cases an intensive day or two may be sufficient for a prospective doctor
to get an insight into medical life.
Work Observation can be valuable in contributing to prospective doctors’
understanding of medical careers as it is one practical way for pupils to get
information about these careers. However, pupils should only take part when
they have found out as much as they can from other sources. These include:
talking to careers advisors and doctors, reading the various guides to medical
life and volunteering in a nursing home or hospice. (See Appendix 4 for
sources of further information)
There are other kinds of valuable work experience. Pupils may undertake
voluntary or paid work in healthcare settings, e.g. nursing homes, hospitals,
hospices or health authorities. They may also gain more general experience
working with the public outside the healthcare sector through working in a
shop or other similar 'holiday job', however, well organised work observation
placements can provide pupils with a real-life experience they will not get from
other sources.
What’s in it for the pupils?
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Accurate and specific careers information
A more realistic picture of medical life
Increased awareness and understanding of clinical General Practice
Enable them to incorporate these aspects into their application
An opportunity to discuss a medical career with an established doctor
What’s in it for General Practice?
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Early positive picture of life as a GP
Potential to attract students who might not otherwise consider general
practice
Allows us to showcase modern General Practice
Access to Work Observation
Historically work observation has been more easily accessible to pupils with
personal contacts within the medical professions with placements arranged on
an ad hoc basis. This has meant that those who come from non-medical
families have found it more difficult to arrange a period of Work Observation
RCGP Work Observation Advice for Practices
and potentially chosen to go into careers which are more easily accessible to
them.
There are hospital based Work Observation schemes in existence which are
advertised through school careers departments/advisors and commercial
schemes such as Med link advertised through the Times newspaper and mail
shots to schools.
Alternative support
The Highland Schools Mentoring Scheme links pupils with volunteer doctors
who meet with them over the course of a year to discuss medical life,
applications to medical schools etc. The programme ensures that time spent
with doctors is planned and organised as high quality reflection and
discussion rather than passive observation and is based on the premise that
students can gain experience of a caring role from other situations.
Guidelines
Doctors, pupilss and practice staff should all be clear that patient
confidentiality is the key issue for time spent in work observation. These
guidelines contain some practical ways to ensure the autonomy and privacy of
patients.
 Practice staff should be informed of any applications being considered,
be involved in the discussions and agree to any plans.
 Placements should be outwith the observer’s locality where possible.
 Ensure that the observer is mature and responsible enough to
understand the principles of confidentiality
 Send information about confidentiality to the observer prior to
placement. Observers should be made aware that event the fact that
an individual has visited a surgery or hospital is confidential.
 References should be obtained from an appropriate adult, normally a
Form teacher who knows the pupil, well before the placement is
agreed. (See Referee Statement – Appendix 1)
 Ensure a confidentiality agreement is signed (Pro-forma Confidentiality
Agreement – Appendix 2))
 Regularly emphasize to observer the importance of confidentiality
 Patients should give informed consent ideally in writing with time to
reflect and change their mind if they wish. A notice to this effect should
be prominently displayed in the waiting room
 Patients should be informed of the identity of the observer and the
purpose of the observation. Doctors should still speak to patients
individually even if a notice is clearly displayed.
 Observers should be made aware that they may only sit in on
consultations where permission has been received from the patient and
that they may encounter traumatic or distressing situations during their
placements.
RCGP Work Observation Advice for Practices
Referee statement
Confidentiality is paramount in the doctor patient consultation and is outlined
in the General Medical Council’s Good Medical Practice http://www.gmcuk.org/guidance/good_medical_practice.asp Therefore it is important to
highlight any factors that might question the observer’s suitability so that this
special relationship is not compromised.
The Doctor is ultimately responsible for any breach of confidentiality that
might occur.
The Doctor also has to reassure him or herself that the Observer is genuinely
interested in a career in medicine and has already obtained information from
other sources. e.g. reading, talking with healthcare professionals, work
experience in care homes, hospital, including general work experience that is
not necessarily in a medical setting.
I confirm that ………………………. is a mature and suitable individual to take
part in work observation in a general medical practice.
Additional comments (if any)
Signed
Position / Relationship to Work Observer
Please return this reference directly to:
RCGP Work Observation Advice for Practices – Appendix 1 – Referee Statement
Confidentiality Agreement
I understand that information received about patients held by this Practice is
confidential and that this confidentiality is permanent.
I have received information on this matter.
I have read and understood the Practice’s policy on confidentiality, and agree
to be bound by its terms.
I undertake not to disclose personal information learnt in the course of my
presence in the Practice to anybody outside the practice.
If I feel disclosure is necessary in the public, patient or family interest, I will
discuss this with the appropriate health professional.
I understand that a breach of this obligation may result in my work observation
being terminated and that other appropriate action may be taken.
Signed
Date
Name
Address
RCGP Work Observation Advice for Practices – Appendix 2 – Confidentiality Agreement
Sources of Further Information
Further General Information:
Guiding Principles for the admission of medical students” Council of Heads of
Medical Schools, 1999
“Selecting our Doctors”, BMA Conference Report, BMA, 1999
“Don’t waste Doctors” J Harvey et al., Manchester NHS Executive, 1998
“Commited but critical: an examination of young doctor’s views of their core
values” I Allen, BMA, 1997
Further Information for students about a medical career:
“The New Learning Medicine” – P Richards & S Stockhill, BMJ Books, 1997
“So you want to a be a brain surgeon?” – C Ward & S Eccles, Oxford
University Press
“Getting into Medicine” – A Houghton & D Gray, Hodder & Stoughton
“Getting into Medical School” – J Rushton & J Burnett, Trotman & Company
“The Insider’s Guide to Medical Schools” – A Almoudaris, C Ferguson & S
Girgis, BMJ Books
Local University Contacts / Prospectus Information
University of Aberdeen
Admissions Office, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD
Tel: 01224 681818 Ext 52475 / 53113 Fax: 01224 7840708
Website:
Websites:
Monklands Hospital www.monklandsnextgen.com
A large amount of helpful material on UCAS interviews & work experience
The General Medical Council www.gmc-uk.org
The UK Medical Schools Guide www.medschoolguide.co.uk
A new independent guide for UK Medical students and applicants to UK
Medical Schools.
RCGP Work Observation Advice for Practices – Appendix 4 – Sources of Further Information