May 2007
GP Specialty Training Intended Learning Outcomes
from Clinical Placement
1. A&E
2. Community O&G
3. Dermatology
4. ENT
5. GUM
6. MSM
7. O&G
8. Ophthalmology
9. Palliative Care Curriculum
10.
Palliative Care
11.
Psychiatry
12.
Rehab. Medicine
October 2007
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
Accident and Emergency
SPECIALTY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
1. Knowledge-base relevant to the placement
1.Principles of resuscitation
 Adult cardiac arrest ; BLS, ALS algorithms, Defibrillation
 Paediatric Resuscitation; BLS, Airway Management, ALS algorithms
 Assessment of critically ill/injured patient; Adult critical illness, Adult critical injury, Child critical
illness, Child critical injury.
2. Initial management of common complaints
 Breathlessness (adult) ; Asthma, COPD, Pneumonia, PE, Heart Failure
 Respiratory problems (paediatric); Asthma, bronchiolitis, Croup and croup scoring
 Chest pain (adult) ; ACS, thrombolysis, Non cardiac chest pain
 Abdominal pain (adult); GI, vascular, urological, gynaecological
 GI (paeds) Asessment of abdominal pain, UTI, gastroenteritis, assessment of dehydration
 Altered level of consciousness; Fits (adult) Fits (child), Head injury (adult) Head injury (child),
Stroke/CVA, CNS infection
 Acute confusional state; Mental state assessment, Differential Diagnosis
 Deliberate self harm; Risk assessment, Management of common overdoses, access to psychiatric
services, Application of the Mental Health act in A&E , Disturbed/violent patient
 Vascular emergencies; GI bleed, Ruptured AAA, DVT/PE, Embolism/thrombosis
 Opthalmic emergencies; Use of slit lamp, Examination of the eye, Acute red eye, Sudden change in
vision
 ENT emergencies,; Examination of ENT, R?O FBs from ear, nose and throat, Management of
epistaxis,
 Acutely painful joint; Examination and differential diagnosis
 Rashes; Diagnosis and management of common skin conditions presenting to A&E
 Management of traumatic conditions; ATLS ;principles, Interpretation of trauma series
 Principles of wound care; Local anaesthetic, Digital nerve block, Wound closure (sutures), Wound
closure (non sutures)
 Assessment and management of soft tissue injuries; Hand, shoulder, Hip, Knee, Ankle
 Diagnosis and management of fractures and dislocations; Colles Fracture, Biers Block, Shoulder
dislocation, Digit fracture/ dislocation










May 2007
Paediatric orthopaedics; Greenstick fracture and Salter Harris Classification, limping child, Pulled
elbow,
Non accidental injury; Risk assessment, Referral and reporting, Domestic violence
Bur ns; Diagnosis and Management of burns, Indications for referral ,
Use and interpretation of diagnostic aids; Vital signs and monitoring, PEFR, ABG, ECG (common
A&E conditions)
Xray examination; CXR, AXR, KUB, IVU, Xray upper limb, Xray lower limb, Pelvic xrays, CT head
(NICE guidelines)Other CT scans
Ultrasound; Indications and use
Haematology; Indications and interpretation of common investigations, Indications for massive
transfusion
Biochemistry; Indications and interpretation of common investigations
Microbiology; Indications and interpretation of common investigations
Knowledge of Clinical Governance; Trust consent policy, Incident reporting procedures, Safer
prescribing, Use of BNF and guidelines,
3. Practical Skills relevant to the placement

Practical skills (Airway and Breathing); OPA and NPA insertion, Use of BIPAP, Arterial Gas sampling,
PEFR measuring, Use of Inhaler, Chest drain insertion/Aspiration of pneumothorax

Practical skills (circulation) Venous cannulation, Use of vacutainer, IV fluid administration, Drug
administration, CVP (cvp or manikin or patient, Urinary Catheter (male and female), Wounds closure
(sutures and non sutures)

Practical skills (others) NGT, BM analysis, Urinalysis, Pregnancy testing, Toxicology screening

Drugs and therapeutics ; (Pain control drugs and others), Local anaesthetic, Regional Blocks, Procedures
under sedation
Please note all areas marked in bold are covered on the induction days in order for the doctors to be
safe to practice and be covered by the Trust Insurance policy
4. Professional Competencies
1. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
2. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and cultural
aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
3. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering information,
using questions that are appropriately focused, making use of existing information, choosing physical
examinations and targeting investigations appropriately, making appropriate inferences from the findings and
results.
4. Making diagnosis / making decisions
This competency is about a deliberate, structured approach to decision-making. Behaviours you may wish to
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
consider: clarifying the decision that is required, integrating information to aid pattern recognition, using probability
to decide what is likely, revising hypotheses in the light of further information, thinking flexibly around the problem.
5. Clinical Management
This competency is about the recognition and management of medical conditions. Behaviours you may wish to
consider: recognising common presentations, utilising the natural history in management decisions, using simple
measures when appropriate, varying management options when required, prescribing appropriately, referring
appropriately and coordinating care with other colleagues, responding quickly and skilfully in emergencies.
6. Managing medical complexity
This competency is about aspects of care beyond managing straightforward problems, including the management of comorbidity, uncertainty, risk and thinking about health rather than just illness. Behaviours you may wish to consider:
simultaneously managing the patients health problems both acute and chronic, tolerating uncertainty where this is unavoidable,
explaining risks associated with management to the patients, encouraging patients to have a positive approach to their health.
7. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
8. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
9. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
10. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event reviews,
Contributing to the ongoing learning of students and colleagues
11. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish to
consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and others
fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between people and
avoiding prejudice.
12. Fitness to practice
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that of
others might put patients at risk and the action taken to protect patients. Behaviours you may wish to consider:
observing the accepted codes of professional practice, allowing scrutiny and justifying professional behaviour to
colleagues, achieving a healthy balance between professional and personal demands, seeking advice and
engaging in remedial action where personal performance is an issue
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
May 2007
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locally with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Community Women’s Health
GP Specialty Training Intended Learning Outcomes from Clinical Placement
SPECIALTY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
5. Knowledge-base relevant to the placement
Symptoms
Pruritus vulvae, vaginal discharge, dysparaeunia, pelvic pain, endometriosis
Amenorrhoea, Menorrhagia, Dysmenorrhoea, Intermenstrual Bleeding, irregular bleeding patterns, post
menopausal bleeding, pre-menstrual problems
Infertility primary Secondary
Urinary malfunction : dysuria urinary incontinence
Contraception,all methods. Emergency contraception,advising on unplanned pregnancy.
Sexual history taking, sexual health screening, treatment of stds, contact tracing
Initial counselling of rape and assault victims
Common and / or important conditions
Abnormal cervical Cytology
Vaginal and uterine prolapse
Fibroids
Gynaecological malignancies
Miscarriage Abortion
Ectopic pregnancy
Trophoblastic disease
Pregnancy Problems
Menstrual problems
Sexually transmitted diseases
Menopause
Infertility
osteoporosis
Investigations
Colposcopy and subfertility investigations
Cervical cytology
Vaginal and cervical swab taking
Breast examination
Bone densitometry
Treatments
May 2007
Knowledge of Laparoscopy, D+C, hystererctomy, oophrectomy, ovarian cystectomy, pelvic floor repair medical and
surgical termination of pregnancy sterilisation
Understanding the risks of prescribing in pregnancy
Prescribing contraception
Treatment of STDs
6. Practical Skills relevant to the placement
Perform a gentle and thorough pelvic examination including digital and speculum examination,
assessment of the size position and mobility of the uterus and the recognition of abnormality of the
pelvic organs paying attention to professional etiquette patient consent comfort and information
Competently perform a cervical smear with sensitivity and care, providing a positive, informative
experience for the woman that allows her to control the process and enhances her view of herself and
her body
Catheterisation
Change a ring pessary
7. Professional Competencies
1. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
2. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
3. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
4. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
5. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
6. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
7. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
8. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
9. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
10. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
11. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
12. Fitness to practise
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
May 2007
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locallly with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
DERMATOLOGY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
See RCGP curriculum section 15.10
http://www.rcgp-curriculum.org.uk/PDF/curr_15_10_Skin_problems.pdf
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
8. Knowledge-base relevant to the placement
1) SYMPTOMS
Rashes, hair loss, itch/pruritus, pigmented lesions, signs of skin infection, bruising & purpura, lumps,
photosensitivity and red face
2)COMMON/IMPORTANT SKIN PROBLEMS
 Eczema, psoriasis, generalised pruritus, urticaria & vasculitis, acne & rosacea, infections,
infestations, leg ulcers & lymphoedema, skin tumours (benign & malignant), nail & hair
disorders, drug eruptions.
 Less common disorders such as bullous disorders, lichen planus, vitiligo, photosensitivity,
pemphigus & pemphigoid, discoid lupus, granuloma annulare and lichen sclerosus.
 Prevalence of common skin problems
3) INVESTIGATIONS
Be able to take mycology specimens from skin, hair & nail; basic interpretation of histology reports;
skin biopsy.
4) TREATMENT
 Commonly used treatments in Primary Care, appropriate prescribing and usage, side effects.
 Principles of protective care- sun, occupational, hand.
 Awareness of specialised treatments e.g retinoids, ciclosporin, phototherapy, methotrexate.
 Indications for and skills to perform: curettage, cautery, cryosurgery.
 Dermatological side effects of medicines used to treat other conditions.
 Educating patients to self-manage their skin conditions
 Key National Guidelines e.g NHS Cancer Plan 2000
 Social/psychological impact on health and quality of life, fitness to work, relationships.
May 2007
5) EMERGENCY CARE
Recognition, urgent intervention, acute treatment and appropriate referral as necessary of people
presenting with skin problems, including:
Angiodema & anaphylaxis, meningococcal sepsis, disseminated HSV, erythroderma,pustular
psoriasis, severe nodulocystic acne, toxic epidermal necrolysis, Stevens-Johnson syndrome,
necrotising fasciitis.
6) PREVENTION
Sun, fixed factor (genetics), occupation, care of the hands
7) GENETICS
How genetic factors influence inheritance of common disease such as psoriasis & atopic eczema.
9. Practical Skills relevant to the placement
Biopsy, curettage, cautery, cryosurgery.
10. Professional Competencies
13. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
14. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
15. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
16. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
17. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
18. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
advice and engaging in remedial action where personal performance is an issue
19. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
20. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
21. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
22. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
23. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
24. Fitness to practise
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locallly with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
May 2007
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
EAR NOSE AND THROAT SURGERY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)

To be read in conjunction with RCGP Curriculum statement 15.4: Clinical Management:ENT and Facial Problems
http://www.rcgp-curriculum.org.uk/PDF/curr_15_4_ENT_&_facial_problems.pdf
11. Knowledge-base relevant to the placement
Symptoms
Hearing loss; ear wax, otalgia; discharging ear; dizziness; tinnitus; epistaxis; sore throat, hoarseness;
dysphagia;croup; goitre, lymph nodes and other neck swellings; speech delay; foreign bodies; facial
weakness.
Common and/or important conditions
Otitis media (suppurative/secretory); otitis externa; perforated tympanic membrane; cholesteatoma
Vertigo; Ménière’s disease
Bell’s palsy; tempero-mandibular pain, trigeminal neuralgia
Pharyngitis; tonsillitis; laryngitis; glandular fever; oral candida, herpes; salivary stones; gastrooesophageal
reflux disease (GORD)
Infective and allergic rhinitis; sinusitis; nasal polyps
Nasal fracture, haematoma auris
Snoring and sleep apnoea
Suspected head and neck cancer12
Unilateral hearing loss in the absence of external ear pathology or obvious cause
Investigation
Otoscopy
Tuning fork tests
Awareness of: pure tone threshold audiogram; speech audiometry, impedance tympanometry, auditory
brainstem responses and otoacoustic emissions
Treatment
Watchful waiting and use of delayed prescriptions
Nasal cautery
Fractured nose (need manipulation under anaesthetic within two weeks for optimum result).
Emergency care
Septal haematoma
Epistaxis
Tonsillitis with quinsy
Otitis externa if extremely blocked or painful
Foreign body
Auricular haematoma or perichondritis
Prevention
Screening for hearing impairment in adults and children
Awareness of iatrogenic causes of ototoxicity
May 2007
12. Practical Skills relevant to the placement
Otoscopy
Nasal cautery
Rinne and Weber tuning fork tests
13. Professional Competencies
25. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
26. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
27. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
28. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
29. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
30. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
31. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
32. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
33. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
34. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
35. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
May 2007
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locally with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
GU medicine
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
To be read in conjunction with RCGP Curriculum statement 11: Sexual health
http://www.rcgp-curriculum.org.uk/PDF/curr_11_Sexual_Health.pdf
14. Knowledge-base relevant to the placement
Symptoms:
Key issues in the diagnosis of sexual health problems will be the eliciting of appropriate signs
and symptoms, and subsequent investigation and treatment or referral of people presenting with:
• Genital skin conditions including rashes, ulcers and lichen sclerosis
• Ano-genital lumps
• Abnormal genital smell
• Unusual or different vaginal discharge or penile urethral discharge
• Pain on passing urine in men and women
• Lower abdominal pain in women
• Testicular pain and swelling
• Pain on intercourse
• Intermenstrual bleeding
• Vaginal bleeding after sex.
Common and/or important conditions in men and women:
• Urinary tract infections in women
• Bacterial vaginosis
• Candidiasis
• Group B haemolytic streptococcus
• Chlamydial infections
• Gonorrhoea
• Trichomonas vaginalis
• Ano-genital ulcers – herpes simplex, syphilis, tropical infections, primary HIV infection
• Ano-genital warts
• Conditions suggestive of immunosuppression (e.g. pneumocystis, pneumonia,
tuberculosis, lymphoma, seborrhoeic dermatitis or oral thrush) or of primary HIV
infection
• Syphilis
• Conjunctivitis (neonatal and adult)
• Reiter’s syndrome
• HIV/AIDS and the presentations/complications including pneumocystis pneumonia,
candidiasis, cryptococcus, Kaposi’s sarcoma, toxoplasmosis, lymphoma, hepatitis,
tuberculosis
• Sexual dysfunction.
May 2007
Investigation:
• Pregnancy testing
• Urinalysis
• Blood tests for HIV and syphilis
• Blood tests for hepatitis B and their interpretation
• Microbiology and virology swabs – which to use, which samples to take, limitations of
tests and interpretation of results
• Secondary care investigations, e.g. colposcopy.
.
Treatment/management:
• Contraception – effectiveness rates, risks, benefits and appropriate selection of patients
for all methods, including methods of emergency contraception
• Contraception – the safe provision of all methods of oral contraception (including
emergency hormonal contraception) and also contraceptive patches and DMPA injections
• Contraception – knowledge and availability of intra-uterine methods of contraception
(including as a method of emergency contraception), subdermal implants, sterilisation
and natural family planning
• Abortion – methods and the legal procedures relating to referral for abortion
• Principles of treatment for common conditions diagnosed and/or managed in primary
care (see above)
• Principles of antiretroviral combination therapy for HIV/AIDS, potential side effects and
the role of the GP in their management in primary care.
Emergency care:
• Emergency hormonal contraception
• Emergency intra-uterine contraception
• The role of post-exposure prophylaxis (PEP) in HIV prevention
• Referral for suspected Pneumocystis carinii pneumonia
• Responding to early presentation of rape and sexual assault.
. Prevention:
• Health education and prevention advice – safe sex and risk reduction
• Unplanned pregnancies
• National screening programmes – cervical screening, chlamydia, antenatal HIV testing
• Hepatitis B immunisation programme
• Occupational risks – exposure to needle stick injuries.
15. Practical Skills relevant to the placement




Perform a sexual health examination including digital and
speculum examination, assessment of the size,
position and mobility of the uterus, and the recognition of
abnormality of the pelvic organs.
Intramuscular injection.
Take microbiology and virology swabs from ano-genital areas.
Teach the patient about male and female condom use.
Take a cervical smear.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
16. Professional Competencies
36. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
Take a sexual history from a male or female patient in a way that is private and confidential, non-judgemental,
responsive to the reactions of the patient and avoids assumptions about sexual orientation or the gender
of the partner(s), assumptions related to age, disability or ethnic origin.
37. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
38. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
39. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
40. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
41. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
42. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
43. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
44. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
May 2007
45. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
46. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
MUSCULOSKELETAL MEDICINE SPECIALTY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
To be read in conjunction with RCGP Curriculum Statement 15.9: Clinical Management: Rheumatology and
conditions of the muculoskeletal system (including trauma)
http://www.rcgp-curriculum.org.uk/PDF/curr_15_9_Rheumatology_&_musculoskeletal_problems.pdf
17. Knowledge-base relevant to the placement
Symptoms:
• Inflammation – pain, swelling, redness, warmth
• Lack of function – weakness, restricted movement, deformity and disability
• Injuries – cuts, bruises, wounds
• Systemic manifestations – rashes, tiredness, nerve compression, etc.
Common and/or important conditions:
• Acute back/neck pain
• Chronic back/neck pain
• Shoulder pain
• Knee pain
• Soft-tissue disorders
• Osteoarthritis
• Osteoporosis
• Somatisation/fibromyalgia and allied syndromes
• Pain management
• Acute arthropathies
• Chronic inflammatory arthropathies
• Polymyalgia rheumatica and allied conditions
• Awareness of rare diseases
• Chronic disability
• Common injuries.
NB: these topics should be considered throughout the age range including children.
Investigation:
• Indications for plain radiography, ultrasound, CT and MR scan including the use of tools
such as the ’Ottawa Rules’i
• General rules of X-ray interpretation
• Implications of ’Misses’ on X-rays, common errors
• Indications for additional investigations, for example blood tests.
May 2007
Treatment:
• Understand the principles of treatment for common conditions managed largely in
primary care including the use and monitoring of NSAIDs and disease-modifying drugs
• Knowledge of when joint injections and aspirations are appropriate in general practice
and the ability to perform when appropriate, e.g. shoulder and knee joints and injections
for tennis and golfer’s elbow
• Understand the roles of allied health professionals (nursing, physiotherapy, chiropody,
podiatry, occupational therapy, counselling and psychological services)
• Chronic disease management including systems of care, multidisciplinary teamwork and
shared-care arrangements.
18. Practical Skills relevant to the placement
• Demonstrate complete examination of the following areas:
o the neck and back
o the shoulder, elbow, wrist and hand
o the hip, knee and ankle.
• Knowledge of when joint injections and aspirations are appropriate in general practice
and the ability to perform when appropriate, e.g. shoulder and knee joints and injections
for tennis and golfer’s elbow
19. Professional Competencies
47. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
48. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
49. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
50. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
51. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
52. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
53. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
54. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
55. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
56. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
57. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
May 2007
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locally with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Women’s Health
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
SPECIALTY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
20. Knowledge-base relevant to the placement
Symptoms
Pruritus vulvae, vaginal discharge, dysparaeunia, pelvic pain, endometriosis
Amenorrhoea, Menorrhagia, Dysmenorrhoea, Intermenstrual Bleeding, irregular bleeding patterns, post
menopausal bleeding, pre-menstrual problems
Infertility primary Secondary
Urinary malfunction : dysuria urinary incontinence
Common and / or important conditions
Abnormal cervical Cytology
Vaginal and uterine prolapse
Fibroids
Gynaecological malignancies
Miscarriage Abortion
Ectopic pregnancy
Trophoblastic disease
Pregnancy Problems
Investigations
Colposcopy and subfertility investigations
Treatments
Knowledge of Laparoscopy, D+C, hystererctomy, oophrectomy, ovarian cystectomy, pelvic floor repair medical and
surgical termination of pregnancy sterilisation
Understanding the risks of prescribing in pregnancy
21. Practical Skills relevant to the placement
Perform a gentle and thorough pelvic examination including digital and speculum examination,
assessment of the size position and mobility of the uterus and the recognition of abnormality of the
pelvic organs paying attention to professional etiquette patient consent comfort and information
Competently perform a cervical smear with sensitivity and care, providing a positive, informative
experience for the woman that allows her to control the process and enhances her view of herself and
her body
May 2007
Catheterisation
Change a ring pessary
22. Professional Competencies
58. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
59. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
60. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
61. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
62. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
63. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
64. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
65. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
66. Community orientation
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
67. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
68. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
69. Fitness to practise
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
May 2007
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locallly with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
SPECIALTY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
23. Knowledge-base relevant to the placement
Disorders of the lids and lacrimal drainage apparatus: (Blepharitis, Stye and Chalazion, Entropion and
Ectropion, Basal-cell carcinoma, Naso-lacrimal obstruction and dacryocystitis).
External eye disease: sclera, cornea and anterior uvea: (Conjunctivitis (infective and allergic), Dry eye
syudrome, Episclenitis and scleritis, Corneal ulcers and Keratitis, Iritis and Uveitis).
Disorders of refraction: (Catarac, Myopia, Hypermetropia, Astigmatism, Principles of refractive surgery,
Problems associated with contact lenses).
Disorders of aqueous drainage: (Acute angle closure glaucoma, Primary open angle glaucoma, Secondary
glaucoma).
Vitreo-retinal disorders: (Flashes and floaters, Vitreous detachment, Vitreous haemorrhage, Retinal
detachment).
Disorders of the optic disc and visual pathways: (Swollen optic disc: recognition and differential diagnosis,
Atrophic optic disc: recognition and differential diagnosis, Pathological cupping of the optic disc, Migraine,
Transient ischaemic attacks (TIAs)).
Eye Movement Disorders: (Diplopia, Non-paralytic and paralytic strabismus).
Investigations:
 Undertake an examination of the eye assessing both structure and function.
 Understand the appropriate investigations to exclude systemic disease.
 Know the secondary care investigations and treatment including slit lamp, eye pressure
measurement.
Emergency care: Ability to recognise and institute primary management of ophthalmic emergencies and refer
appropriately: (Superficial ocular trauma, including assessment of foreign bodies, abrasions and minor lid
lacerations, Arc eye, severe blunt injury, including hyphaema, sever orbital injury, including blow-out fracture,
Penetrating ocular injury, and tissue prolapse, Retained intra-ocular foreign body, sudden painless loss of
vision, sever intra-ocular infection, acute angle closure glaucoma.
Community Orientation:
Describe the role of, and appropriate referral to, the community optician, Describe the DVLA driving regulations
for people with visual problems, facilitate patients’ access to sources of social support for the visually impaired
child:
 The ‘statementing’ process for children with special educational needs.
 Schooling requirements and role of peripatetic teachers.
 Career guidance for visually impaired children.
Facilitate patients’ access to sources of social support for visually impaired adults:
 RNIB, talking-book services.
 Social Services
 Local services
 Low vision aids.
24. Practical Skills relevant to the placement
May 2007
Treatment:


Understand and be able to explain to the patient about the use of medications including
mydriatics, topical anaesthetics, cotocosteroids, antibiotics, glaucoma agents, how to
administer eye drops.
Removal of superficial bodies from the eye.
3. Skills to be assessed by DOPS
History taking
Assessment of ophthalmic symptoms
Association between eye and systemic disease.
Association between eye and neurological/
neurosurgical disease.
Ocular examination
Visual acuity testing
Slit lamp examination
Pupil assessment
Measurement of intraocular pressure
Dilated fundoscopy
Investigations
Colour vision
Visual fields
Amsler grid testing
Orthoptic assessment Measurement of visual acuity in children
Assessment of children with squint
Cataract
Diagnosis
Pre-operative assessment and consent
Post-operative management
Glaucoma
Diagnosis and assessment
Retina
Age related macular degeneration
Diabetic retinopathy screening
Posterior vitreous and retinal detachment diagnosis
Oculoplastics
Diagnosis of ptosis and other eyelid disorders
Thyroid eye disease, indications for surgery
Casualty
Differential diagnosis and management of the red eye
Visual Loss,
4. Professional Competencies
70. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
71. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
72. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
73. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
74. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
75. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
76. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
77. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
78. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
79. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
80. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
81. Fitness to practise
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that of others
might put patients at risk and the action taken to protect patients. Behaviours you may wish to consider: observing the
accepted codes of professional practice, allowing scrutiny and justifying professional behaviour to colleagues, achieving a
healthy balance between professional and personal demands, seeking advice and engaging in remedial action where
personal performance is an issue
May 2007
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locallly with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
DRAFT OPHTHALMOLOGY VTS TRAINEE
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
LEARNING OBJECTIVES AND ASSESSMENT
INTRODUCTION
The general practice vocational training scheme post in Ophthalmology is a six month appointment based at the
Royal Berkshire Foundation NHS Trust, Reading.
The aim of the attachment is to provide exposure to a broad range of ophthalmology practice, to reform the
trainees future care of patients with ophthalmic disease. This may be within a general practice setting, or as a
general practitioner who has a special interest in ophthalmology. Trainees interested in taking on GP wsi role in
ophthalmology would be encouraged to sit Post Graduate examination such as the DO.
TIMETABLE
MON
TUES
AM
STUDY
ML CLINIC
PM
OXFORD
ASB
PLASTICA
WEDS
FLEXIBLE
A&E
THURS
FRI
ASB CLINIC
PHC CLINIC
A&E
SLW MED
RET
The VTS trainee will not have profiled patients. This will allow them timeto develop their skills and then contribute to
service provision as they become competent to do so. Eye A&E sessions will be in parallel with more senior staff.
The VTS trainee will have an on-call commitment, but will work in parallel with a more senior ophthalmic trainee at
all times.
LEARNING ASSESSMENT
At the beginning of the attachment, after two month, and at the end of the attachment, there will be formal time set
aside with the College Tutor (Mr Leyland) for establishing a training agreement, assessing progress and at the end
of the attachment assessment of outcomes and appraisal. Work based assessment will include direct observation
of practical skills (DOPS), case based discussions and mini CEX.
May 2007
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
SPECIALTY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
25. Knowledge-base relevant to the placement
Management of Palliative Patients
1-Physical Symptoms:
 Symptom control eg nausea, vomiting pain, constipation/diarrhoea, breathlessness, neuropathic
pain, bowel obstraction, medical management of cord compression.
 Recognising and managing terminal phase.
2-Emergency treatment in palliative medicine:
 Spinal cord compression, Superior vena cava obstruction, major haemorrhage.
 Management of psychological/psychiatric symptoms like delirium, depression, anxiety, emergency
drugs.
3-General Medicine:
 Horner’s syndrome, Hyper calcaimia, Bowel obstruction, medication used in palliative care, use of
syringe driver, symptom control in the final stages of terminal care.
4- Multidisciplinary liaison:
 Liaising with GPs and the primary care team, community orientation, social services, and benefits to
patients and carers, multidisciplinary meetings, continuity of care.
5- Communication Skills:
 Communication with the patient, family and team, Holistic care of patient and family, the grieving
process.
6- Ethical Issues eg:
 awarness of mental capacity act, the use of living will or the equivalent advance
directives the ethical issues about decisions, the ethical issues about decisions to treat or not
to treat.
7- Evidence based medicine:
 Knowledge of EBM in palliative medicine.
 Ability to learn from clinical experience.
 Knowledge of cancer treatment trials and how to inform patients.
26. Practical Skills relevant to the placement
Phlebotomy,
Paracentesis,
Pleural taps as appropriate if clinically indicated.
Suturing
Catheterisation
and use of intravenous antibiotics
Practical use of syringe driver.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
27. Professional Competencies
82. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
83. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
84. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
85. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
86. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
87. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
88. Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
89. Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
90. Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
91. Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
May 2007
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
92. Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
93. Fitness to practise
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that of others
might put patients at risk and the action taken to protect patients. Behaviours you may wish to consider: observing the
accepted codes of professional practice, allowing scrutiny and justifying professional behaviour to colleagues, achieving a
healthy balance between professional and personal demands, seeking advice and engaging in remedial action where
personal performance is an issue.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locallly with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
May 2007
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
PALLIATIVE CARE
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
See RCGP curriculum statement 12
http://www.rcgp-curriculum.org.uk/PDF/curr_12_Cancer_and_palliative_care.pdf
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
28. Knowledge-base relevant to the placement










Principles of palliative care and how it applies to non-cancer illnesses such as cardiovascular,
neurological, respiratory and infectious diseases.
Managing pain and other symptoms
Syringe drivers: suitable drugs; conversion of oral doses to syringe driver (IV or subcutaneous)
Palliative care emergencies, recognition and management:
 major haemorrhage
 hypercalcaemia
 superior vena cava obstruction
 spinal cord compression
 bone fractures
 anxiety/panic
 use of emergency drugs
Management of cancer and non-cancer symptomatology in the same patient
Knowledge of normal and abnormal grieving and its effect on symptomatology and on carer(s)
Understand key health service policy on provision for palliative care, including funding
Knowledge of ethical aspects of treatment, investigative choices, end-of-life care and advanced
directives
Knowledge of own personal attitudes and experiences which may affect attitude towards terminal care
patients
Knowledge about provision of 24 hour continuity of care throughout various systems
29. Practical Skills relevant to the placement







Setting up, using, and removing a syringe driver
Managing oxygen
Ability to counsel and explain symptom control
Ability to .attend to the full range of physical, social, and spiritual needs of the patient and carer(s)
Ability to function as a member of a palliative care team
Ability to communicate effectively with the patient and carer(s) regarding difficult information about
the disease, treatment or prognosis
Ability to learn from clinical experience
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
30. Professional Competencies
94. Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
95. Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
96. Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
97. Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
98. Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
99. Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
100.
Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
101.
Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
102.
Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
May 2007
access available resources, using health care resources effectively e.g. through cost-effective prescribing
103.
Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
104.
Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
105.
Fitness to practise
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locallly with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
PSYCHIATRY
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
To be read in conjunction with RCGP Curriculum statement 13: Care of People with Mental Health Problems
http://www.rcgp-curriculum.org.uk/PDF/curr_13_Mental_Health.pdf
31. Knowledge-base relevant to the placement
Symptoms
Tired all the time, insomnia, anxiety, depression, multiple somatic complaints, dizziness, palpitations,
paraesthesiae, abdominal pain (children), early signs of possible psychotic illness.
Common and/or important conditions
The most common primary care mental health problems are depression, eating disorders and anxiety
disorders. ADHD, post-traumatic stress disorder. Alcohol and drug misuse. Dual diagnosis.
Investigations
Use of depression rating scales, and other aids in the evaluation of possible diagnosis and severity
Treatment
Pharmacology, cognitive behavioural therapy (CBT) and simple behavioural techniques, problemsolving therapy and basis of systemic and strength-focused therapies, self-administered therapy, ECT
and detox.
Emergency care:
Threatened or attempted suicide, delirium, psychosis, panic, aggressive or violent patients, drug
overdose and alcohol withdrawal
Resources
The family of the patient
Members of the primary healthcare team, receptionist, counsellor, Citizens' Advice Bureau (CAB)
worker
Specialist mental health services and non-medical agencies (non-professional, lay or voluntary
resources).
When and how the Mental Health Act is used.
Police, working w CPN, day services
Prevention
Mental health promotion, especially children, families and adolescents
Screening of all language-delayed children for autism
Early intervention in psychosis.
Driving issues
32. Practical Skills relevant to the placement
May 2007
Mental state assessment
Suicide risk assessment
33. Professional Competencies
106.
Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
107.
Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
108.
Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
109.
Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
110.
Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
111.
Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
112.
Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
113.
Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
114.
Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
115.
Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
116.
Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
May 2007
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locally with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Oxford PGMDE
GP Specialty Training Intended Learning Outcomes from Clinical Placement
REHABILITATION MEDICINE
This guideline is for GP Specialty Trainees and Clinical Supervisors during clinical placements, and should
accompany the trust job description. The intended learning outcomes should inform the planned clinical experience
and training, and should be used as a template for the clinical supervisor’s assessment of the trainee’s
performance at the end of the placement.
The intended learning outcomes relate to three main areas:
 Knowledge (relevant to the placement)
 Practical skills (relevant to the placement)
 Professional competencies (generic GP Curriculum)
34. Knowledge-base relevant to the placement








Principles of rehabilitation for spinal cord injury, musculoskeletal problems, neurological
disability and amputees.
Prevention and treatment of complications of underlying condition, eg continence/bowel
management/pressure sore management/UTI and septicaemia/MRSA infection.
Assessment of the common psychological disorders,
psychosocial and behavioural consequences commonly seen in disabling disorders, and
also the corresponding contextual factors that influence activity and participation.
Social and cultural factors which influence disability and their impact on the rehabilitation
process.
Working with a multidisciplinary team to plan goal setting and coordinate discharge.
Legal issues: Court of protection, power of attorney, principles of the mental health act,
disability discrimination act and mental capacity act
35. Practical Skills relevant to the placement
Management of tracheostomies
Joint aspiration
36. Professional Competencies
117.
Communication and consultation skills
This competency is about communication with patients and the use of recognised consultation techniques.
Behaviours you may wish to consider: listening well, exploring patients ideas, providing good explanations,
checking the patient' s understanding, tailoring communication to the patient' s needs.
118.
Practising holistically
This competency is about the ability of the doctor to consider physical, psychological, socioeconomic and
cultural aspects, taking into account feelings as well as thoughts.
May 2007
Behaviours you may wish to consider: exploring the way in which the problem affects the patient’s life, exploring
the impact of the problem on the patient' s family/carers
119.
Data gathering and interpretation
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
120.
Making diagnosis/ making decisions
This competency is about the gathering and use of data for clinical judgement, the choice of examination and
investigations and their interpretation. Behaviours you may wish to consider: systematically gathering
information, using questions that are appropriately focused, making use of existing information, choosing
physical examinations and targeting investigations appropriately, making appropriate inferences from the
findings and results.
121.
Clinical Management
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
122.
Managing medical complexity
This competency is about the doctor’s awareness of when his/her own performance, conduct or health, or that
of others might put patients at risk and the action taken to protect patients. Behaviours you may wish to
consider: observing the accepted codes of professional practice, allowing scrutiny and justifying professional
behaviour to colleagues, achieving a healthy balance between professional and personal demands, seeking
advice and engaging in remedial action where personal performance is an issue
123.
Primary care administration and IMT
This competency is about the appropriate use of primary care administration systems, effective record-keeping
and information technology for the benefit of patient care. Behaviours you may wish to consider: using
administrative and computer systems appropriately, keeping good clinical records (timely, coded, sufficiently
comprehensive)
124.
Working with colleagues and in teams
This competency is working effectively with other professionals to ensure patient care, including the sharing of
information with colleagues. Behaviours you may wish to consider: being available to colleagues, working
cooperatively, sharing information with others involved in the patient's care, using appropriate methods of
communication according to the circumstances.
125.
Community orientation
This competency is about the management of the health and social care of patients in the local community.
Behaviours you may wish to consider: identifying important characteristics of the local community that might
impact upon patient care, particularly the epidemiological, social, economic and ethnic features, using this
understanding to improve patient management, identifying resources in the community, encouraging patients to
access available resources, using health care resources effectively e.g. through cost-effective prescribing
126.
Maintaining performance, learning and teaching
This competency is about maintaining the performance and effective continuing professional development of
oneself and others. Behaviours you may wish to consider: the appropriately using evidence-based medicine,
keeping up-to-date, identifying and addressing learning needs, participating in audit and significant event
reviews, Contributing to the ongoing learning of students and colleagues
127.
Maintaining an ethical approach to practise
This competency is about practising ethically with integrity and a respect for diversity. Behaviours you may wish
to consider: Identifying and discussing ethical issues in clinical practice. Treating patients, colleagues and
others fairly and with respect for their beliefs, preferences, dignity and rights. Valuing differences between
people and avoiding prejudice.
Oxford Deanery GP Specialty Training Clinical Placement Guidelines
Deanery Guidelines for inclusion in the Trust Job Description
Clinical Supervision
All GP Specialty Trainees should have a named clinical supervisor, with whom they will meet at
the beginning, middle and end of their training placement.
Training
All GP Specialty Trainees should have a minimum of 10 days / annum of study leave in each of
their training years to support the generic GP Specialty Programme training programme,
together with 5 further days of study leave for placement in a GP training practice.
Arrangements for release to be negotiated locally with trusts.
Assessment
All GP Specialty Trainees should collect a minimum data set of evidence about their clinical
performance and professional behaviour, and clinical departments are expected to support this
process and including recording assessments in the electronic portfolio. At the end of each
clinical placement, the clinical supervisor is required to complete a clinical supervisor’s report
against the intended learning outcomes guideline.
Educational Supervision
All GP Specialty Trainees will have an educational supervisor, usually based in primary care,
whom they will meet at 6 monthly intervals for review of the electronic portfolio documenting
progression through the GP training programme.