GP Teaching

Year 6 General Practice Senior Assistantship
Dr Sian Powell

The GPPHC Patient Project aims to increase students’ understanding of person-centred care in the context of complex health needs and/or social factors. Students are able to understand and enhance the care of patients by exploring wider issues surrounding care pathways and the interaction between primary/secondary and social care.

Winner: Christie Tsang
Nitrous Oxide Toxicity

Winner: Anežka Macey-Dare

Year 3 Community Action Project
Dr Georgina Neve

Years 1 and 2 Patients, Communities and Healthcare
Dr Viral Thakerar

Read Annual Teachers Conference 2024: Student prizes in full

Congratulations to all the winners of tutors prizes at the 2024 Annual Teachers Conference. Below you can read feedback from students placed with each of the winners:

Teaching Excellence Award: Dr Yulia Peysakhova,  Cavendish Health Centre

“My supervisor Dr Peysakhova is so awesome. She actually wants us to learn and gives us opportunity to do this.”

“Dr Peysakhova doesn’t waste time. She makes sure everything is a learning opportunity and she’s so well versed in teaching younger years. Very lucky to be put on this placement. Thank you!”

“She’s so awesome. Would definitely recommend her to be put forward to teach more students.”

“She lets us take calls to practice history taking. Her advice is actually targeted and useful. I’ve learnt so much from her.”

Teaching Excellence Award: Dr Sabri Trepca, Barlby Surgery

“Dr Trepca is very encouraging and teaches useful and relevant lessons during his clinic.”

“Dr Sabri Trepca was an excellent teacher who discussed all the cases that presented with us – he was kind and understanding and gave good advice – contributing to our clinical knowledge and general life knowledge. Dr Sabri created a relaxed environment for us – where we felt comfortable to speak up and ask questions. He was non-judgmental and did not use harsh language. He showed us how to deal with difficult patients, how to perform and interpret findings from otoscopy/ophthalmoscopy/blood pressure measurements/urine dipsticks/blood results, what to notice in a patient when they walk in – signs that show a child is ill – what to do when in clinical doubt. He covered a vast scope of topics with us including multiple myeloma, nutrient deficiencies, ear infections, tonsillitis, vitamin deficiencies, 8 week checks, smear tests etc It was a pleasure to be on placement with him – he worked hard and made it as enjoyable and as engaging as he could.”

Teaching Excellence Award: Dr Stephanie Hughes, The Friarsgate Practice

“Dr Hughes was absolutely amazing, such a well organised and useful placement This was genuinely one of my favourite placements of medical school. I was going to GP not expecting to enjoy it much as I had not enjoyed it in previous years due to insufficient opportunity to get involved with the team. However I had the opportunity to get involved with multiple members of the MDT, run numerous clinics and decide patient plans. I also think this placement prepared me for being a doctor – I got practice writing patient prescriptions, writing referral letters, requesting investigations and I was well supported by all the doctors who supervised me. I would really strongly recommend this placement. All the doctors were instrumental in my education especially Dr Stephanie Hughes who is an excellent GP tutor.”

Supporting the Student Experience Practice Award: KS Medical Centre, Southall

“KS Medical Centre welcomed us so well and made us feel a part of the team. Dr Kamini was an amazing mentor and teacher, who always went above and beyond to give us useful teaching and experience. She was very passionate about us getting more confident throughout the 8 weeks and she ensured that we became more confident with our own skills and knowledge. Both Dr Kamini and Dr Ross taught us really well and also understood the importance of getting our sign offs done so we felt really comfortable and did not have to worry about not getting things done.”

“Overall, they were incredible and definitely should be praised for giving both me and my partner such an enjoyable time during MICA. Dr Kamini Gautam+ Dr Ross Mcjannette were incredibly accomodating. They went above and beyond in support, teaching and general care. I have never enjoyed and learnt so much from a placement before.”

Supporting the Student Experience Practice Award: Millbank Medical Centre, Westminster

“This was the best medical placement I have had up to date in my medical education. The structure and organisation from the get go with regards to teaching and the forms we needed, the additional opportunities provided by Dr McLaughlin; the hospice, the district nurses and the coroners court. She went above and beyond what is required for our medical teaching and provided experiences that I will not forget throughout my professional career. All the GPs, in particular Dr Dee and Dr Patel, made sure to have us as included as possible within the team and would actively involve us in any learning experiences available. The teaching was centred on what we wanted to get out of the placement and made us feel involved with the practice team as well as being able to take control of our learning was something I haven’t experienced at any other placement. I have no improvements to recommend. This experience was incredible. If there are any accolades awarded I would like to nominate both the practice and Dr Niamh McLaughlin as it is well deserved for the effort and care they put in their teaching. Truly exceptional. Again just to emphasise any medical student should feel privileged to have the opportunity to learn at Millbank! Absolutely fantastic GP tutor and team at the practice, really welcoming, keen to learn and to teach and open to answering any questions. Niamh McLaughlin is a great mentor, who is keen to facilitate our learning and catered our timetable to what we wanted to achieve. Couldn’t have been better.”

Supporting the Student Experience Award: The Croft Medical Centre, Leicester

“The entire team at the croft medical center was so lovely! I had the best time, all of the reception staff, all nurses and of course all of the lovely GP’s I got to spend time with were all kind beyond end. A HUGE thank you to Dr Makda for being such a great student mentor, his team gave me a perfect amount of authority during the time I was there; I was allowed my own clinics but was guided in terms of management and quieres along the way. He was an outstanding GP and even more so teacher; very understanding, very enthusiastic and extremely kind. I can only recommend this practice highly. Generally as a GP service, this practice was by far one of the most organised and thought through practices I have ever seen. From splitting the workload to timetabling students, whether these were from London universities or Leicester university, all of it was done seamlessly with absolutely no problems; no IT problems, no reasons to be shy, no problems accessing the GP center. It was top tier.”

Outstanding contribution to teaching: Fulham Medical Centre

Jan 2024: “The entire team at the Fulham Medical Centre was exceptional. In particular, Dr Libby Pearson and Dr George Hawche went above and beyond in their teaching and support, making this one of the most enjoyable and useful placement I have had to date.”

Oct 2023: “All of the members of the team at this GP were extremely friendly and welcoming and made us feel at home in the practice. In particular Dr Tim and Dr Libby gave us excellent teaching and feedback. They always picked out specific patients for us to see which would be most useful to our learning, which I found very beneficial.”

Sept 2023: “The entire team were very kind and inviting. They all welcomed us and would ensure that any queries we had were dealt with efficiently. Moreover, the doctors were very kind. Particularly, the leads (Libby Pearson and Tim McNicholas) always ensured we were seeing interesting patients and were fulfilling any goals or objects we had set out. Dr Pearson is a very wonderful mentor and I understand why she has won so many teaching awards! She had a very kind and reassuring demeanour. If any issues had arisen, I would have felt more than happy to discuss with her.”

August 2023: “Dr Libby Pearson, Dr Tim Mcnicolas and Dr George Hawche were excellent in providing opportunities for me to clerk patients independently, while feeling involved in the team”

“This GP practice is a shining beacon of what a GP team can achieve. Dr Pearson, Dr Hawche and Dr Tim (forgetting his last name) were all thorough and patient teachers despite having busy schedules. All staff members at the practice were warm and welcoming and provided any support needed.”

Oct 2022: “Dr Pearson was incredibly supportive throughout the placement. Along with support from Dr MacNicholas, the practice was very welcoming and granted me a high level of autonomy and independence which was very helpful for my professional development.”

 July/Aug 2022: “The team at Fulham Medical Centre were amazing! I felt so welcomed by all the doctors and staff there. Dr Pearson was so lovely and eager to teach, and gave us our own clinic from week 1 so we could practice independent interactions with patients. Dr George was also particularly enthusiastic about teaching us regarding various topics and cases presented.”

“This was such a great placement, my anxieties of continuing clinical years after finishing my BSc were mostly gone after this placement! My confidence greatly increased due to the guidance provided by the team here.”

Read Annual Teachers Conference 2024: Tutor prizes in full

by Dr Viral Thakerar

A student reflection

PCH2 is the first clinical placement where our students take histories. This year, it occurred at a critical time in the NHS’s journey when technologies that promote personalised care may ironically lead to the loss of the personal touch. One of our students shared their reflections on this.

I admit that on my first encounter with a treatment algorithm, a faint feeling of dread came over me. Fears I thought I had put to bed when applying for medicine were renewed; was medicine just a form of glorified factory work? Would an algorithm not be better adhered to by a computer?

My last primary care placement went some way to assuage these fears and led me to consider the importance of human connection for patients. Despite current staffing pressures, clinicians on my placement knew patients well and patients seemed to really appreciate this. This is in the context of evidence suggesting patients who receive a greater continuity of care have improved health outcomes. Beyond recommending treatments or making diagnoses, I came to appreciate the role healthcare professionals could have in helping patients navigate difficult times in their lives. Often, it seemed that just lending an ear while patients talked through their concerns could have its own therapeutic value. Thank you!

A tutor reflection

One of our longest standing PCH tutors shares his experience of the community projects and how they give them insight into what matters to their population.

PCH1 was a particular eye opener for us as they looked at satisfaction amongst our patients and the appointment system. There was a lot of free text for them to also write comments and suggestions. The feedback was more positive than I thought. One interesting thing we learnt is trying to give better access to people with hearing impairments. This group of patients will often send in for request via email etc, but when there is something urgent it is a lot more challenging for them to book an appointment personally via calling up. As GPs we only think of the things we can improve or the negative things, but both PCH1 and PCH2 gave us some much-needed positive feedback which I have been able to share with colleagues.

PCH2 was particularly useful with regards to looking at Mental Health in young people. One of the projects also looked at homelessness. We looked at many of the issues. I was able to also explain the challenges from Primary Care- by thinking out loud that not all changes could be implemented- but that there were still changes which would be helpful. For example, young people with mental health problems often want to feel listened to and that their experience is believed, and that some people in this group prefer to talk to older doctors as they may feel judged by younger doctors.

Read Patients, Communities and Healthcare (PCH 1 & 2) reflections from a student and a tutor in full

by Dr Stephanie Bull

As part of its commitment to promoting conversations between students studying healthcare across the globe, MEdIC have created a Global Creative Competition. Initially established in 2020, the competition invited students to understand and reflect on the global COVID-19 pandemic. Further iterations of the competition have focussed on the themes of: Global Unity (2022) and the United Nations Sustainability goals (2024) reflecting international priorities. In 2024 the competition was also opened to all healthcare profession students from across the globe to reflect the multidisciplinary nature of healthcare delivery globally.

Students were asked to produce creative work and to submit a reflection about what their work meant to them personally and professionally.

In 2024 we had hundreds of applications which were shortlisted by a panel of judges and experts to our finalists. An awards ceremony provided an opportunity for healthcare students from both low- and high-income countries to celebrate our finalists and engage in knowledge conversations on topics that are important to the transformational change of global health systems. The finalists from 2024 will be taking part in a panel discussion in March 2024 and we are working to develop a digital exhibition of their work to further showcase their achievements.

Read MEdIC update: Global Creative Competition 2023 in full

by Dr Sian Powell

This year’s annual conference of academic primary care for the South East and London was hosted once again at Madingely Hall, Cambridge and a number of the team were in attendance to present various aspects of our work. The theme for the conference was ‘Challenging Inequality and Promoting Inclusiveness’ and we were treated to fantastic key note speeches from Drs Sally Hull, Margaret Ikpoh and Ban Haider which got us all thinking and on our feet as we heard about their inspiring work and initiatives in this field.

Our team also had an opportunity to showcase some of our recent work and departmental priorities. Drs Ismail Ismail and Aamena Bharmal presented our faculty development work on recruiting GP practices from lower IMD deciles to teach medical students and Dr Agalya Ramanathan described our recent faculty workshop and video for community GP teachers to support students experiencing discrimination in primary care placements. Agalya also described the development of a Student Selected Choice (SSC) for medical students on critical appraisal that incorporated a decolonising lens, and Dr Felicity Lalloo and Steph Powell presented their work on identifying interprofessional multidisciplinary learning opportunities within the undergraduate primary care curriculum.

However, what we probably all enjoyed most was hearing medical students from South East England presenting in the creative enquiry category which included paintings, photography, prose, poetry and film, all accompanied by the student’s reflection on their piece. The standard was exceptional and it was inspiring to see how talented, thoughtful and reflective the students were and to experience their perspectives on complex aspects of life as a doctor.

Of particular note was a poem by Maisie Irvine, an autistic medical student who powerfully described stereotypes and challenges she has experienced as a medical student on placement. We’re privileged and honoured that Maisie will be able to join us for our Annual Teachers’ Conference in June to share her poem with our community GP teachers.

Read Society of Academic Primary Care conference 2024 in full

by Stephanie Powell

As part of the primary care curriculum, our medical students learn about the wider determinants of health and health inequalities, and how these impact on healthcare access, experiences and outcomes. Our students also need to learn skills in holding more person-centred, inclusive conversations with patients, including those with complex health needs and those experiencing social exclusion.  As part of this, we are keen to develop curriculum materials that reflect diverse lived experiences of patients and communities.

We have worked with Expert Focus, who are a team with lived experience of homelessness, to explore their perspectives about health, healthcare and what they would most like our students to know. Their insights highlight the reality of experiencing homelessness and the diversity within this experience.

Some examples include:

• The stigma associated with experiencing homelessness and the impact on experiences of and access to healthcare
• The challenges of accessing primary care, whether by phone or through an online booking system, when a person might not have enough credit on their device.
• The importance of building trust and the life-changing impact of engaging with a healthcare professional that listens and believes you.
• The impact of using clear and simple vocabulary when explaining a diagnosis or procedure, particularly if a patient speaks English as an additional language.
• The constant worry associated with a low income.

We are weaving these insights throughout our curriculum materials. For example, in a case-based session on inclusion health, our Phase 1c (year 3) students listen to audio clips of people discussing their lived experiences of homelessness, and these prompt exploration about how to take a person- centred, trauma-informed approach. Similarly, in our Promoting Health Equity module, Phase 1c students reflect on lived experience excerpts to develop a better appreciation of the impact of wider determinants of health, and on what could make the most difference, including the role of advocacy. Student feedback has been overwhelmingly positive, with many students citing how impactful it has been for them to hear from people with lived experience, including their insights and advice, and that the audio clips made the topic feel more real. We would like to extend a huge thank you to the Expert Focus team for their involvement.

We know that our students hugely value the opportunities they receive on their primary care placements to build on this learning, through meeting and consulting with diverse patients and working with community organisations as part of their project work. Thank you so much to all our GP tutors and practices for facilitating this vital and impactful experiential learning.

If you have any questions about the collaboration or curriculum materials, please contact Steph Powell, Community Collaboration Lead: stephanie.powell@imperial.ac.uk

Read Lived experience insights in the primary care curriculum in full

by Dr Agalya Ramanathan and Dr Sian Powell

It is known that medical students may experience discrimination in clinical placements and the BMA and GMC have called for universities to provide training for clinical teachers to create more inclusive learning environments. In a recent survey, we asked our community GP Teachers for their perspectives on what training would help them to best support our students if they experience discrimination. Many of our GP Teachers reported feeling unsure how to advise students to report discrimination or access further support. To address this, we developed contextualised training materials in partnership with a community GP tutor and students with lived experience. 

We have created a short video for GP tutors which includes tips on creating an inclusive learning environment and supporting students experiencing discrimination, and information about the faculty’s reporting and support systems. If you have not already seen the video, you can access it here. We are grateful to Dr Saad, a GP tutor, and to medical student Thivyaa Gangatharan for contributing their insights in the video.  

We have also held two interactive workshops. The first was in person at our Annual Teachers’ Conference in June and was well received. Our online ASTIC (Advanced Skills for Teachers at Imperial College) workshop in October offered space and time for authentic facilitated case-based discussions in a safe environment where participants could reflect on ways to support students experiencing different forms of discrimination and where to signpost them to for additional support. 

We will run this workshop again in 2024 and welcome as many of you to attend as possible so that we can continue discussions on how best to create inclusive clinical learning environments for our students. We know all of you will have different perspectives that we can all learn from, and we look forward to seeing you at future workshops.  

Read Supporting students experiencing discrimination during GP placements in full

Dr Georgina Neve has taken over from Dr Renee Ewe as Year 3 Medicine In the Community Apprenticeship (MICA) placement lead whilst Renee is on maternity leave.  Georgina was an Academic Clinical Fellow in the department between 2018 and 2020 and completed her GP training locally on the Riverside Vocational Training Scheme.  Now post CCT, Georgina is very pleased to be returning to the team at the Department of Primary Care and to be taking on this role.  Georgina has previous experience as a tutor group lead on the MICA course and is excited by recent developments and innovations in the course, including the strengthened focus on community collaboration and the new central teaching opportunities.  

 Georgina is passionate about medical education and has a Masters in Medical Education as well as a breadth of experience teaching across the MBBS course, both within the primary care teaching faculty andin her clinical role.  Georgina has a special interest in Digital Health and has published on this topic, as well as a wider interest in Medical Leadership having completed the National Medical Directors Clinical Fellow Scheme at NHS England.  Georgina is looking forward to this new challenge and to supporting students to realise their potential in pursuing a career in primary care.  She is committed to empowering students to make a difference to both patients and their local communities.

Georgina is looking forward to getting to know all the MICA GP tutors and working with them over the coming year.   Georgina will be in touch with the tutors before the beginning of next term with updates and key course dates.  In the meantime, she can be reached via email on georgina.neve14@ic.ac.uk if you need to get in touch.

Read Year 3 Medicine In the Community Apprenticeship (MICA) placement lead in full

by Dr Sian Powell

Students on their Year 6 General Practice Senior Assistantship (GPSA) placements are required to complete a quality improvement project (QIP) during their 4-week placement. By conducting a QIP we hope that the student will engage with the local patient community to make a sustainable difference.  

Here is a recent example of a QIP that one of our Year 6 students, Alexandra Cardosa-Pinto, completed whilst on placement at The James O’Riordan Medical Centre with Dr Baskaran. 

Here, Dr Baskaran first tells us about their experience of supervising the setting up of a new clinic at the practice as part of Alex’s QIP. Alex then shares her reflections on this experience and what she gained.  

Dr Lavan Baskaran, GP Senior Partner, James O’Riordan Medical Centre, Sutton and Addington Medical Practice, Croydon

The James O’Riordan Medical Centre, was started in 1938. We’ve had a long tradition of teaching students and had the opportunity to support students from all five medical schools in London. Over the last few years, when it came to student projects, we’ve tried to avoid the usual audit on vitamin D or ECGs for those on Citalopram. This has shown both little impact for us as a practice, but also for the student.  

We have been fortunate to have had very keen, inspiring students, who have taken on projects like Transgender clinics in Primary Care, ADHD stable follow up clinics (resulting in a prize at UCL) and more recently, a Chronic Kidney Disease-Diabetes Holistic clinic, designed and set up by Alexandra Cardosa-Pinto, a student from Imperial College. Initially, the assumption was this would be a very “medical” clinic, tackling proteinuria, hypertension and use of ACE-inhibitors and SGLT-2 inhibitors. However, a more rounded approach was taken, through Alexandra’s skill in health coaching, as well as genuine care and empathy and a desire to make a long term difference and leave a legacy effect. 

It was a success! Patients were extremely grateful, telling us that her approach had given them the impetus to change their lifestyle, and others saying the traditional DESMOND diabetes teaching had not been inspiring, but that Alexandra, in one session, had been able to have them think differently. She had adapted her consultation to focus on their mental health, appreciating that this was barrier that did not allow for change, and addressing and supporting this would see the difference these patients needed. It was heartwarming to jointly consult the last patient, in her clinic, who offered her a hug for all the care and time she had given, and indicated she was very special for giving her time and effort for this. 

Learning on aspects of both diabetes and chronic kidney disease were gained, as well as an appreciation for general practice, and the part it plays in chronic disease management in the community. Moving from what is good to eat and drink in kidney disease, to whether a lack of employment may be contributing to stress and therefore health was all included in the assessment. 

As a practice, we have certainly learnt that chronic disease clinics, with a holistic angle can not only help our practices gain great feedback from patients, add a tick for CQC, but actually lead to a great project experience for medical students. The pride and energy that develops from allowing the student to develop the clinic on their own, with our oversight and then seeing the final creation with results, is fulfilling for patient, student and ourselves as teachers. It allows for other members of the practice to be included, such as social prescribers, mental health counsellors, paramedics and physician associates of the practice, and thereby leads to the imprinting of a clinic, that can be continued by the next student or adapted to support another chronic disease.

I have been teaching for a decade, and although students have always been a joy to teach, there was some lack of fulfilment from students walking away without a proud project. One of the very few rays of light to come from the pandemic was to allow some time to reflect on the student experience with us at the practice and being inspired to change project work to include a genuine interesting topic for the student whilst mobilising a new clinic in a short space of time. 

Alexandra Cardoso Pinto, Year 6 Imperial College Medical Student:

I had an amazing time during GPSA; I genuinely felt part of a team (that was so welcoming to me) and felt like I was able to make a (even if only small) difference to patients.   

 Throughout the 4-weeks I was given the opportunity to consult patients independently and later set up my own clinic for patients with multiple comorbidities, where I not only performed physical health and medication reviews, but also had the chance to practice coaching skills to support lifestyle changes. I remember feeling incredibly out of depth in my very first consultation, but by the end, I found myself surprised at how natural those conversations became. These patients and our consultations were tremendously impactful in helping me see myself not just as a final year medical student, but as a (hopefully) soon-to-been junior doctor.   

 My time in GPSA also emphasised the value of working within a welcoming, diverse, multidisciplinary team. Alongside developing my clinical skills, I practiced communicating with different team members and gained better understanding of how different professionals have a unique (but each vital) role to play in a patient’s healthcare journey. From a more personal perspective, I also found that working within a friendly, supportive team makes a world of difference to overall happiness and motivation!   

 Finally, GPSA also highlighted the importance of having supervisors who I can ask for advice from and share my concerns with, who are ready to support my management plans – or constructively challenge them – and who enable me to practice holistic patient care.    

 I am grateful to everyone at the James O’Riordan Medical Centre for welcoming into their team and providing me with learning opportunities that I will carry forward throughout my career.  

Read Quality Improvement Projects in GPSA – a GP Tutor and Year 6 student share their experience in full

by Stephanie Powell

This academic year we have expanded our community connections and made progress in weaving their valuable insight through everything we do. We also collaborate directly with community organisations and have highlighted examples below. We would like to extend a huge thank you to all community organisations, GP supervisors and practice team members that support this work, and we hope that it has continued to create new opportunities and insights for you.  

Community organisations presented to second year students undertaking their Community Collaboration Projects, about how their organisations positively impact health and the opportunities that collaborations with medical students and GP practices offer. Speakers were from Dalgarno Trust, a community centre whose countless initiatives support the health and wellbeing of residents in North Kensington, and QPR in the Community Trust whose programmes are supporting residents to flourish in White City.  

The BME Health Forum, whose work provides space for marginalised groups to voice their healthcare priorities and feed this back to healthcare providers, co-created curricular materials to support third year students to consider effective collaboration and co-creation during their Community Action Project in MICA. 

Third year students who undertook an optional short course in Promoting Health Equity visited local groups to understand how their activity impacts health equity. They toured almshouses and had coffee with residents at Hammersmith United Charities, joined an adult English language class to discuss what matters to the health of attendees at Urban Partnership Group and spoke to volunteers and attendees of the food bank at Dalgarno Trust. 

There have also been countless examples of community collaboration during student projects during their GP practice placements. During the Annual Teachers Conference, GP tutors and community organisations shared the opportunities that community-engaged student projects provide. Attendees mentioned they are an opportunity to: forge new connections with community organisations, to understand and address local health priorities that might not be visible from the practice alone, and enhance local trust towards the practice. 

If you have any feedback, suggestions or questions please contact Community Collaboration Lead Steph: stephanie.powell@imperial.ac.uk  

Read Community spotlight  in full