GP Teaching

The brand new PCH (Patients, Communities and Healthcare) boat officially set sail from the harbour with a tutor introduction evening on 7th October. Representatives from over half of the GP PCH tutors’ practices attended to give their thoughts on this exciting new course for our first year students, and we worked together to explore how to make PCH work for everyone (patients, practices, students and faculty). We are delighted that the course launch has been received so positively by both practices and our new first year students.

To those unfamiliar with PCH, The PCH module runs across years 1 and 2 of the medical school curriculum. Its aim is to integrate the biological, psychological and social aspects of health, illness and disease, and explore how these impact on patient experiences and on health outcomes.

The start of the course involves a couple of interactive lectures to orientate the student to sociological concepts, hearing from a patient sharing their experience of health/illness, exploration of the NHS structure and logistics of the course. The students then visit their allocated GP practices on eight Thursdays spaced from November till March. During these days, the students will:
• visit patients in their own home (who are invited on criteria including whether the practice feels the patient would benefit from these visits)
• conduct a survey project of local patients exploring healthcare satisfaction or perception of health
• practice starting real consultations with patients during GP clinics
• discuss and reflect on their experiences in small group tutorials
They are assessed through a range of workplace based assessments and through the survey project.

PCH has been designed to serve the needs of the whole community, including patients, practices, students and faculty. Its development has been informed by feedback from GP tutors, students and patient representatives. We look forward to updating you with how it progresses. Many thanks to the whole PCPH team for their help with this, including Sonia, Arti, Michael, Jenna and Nadine, and a special thanks to Dr Libby Pearson for her input.

Read Launch of the New Patient, Communities and Healthcare Course in full

The Imperial College student GP Society were awarded the ‘most improved GP society’ award at the annual RCGP Inspire awards 2019.

Additionally the Undergraduate Primary Care Education team were shortlisted for the ‘Outstanding Teaching in General Practice’ award in recognition of the team being one of the UK-leading sites in the development of longitudinal placements, both in GP and integrating primary and secondary care. The team focuses on the delivery and expansion of undergraduate primary care community teaching, harnessing the skills of GP teaching fellows within the team to design and develop innovative new community teaching placements which have impacted positively on the student experience.

These awards celebrate the invaluable contribution of RCGP members and the difference they make to better general practice.

The awards ceremony was held in Liverpool at the iconic Anfield football stadium, and was attended by Dr Nina Dutta, Ms Nadine Engineer and Mr Steve Platt.

Read Royal College of GPs ‘Inspire’ awards in full

The MEdIC team (Medical Education Innovation & Research Centre), part of the PCPH Undergraduate Primary Care Education team, attended the 2019 AMEE (International Association for Medical Education) conference in Austria, Vienna.

AMEE 2019 was a fascinating conference exploring a whole host of topical issues in medical education, including threshold concepts, the conceptual framing of educational research, diversity and inclusion in medical education, clinical reasoning and simulation amongst a whole host of other areas. Our MEdIC team were able to showcase a variety of our educational research projects carried out in the past year. Dr Andy McKeown presented his prize-winning M(Ed) thesis looking at the role of educational authenticity in medical students’ experiences in longitudinal placements. Dr Ravi Parekh & Dr Andy McKeown presented their research on how medical students’ professional attributes are affected through clinical placements. Dr Arti Maini presented the work she has led (with Dr Molly Fyfe and Dr Sonia Kumar), describing their research findings of the broad impact of training medical students in health coaching. In front of an esteemed audience of medical educators, Dr Jo Horsburgh described her PhD thesis exploring the identity of medical educators.

Aside from fascinating conference sessions, talks, plenaries and workshops, we were able to network with colleagues from USA, Australia and Europe to discuss the development of future educational research & innovation collaborations. Watch this space!

Read MEdIC Team at the International Association of Medical Education Conference 2019, Vienna in full

Dr Pearson is one of our longstanding tutors and has been teaching students for us for over 15 years. She teaches on a number of courses and over the years she has consistently received fantastic feedback from students. This year she won an award for her Outstanding Contribution to Teaching at our Annual Teachers Conference.

How long have you been teaching and what inspired you start teaching originally? I started teaching soon after joining The Fulham Medical Centre in 2004 and have increased my teaching commitment over the years. I spent hours at medical school hanging around being ignored and the one attachment where I felt included was my GP attachment. My GP in year 5 inspired me so much as he had a positive attitude to his job, his patients loved him and he was making a real difference. I wanted to do the same and make the students see general practice as an amazing and privileged job, which is so much more interesting than hospital work as we are almost the last generalists in the NHS.

Tell us about the practice you work in and your role in the practice. I am a partner in my practice and it really helps having a supportive team. I am the most enthusiastic but they all help and any staff joining our team know it’s a vital part of our work, so will be part of the their day to day practice too.

Since you have been teaching for us you have maintained a consistently high standard of feedback – what tips do you have for teaching? My biggest tip for anyone considering teaching is to think of the benefits for yourself, for surgery, your patients and your students. Everyone benefits from Undergraduate teaching. Imperial students are very intelligent and ask really probing questions, so keep me on my toes. When asked a question I don’t know the answer to I ask them to research the answer and let me know! I have a catch-up during my surgery so can run a little slower which the patients appreciate. They love having their problems discussed between us all so they understand the plan we come up with. You must have the support of your front desk to warn patients that you have students, so it saves you time explaining who is with you and why.

How do you balance teaching on top of clinical pressures faced in primary care? The catch-up slot I have helps, but I pre-book my clinic with long term patients for the first half and then quicker ‘on the day appointments’ for the latter part. This means I am running on time for the pre-booked patients and the emergencies are generally happier to wait if I am running late and give often quite simple problems with focused histories. A good balance, I feel. The students are so clever and enthusiastic; keen to help with audits, chronic disease management etc. that it helps the practice too.

Tell us about a moment that particularly stands out as a highlight from your time teaching Imperial Undergraduate Medical Students.
The two most memorable moments of teaching students are very different situations. The first was doing a home visit with a year 5 student, arriving at an elderly ladies flat to find her having a cardiac arrest. It’s a rare occurrence (thankfully!) for us GPs, so I felt very stressed and worried having to quickly flick into emergency mode. My year 5 student had never experienced anything like it, but was great at dialling 999, speaking to the operator and asking for the ambulance, then assisting me with CPR. I was so thankful to have her with me. It made me realise how important our CPR training was and how grateful I was to have someone so competent with me. The second case involved one of my war veteran patients. The practice is in the Sir Oswald Stoll Foundation and we care for lots on veterans. One of our 90+ year old gentlemen had been on the beaches in northern France during the D-Day landings and so had the student’s great grandfather. Sadly his great grandfather had died in France and the student sat and chatted to the patient for a long time about his experience. He then described how enormously privileged he felt having met a man who lived through what his great grandfather had been through and it helped him realise what a sacrifice he had given.  It was a very emotional experience for both patient and student, and for me too. The student still emails me now about his progress up through the ranks to be a consultant and mentions how this meeting has been such an important experience in his life.

When you’re not teaching students or working in the practice, how do you like to spend your free time?
I work full time so I don’t have a lot of spare time, but I love travelling. I have three kids (12, 10 and 7 years old) and we go to South Africa at least once a year on safari, or to go on a new adventure to Zimbabwe, to see Victoria Falls, or Mozambique to relax on their glorious beaches. It’s always such an exciting trip and so different from our lives in London which is why we all enjoy it so much.

Read Interview with Dr Libby Pearson in full

by Dr Gautham Benoy

So, I’ve just finished medical school, got my results and passed exams. Now what? I’m a doctor supposedly? These are my last few weeks in Imperial now! I start my FY1 in Sheffield so it’s not just bye bye Imperial, It’s bye bye London! But before I leave, I had one last act to finish; my elective. Ever since participating in the ICA (the Integrated Clinical Apprenticeship) at Imperial College, I’ve started to develop a fond interest in medical education and Primary Care. Partly to blame for this are 2 of my most inspiring role models, Dr Ravi Parekh and Dr Andy McKeown who ran the ICA course which had been the best learning experience I’ve had at Imperial College. Since I’d become quite acquainted with the Department of Primary Care through my participation in the ICA and I had really enjoyed my specialty choice placement in medical education, I decided to do 3 weeks of my elective with the department. I’m also starting my foundation job as an Academic Foundation Doctor in medical education and hope to incorporate medical education into my career; I thought a short glimpse into the future might be useful for me.

Week 1

So, I’m in the middle of packing all my things and moving out of my London accommodation. My contract expires in a week and I’ve also got an AirBnB booked for 2 weeks to complete my elective. Things are quite hectic with packing and tenancy related paperwork e.t.c. But I look forward to starting my elective. I’m getting to work with my favorite department and I’ve still got 2 of my fellow Imperial students and good friends Ann and Seraphina who are still around doing their medical education elective with me.

In our first week, we got to meet Ravi in day 1 who gave us a rundown of what we might expect for the next few weeks. He shows us a big excel spreadsheet with all the activities we would be doing, from teaching, mock-PACES, working on e-modules, the F-Zero Course and other projects going on in the department. We’ve got a lot to do and so little time! So we rush off, sending emails to our supervisors for the projects we’re working on arranging meetings, reminders and decorating my calendar with dates, locations and times. We take the first few days relaxed, just getting to know everyone and doing some of the background reading for our projects and planning, lots and lots of planning and timetabling. While also taking time to register where one can acquire free tea and biscuits.

Worst of all, there was a slight miscalculation, next week was Easter! Meaning I’d have to get some initial work done ASAP and get all the information I need to make sure I know what I’m doing next week. Thankfully, I managed to plan my next few weeks with just enough time to spare.

Most of my work involved designing content for e-learning modules with Dr Ali Dhankot, Dr Sian Powell regarding clinical reasoning and also for the lifestyle and prevention module with Dr Ed Maine. I also got to work with the F-Zero team including Ravi, Andy and Neha to help design in-course assessments. I would also be working with the other students to design a mock PACES and clinical communications stations for the current ICA cohort.

Week 2

This is where all the work gets crammed in. Lots of tea and coffee was drunk, lots of hours typing and lots of jumping up and down on the exercise ball in the office to get the blood pumping.

Even though it was Easter, I still had the company of Ann, Seraphina and also Dr Bhakti Visani and Dr Neha Ahuja who we

re so helpful during the elective. They had their own work to do but both took on the responsibility of baby-sitting us, providing us with much needed guidance whenever we got stuck.

I managed to do more reading into the literature around the content I was creating for the e-modules and the F-Zero assessments. I also made a start on the cases for the ICA students by interviewing some of the current Year 5 Specialty Choice Placement students on what cases they thought would be helpful for their year group. After going through all my specialties knowledge and thinking hard about the cases, I managed to come up with some cases designed to challenge the 5^th years and hopefully improve their preparation for specialties. We also spent a lot of time planning and arranging the mock, considering things like rooms, timings and how it’ll be supervised. This was a really good independent project for us since we were arranging an event ourselves.

I also had the chance to run my own mini-PACES while being assessed by Dr Georgina Neve. When I arrived at the room I was teaching in, it was printed “Dr Gautham Benoy”, now that definitely hit me. I have responsibilities now! I started to worry if the students would actually trust me to be a tutor despite being a student a few weeks ago. I wanted to make sure my students would benefit from the session, so I reflected on teaching I’d already done through the student union and how GP tutors ran mini-PACES sessions. I incorporated all the knowledge and teaching I’ve had on medical education to deliver mini-PACES session which was really immersive for me as a tutor. I felt like I had been given that responsibility as an educator and I really managed to reflect and learn from this experience where I was given full control over the tutorial.

Week 3

Everyone’s back from Easter! Now I’ve got to show my supervisors all the work I’d done. But I still had a lot to do before my meetings spread throughout the week. I crammed a lot of work in, writing content for the e-modules and finishing the assessment forms for F-Zero while simultaneously having multiple meetings and catching up with everyone. I got a feel for what it really is like working in the department and chasing deadlines. It was hard work, but it was definitely enjoyable and useful to experience.

I’d managed it all in the end and with all my tasks complete I had my final debriefs with everyone. It turned out a lot better than I expected. Having rushed some tasks and always questioning whether what I produced was good enough, all my supervisors found my work really helpful and I felt like I had genuinely contributed to the improvement of the medical school. I was happy with what I had done and the whole experience, I felt fulfilled by the end of the week and also went on a lunch social with the department in my last week which was really good fun.

With my elective over, I’m really going to miss Imperial College. I’d learnt so much over the elective and I’m so glad to have been involved. It had driven me even more to pursue my career in General Practice and medical education. I met some amazing, inspirational people and the department was really friendly. I’d definitely hope to take all I’ve learnt forward in my career, but I’d also love to keep in touch with the department even into the distant future since this is where my career began.

Read My last act at Imperial: Medical Education Elective in full

by Dr Ben Stone

“Look mister, there are some rules that you’ve got to follow”

“Yeah, what kind of rules?”

“First of all, keep him out of the light, he hates bright light…Second, don’t give him any water, not even to drink…But the most important rule…never feed him after midnight.”

You’re probably wondering one of two things at this stage, depending on your knowledge of 1980s pop-culture:

1. What on earth is this blog about?
2. Why is this blog referencing Joe Dante’s 1984 comedy-horror cult film: Gremlins?

Prior to a recent teaching session, I was discussing with a colleague about how we felt the session may go: “I suppose you have always got to be prepared for the gremlins” I said, and we chuckled. We repeated the same phrase a few days later, realising that our wireless clicker had inexplicably reversed left and right. I can’t count the various mishaps that occurred in sessions I have witnessed: computers failing, tutors disappearing, printers misprinting, and the list goes on. Our instinctual cognitive reaction to all these events probably protects us from curling up into sobbing balls of human anxiety:

“That will never happen to me!”

I recently wrote another blog “From taught to teacher: the dark side of the moon” in which I introduced myself as a Foundation Year 2 trainee, preparing a teaching session on Prescribing Safety. Like we should with all sessions, see this blog as the debrief; an epilogue to the prologue. As you may have anticipated already, it did not all go to plan.

As Edward Jenner and Randall Peltzer, of smallpox and Gremlins fame respectively, both teach us: prevention is key. On the day of my session delivery I had prepped my facilitators, adjusted my clinical hours and organised my printing materials into one electronic folder. However, I had not prepared for the actions of those photophobic, hydrophilic and nocturnal hyperphagic beings. No, not the students.

The first mishap occurred 25 minutes before the start of the session; a facilitator emailed in unwell. A vital component to my session was to have facilitators for each group to answer questions and, well, facilitate. I am fortunate to have colleagues willing to step in at the last minute, but this meant the countdown to showtime was spent trying to condense two hours of material into a 20-minute rundown. The Gremlin of others.

The second occurred 25 minutes into the start of the session. “Is this everybody for today?” A familiar question for regular teachers. The need to appropriately introduce students to a session vs having enough time to deliver your material. The devilish realisation that you wasted the 20 minutes you spent prepping the extra facilitator that is no longer needed. The Gremlin of time.

The third occurred shortly after that. A face at the door.

“Knock-knock”

“Who’s there?”

“Sorry, I’ve actually booked this room”

“’Sorry, I’ve actually booked this room,’ who?”

Like a punchline delivered by an overexuberant parent at a teenage house party, it had me in tears. The room, seemingly booked on an eternal rolling reservation, had been available on the booking system and utilised for other means. Whilst we could fortunately share the room space, I no longer had use of the computer. The Gremlin of technology, the Gremlin of misfortune and the Gremlin of “…” all at once.

Gizmo is the name of the original mogwai gifted to the protagonist in ‘Gremlins’, whom, despite the actions of his kin, never becomes mischievous or ultimately murderous. It would have been very easy for this string of mishaps to derail the session completely, like the mogwai upon Kingston Falls, but that never happened. It was at this stage I appreciated the journey here, to the dark side of the moon. It wasn’t perfect, but the materials and content I had prepared could be utilised by the students. It was adaptable. I learnt that even when it looks like everything is going wrong, there will still be something right: not every Gizmo becomes a Gremlin.

In the final moments of Dante’s film, Randall gives the following advice:

“If your air conditioner goes on the fritz, or your washing machine blows up, or your video recorder conks out, before you call the repairman, turn on all the lights, check all the closets and cupboards, look under all the beds, ‘cause you can never tell. There just might be a gremlin in your house”

It is many months since I first made that prescribing error. I have learnt about educational theory. I have learnt about human error. I have learnt that teaching is not just about turning up on the day, with your colleague’s slides and hoping to “wing it”. I have even learnt about fictional villains from 80s cult films. But most importantly, I have learnt that there is always more to learn in the educational sphere. So, in true reflective fashion, what are my three things to take away from this day?

Be prepared. Be adaptable. But most importantly:

Don’t let Gizmos become Gremlins.

Read Gizmos and Gremlins: when things don’t go as planned in full

Medical Education Fellow Dr Neha Ahuja speaks to Co-course Lead Dr Ravi Parekh about the new F-Zero course

Calling all GP Practices referring to Northwick Park Hospital…

Are you an energised, enthusiastic practice referring patients to Northwick Park Hospital?

Do you want to become involved teaching final year medical students from Imperial?

If you are, you may be a perfect GP Practice to host our F-Zero students!

What is your commitment?

• You will host pairs (up to 3 pairs) of final year medical students
• The students will act as true apprentices, running independent clinics for 1 day a week over 30 weeks, able to see all patients and take an active part in the GP Practice activities.
• You will provide a half a day tutorial weekly (which includes pastoral supervision for the students)

What is the benefit for you?

• Generously financially reimbursed for your time (details being finalised)
• The students are also working in Northwick Park Hospital and will have additional medical and surgical consultant supervisors. This allows for a true opportunity for bridges between primary and secondary care.
• Final year students who are highly skilled and able to aid with service delivery.
• Develop a true mentoring relationship with these students.
• Professional development for you as a tutor to develop educational skills

Each pair of student allocated 3 supervisors across Year 6:

• General Practitioner:  Clinical & Educational supervision
• 2 x Hospital Consultant:  Clinical supervision

Proposed individual student timetable (each student’s timetable will vary)

Read An introduction to the new F-Zero course in full

As you may already be aware, the MBBS curriculum is currently undergoing a review which involves all years and, excitingly, has an increased focus on teaching in General Practice. The new curriculum will start to roll out from MBBS year 1 in September 2019 (phasing in over the next 6 years) but there are also few changes which are happening in the later clinical years ahead of the process, giving us more opportunity to demonstrate to our students why General Practice is such an amazing teaching environment and such a rich and varied career. Below are some of the opportunities for the community, beginning this coming academic year.

Patients, Communities and Healthcare (Year 1) November 2019

PCH is a new, community-based early years course to the Imperial MBBS (replacing FCA).Students will spend 8 Thursdays in a GP Practice over the course of year 1 with a further 8 days in the second year.  Mornings will be spent with students visiting patients in their homes or sitting in GP clinics, with the afternoon back at the Practice for a patient de-brief, followed by a tutorial. There is an opportunity now to sign up to year 1 of the course by contacting n.engineer@imperial.ac.uk

F-Zero (Year 6) July 2019

F-Zero is an innovative new course based on the international model of “longitudinal learning” and leads on from our highly successful ICA placement in year 5. F-Zero students will be based in GP, Medicine & Surgery with allocated supervisors in each through the academic year (July to February), taking a meaningful and authentic role in the care of patients across their primary and secondary teams. This coming July 2019, 30 students have self-selected to take part in the course, replacing their traditional Year 6. They will be based at Northwick Park Hospital and a surrounding GP practice that refers into Northwick. There is an opportunity now to sign up to this F-zero course by contacting n.engineer@imperial.ac.uk

GPSA (Year 6) July 2019

From July 2019 the ever popular out of London GPSA course will be extended to 4 weeks, recognising the importance of General Practice teaching and learning prior to finals. There is an opportunity now to sign up to this by contacting n.engineer@imperial.ac.uk

ENT & Ophthalmology (Year 6)

From July 2019, ENT and Ophthalmology teaching will be delivered in a more integrated way. Rather than discrete blocks, both disciplines will be taught through other relevant specialities. Students, especially those in Year 6, may need additional signposting to practise their ENT and Ophthalmology skills so please be mindful of any learning opportunities that arise in your practice.

Other Changes July 2019 (Years 5/6)

Other broader changes outside of General Practice include musculoskeletal medicine moving from year 5 to year 6 and, in exchange, the Specialty Choice Placement will move from year 6 to year 5 and will be increased to 4 weeks. Renal medicine will now be delivered within the 4 week Senior Medicine placement in Year 6 and lastly Emergency Medicine will be extended to 4 weeks in Year 6.

There is no doubt that General Practice being front and centre in the above changes to the curriculum is down to your hard work teaching our students to such a high level. For this, we continue to be grateful and look forward to taking these exciting opportunities together. We will stay in touch as other changes roll out in the forthcoming years and if you have any questions on the above on how this may affect your teaching in the practice or getting involved in any of the new courses, please do contact n.engineer@imperial.ac.uk our Faculty Development Manager.

Read Curriculum Review news in full

The 2nd UK Longitudinal Integrated Clerkship Think Tank was held at Imperial on Thursday 7 February. Representatives of 15 different medical schools from across the United Kingdom attended the day to share knowledge, experience and advice in running longitudinal attachments for their students.

We saw showcases from institutions across the UK including Cardiff University, King’s College London, Hull York Medical School, Sheffield University and Dundee University, with representatives presenting their LIC models alongside their students.

A student discussion panel followed before the group broke out into small group discussions on topics such as The role of social accountability in LICs, The dark side of service learning and Continuity and belonging.

The next meeting of the think tank is due to take place at Cardiff University in 2020.

Read UKLIC in full