I’m in the very privileged position of having a small amount of influence in the delivery of general practice training in my part of the world. I’ve been involved in a number of thought-provoking discussions recently about what is essential education for trainees on their pathway to independent practice.
I’m interested to find out from other recent graduates what they think were the most important and valuable things that they learnt during their training. Also, with the benefit of hindsight, is there any additional education that they think should have been included?
What better way than to put my questions out to the internet to get some crowd-sourced feedback?
This is a shout-out to all current trainees, recent graduates, educators, supervisors, and also those with a few more years under their belt. Please, share your thoughts! Input from both GP and other medical specialties is very much welcomed.
Here’s my take:
When I was a trainee I’m sure I would have said that what I really needed to be taught was how to manage hypertension, diagnose depression, work-up a patient with headaches and assess a febrile child. I wanted to quickly gain the clinical knowledge to be able to (a) pass my exams and (b) be a safe and effective GP.
There is no doubt that an important part of training is gaining the specific clinical knowledge and skills. However, the problem with focusing too much on knowledge is the risk that you graduate with a snapshot of the current way of practicing and get stuck there for the remainder of your career. We all know that medical knowledge is turning over at an alarming rate and one of our biggest challenges is maintaining a quality, up-to-date, evidence based practice while navigating the ever changing bureaucratic requirements.
I’ve now come around to thinking that the skills I really need are (and this is by no means a comprehensive list):
- A practical approach to keeping my practice up to date
- Ways to filter the overwhelming volume of new information
- Interpretation of the quality of that information (ie, critical appraisal / evidence based medicine)
- How to efficiently find answers to clinical questions as they arise
- How to coordinate the health care team, identify and manage the resources available for my patients
- How to be an advocate for my profession and my patients in the complex medico-political system
- How to be an effective clinical teacher so I can pass my knowledge on to up-and-coming doctors and students
- And, in the context of private Australian GP, some business and management skills might have also been handy
Some of the concepts I’ve seen recently about the cognitive processes of doctoring (like this one and this one) are also really important, and generally not touched on much in our formal medical training.
But this is all just my opinion and very much biased towards my own experience and interests.
Over to you, people of the internet! What are the most important things that we need to teach registrars during their training? And has your view changed over time?