Learning Medicine in the Community in Third Year
Getting the most from Community Clinical Placements
Dr. Philip Burns
Philippa Lindsay
Dr. Mark Perry
Dr. Sarah Smithson
Professor Val Wass
Dr. Kurt Wilson
www.manchester.ac.uk/CBME
Why Learn in the Community?
o90% of care takes place in the community
oLess patient time in hospital
o Inpatients are more illoChronic diseaseoFewer hospitalsoTomorrows Drs – GMC
Why Learn in the Community?o Approx 20% of Manchester
clinical curriculumo Boundaries between primary
and secondary care are becoming blurred – hence health education zones (HEZ)
o Intermediate care, changing professional boundaries
o 50% of you will become GP’s
Do GPs see much serious illness?
Yes or No
Do GPs see serious illness? In a typical yearo 10 myocardial infarctionso 5 strokeso 2 new lung cancerso 1 new breast cancer o 1 new prostate cancero 20 deaths (1 suicide every 4
years)
What are you here for?o Not just to pass exams!o To become a competent F1
doctoro To become equipped for
lifelong learningo To become (or remain) a
competent communicatoro Vocational courseo One curriculum
Why is the community different?
o Patients…as individuals o …familieso …communitieso Time. Continuityo Complexityo Uncertaintyo Variety o Populations
Opportunities? Top Ten Tips
Opportunities? Top Ten Tips
o Turn up!
Opportunities? Top Ten Tips
o Turn up!o Patients: ‘pick-your-own’,
do searches
Opportunities? Top Ten Tips
o Turn up!o Patients: ‘pick-u-own’ -
searcheso Check consent
/confidentiality
Opportunities? Top Ten Tips
o Turn up!o Patients: ‘pick-u-own’ -
searcheso Check consent /confidentialityo Use the whole team
Opportunities? Top Ten Tips
o Turn up!o Patients: ‘pick-u-own’ -
searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the
lines
Opportunities? Top Ten Tips
o Turn up!o Patients: ‘pick-u-own’ -
searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the
lineso Ask questions – challenge!
Opportunities? Top Ten Tips
o Turn up!o Patients: ‘pick-u-own’ - searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the lineso Ask questions – challenge!o Find out how the practice
learns
Opportunities? Top Ten Tips
o Turn up!o Patients: ‘pick-u-own’ - searcheso Check consent /confidentialityo Use the whole teamo Be flexible: step outside the lineso Ask questions – challenge!o Find out how the practice learnso Write things down – use your
notes
Opportunities? Top Ten Tips
o Do stuff !
Opportunities? Top Ten Tips
o Do stuff !o Do one
Opportunities? Top Ten Tips
o Do stuff !o Do oneo Do another…Ask for
feedback
Opportunities? Top Ten Tips
o Do stuff !o Do oneo Do another…Ask for feedbacko Do another
Opportunities? Top Ten Tips
o Do stuff !o Do oneo Do another…Ask for feedbacko Do anothero Do another…GET IT WRONG
Opportunities? Top Ten Tips
o Do stuff !o Do oneo Do another…Ask for feedbacko Do anothero Do another…GET IT WRONGo LEARN FROM IT
Opportunities? Top Ten Tips
o Do stuff !o Do oneo Do another…Ask for feedbacko Do another…GET IT WRONGo LEARN FROM ITo Tell your GP what you need –
learning objectives from PBL! – what sort of patient will you need next week?
o Any Problems: ask for help early!
GP tutor / hospital dean
Finally… assessment headaches!
o Does your tutor know YOU want honours?
o Demonstrating excellence: initiative, organisation +
feedback
Community SSCs
Explore new horizons…but plan early!
Send in a proposal!Sportseliteexercise Rxschoolscampaigns
Everything else!OccupationalHealth Law, CharityBusiness
Culturedrama,voice,writing,media
galleries,music,dance,film
.
Disabilities rights, groups, university,deaf/visual impairment,learning dis. OT/mental health
Some other opportunities!
Charity...hospices, Age Concern, Rape Crisis Cancer Research,
Occupational Health...benefits agency, fitness for work
Law...prison health, forensics, probation, rehab, victim support
Community Sign-ups
oOver to Jac
Community Sign-ups
oWhat are they?
oWhy do we need them?
o What areas do they cover?o Podiatryo Dermatologyo Pharmacyo Palliative Careo Diabetic clinicso Ophthalmologyo Out of hours serviceso Homeless Teamo Intermediate Careo Cancer support serviceso Chronic kidney disease teamso Nutritional Therapyo Active livingo Audit Trainingo Suturingo Breast Unito Nursing and Residential Homeso Musculoskeletal Teamo Epilepsy and neurological service
o How do we sign-up?
o Only open to NME students
o Attend 6 placements
o Attend 100% - compulsory
o What do we do when we get there?
o Portfolio cards
o Dress code
o Feedback
o Over to Kurt
Compliments, comments and concerns
o We want to hear your compliments and comments regarding community experience
o Please let the base hospital community administrator teams know
o We want to help you address concerns
o First speak to the team at your practice
o Stuck? Speak to your base administration team and where necessary, the GPEF
We want to hear your thoughts!!
• CBME Complaints/Concerns/Compliments procedure
• MedLea Evaluation • Pop-up reminder • Focuses on all elements of the year
• Only 63% of active practices were given an evaluation report in 2007/08
• Student response rate • 2007/08 was 69% (657 responded out of a
possible 956)• 2008/09 was 23% (220 responded out of a
possible 941)• Remember: put your practice and GP
tutor name on the community part.
Contact us
www.manchester.ac.uk/CBME