Educational Solutions for Workforce Development North Rural-track training in Scotland The NES North...

Educational Solutions for Workforce Development

North

Rural-track training in Scotland

The NES North of Scotland Deanery

Gillian NeedhamPostgraduate Medical Dean


North

Healthcare education in Scotland

•NHS Education for Scotland – NES

•Design and development

•Commissioning

•Provision

SERVICE

WORKFORCEEDUCATION


NorthPostgraduate Medical Education

•Programme-based

•Early-years: Foundation Programme 2 years

•Training for specialty: Core and Run-through

•Academic-track

•Rural-track

MMC = modernising medical careers


NorthOur geography

•4 Scottish Deaneries


NorthOur geography


•The patch – 5 Health Boards


NorthOur geography


•The patch – 5 Health Boards

•The peripherality


North


North

Foundation Years FYA taster?

•All North of Scotland Deanery Foundation Programmes (134 posts) offer as a minimum 4 months in a remote or rural placement

•Aberdeen-based with a placement in one of our 6 Rural General Hospitals RGHs

Belford and the Ben – Fort William


North

Foundation Years A Highland-based year

•Some offer a year in Inverness and a year in Aberdeen

•Best of both worlds in one programme – a big, bustling University Teaching Hospital AND Inverness’ unique Raigmore Campus with its thriving rural undergraduate programme and the Deanery’s heart for Rural-track Specialty Programmes

•We have 27 FY1 and 21 FY2 placements in Highland each for a year


North

Foundation Years Our Rural- track programme

•Based for 2 years in the Highlands and with placements in up to 3 different remote or rural places

•FY1 in Inverness and FY2 rotational between Lochgilphead, Oban and Fort William – 12 posts

Lorne and the Isles Hospital, Oban


NorthFoundation graduates’ views?

Feedback from Foundation doctors who have spent time training in remote or rural posts between (August 2007 – July 2008)

Western Isles General Hospital, Stornoway


NorthFY trainees’ feedback

0% 20% 40% 60% 80% 100%

Educational value of post (R&R)

Educational value of post (Scot)

Opportunity to develop new skills(R&R)

Opportunity to develop new skills(Scot)

Excellent Good Acceptable Poor


NorthFY trainees’ feedback

0% 20% 40% 60% 80% 100%

Quality of formal teaching (R&R)

Quality of formal teaching (Scot)

Quality of informal teaching (R&R)

Quality of informal teaching (Scot)

Excellent Good Acceptable Poor


North

“I loved this post! The staff were supportive, the working atmosphere was positive and enjoyable. The clinical teaching was informal but excellent and related to the clinical presentations of the patients. There was a good variety of interesting clinical symptoms and signs and plenty opportunity to be actively involved with the patient in addition to routine FY1 tasks. I would definitely Recommend this post to others and would consider coming back here in the future.”

(Fort William)


North

“The post is good experience in clinical decision making, particularly out of hours. Without registrar support, as an FY2, the responsibility placed upon you certainly provides a learning experience. As A&E and the entire hospital is covered out of hours, the range of experience is huge. And the opportunity to be an air ambulance escort. This post is very challenging but very good in making you change very quickly from a student mindset to a doctor’s. It was very enjoyable and I feel I have learned a lot which will be useful in the future.”

(Western Isles)


NorthRural-track specialty options

•Delivering for Remote and Rural Healthcare Scottish Government, 30 Nov 2007

•Rural Training Pathways Group Scottish Royal Colleges, Service & NES

•GMC Standards for training The Training Doctor 2011

•Technology in support


NorthRural-track specialty options

•General Practice

•Anaesthesia

•Physician/Acute Medicine

•General Surgery


NorthRural and Rural-track GP

•2007-2011 Highlands and Islands Programme – 3 & 4 year options including 18 months in a practice setting

•2012 National Rural-Track Programme – 4 years entirely RGH & practice-based

•GP Rural FellowsPost-CCT year long option; competitive allocation


NorthRural Anaesthesia

•1 x Rural Fellowship•Pre/Peri/Post-*CCT options•Managed by the Training Programme Director TPD•Approved by GMC•Adaptable to trainee educational needs AND service needs•**EMRS; critical care; RGH-experience *CCT = certificate of completion of training

**EMRS = emergency medical retrieval service


NorthRural Physician/Acute Medicine

•2 x slots in our Acute Medicine programme•Managed by the TPD•Rural placements approved•Enhanced with Intensive Care Medicine; specialty options; breadth of placement


NorthRural surgery

•2 x Rural Fellowships• Pre/Peri/Post-CCT options•Managed by the TPD•Approved by the GMC•Adaptable to trainee AND service needs•Rural placements & broad specialty experience – obstetric/Trauma &Orthopaedics/head injury/urology etc


North

Outputs from our Rural-track programmes?

•GP – “we still struggle to fill R&R GP posts”

•Anaesthesia – 1st Fellow still in-training•Acute Medicine – 3 Consultants (Shetland, Elgin, Elgin); 2 in-training•Surgery – 2 Consultants (Fort William, Elgin); one > main-stream; one still in-training


North….and technology?•Business-critical aspect

•Effective communication for design & development

•Integral aspect of delivery

•A blended approach to the use: eLearning; VC-enabled groups; VC-enabled WPB events eg. CRPC

VC = Video-conferenceWPB = work place basedCRCP = clinico-radiologico-pathological conference


NorthRural-track training

•Access•Content for context•Support

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