by Dr Haipeng Wang
The transition from GP registrar to full GP fellow marks a transformative journey, where aspirations to become a supervisor are nurtured amidst a landscape of challenges and abundant growth opportunities. This path entails the daunting responsibility of making independent decisions, the fear of missing diagnoses, and the struggle to balance training hours with personal life. Continuous development of communication skills, especially for difficult conversations with patients, is essential. Efficient workload management, timely patient care, and handling administrative duties are ever-present challenges. These experiences have shaped the professional journey, fostering growth and preparing us to guide the next generation of medical professionals. 1
A compelling reason for most supervisors' interest in teaching is the desire to offer guidance that empowers trainees to excel.2 Central to the teaching approach is creating an environment of open dialogue, where trainees feel genuinely supported to navigate challenges and uncertainties freely. The teaching of GP registrars, ensuring patient safety, is paramount. It's crucial not to overlook the registrars' clinical notes; regular auditing of these notes is essential for our mutual growth and the enhancement of our practice. The unique dynamics of teaching within a general practice environment present distinct challenges and opportunities that differ from other educational settings. 3
In a recent discussion between a GP trainee and their supervisor, the scenario highlighted the challenges faced by trainee registrars. The trainee recounted a patient who presented with a multitude of complex issues: mental health concerns, work stress, back pain, and diabetes—all needing attention in a single consultation. Feeling rushed and overwhelmed, the trainee attempted to address each issue hastily, resulting in dissatisfaction for both the patient and the doctor. The supervisor used this scenario to emphasize the importance of prioritizing and managing consultation time effectively, teaching the trainee valuable lessons in patient care and time management.4
The patient-centered care is fundamental, emphasizing the prioritization of patient needs. Attempting to address all concerns in a single session may result in hurried decisions and less-than-ideal outcomes. Instead, the author advocates for a concentrated approach, tackling one or two priority issues per visit. This deliberate strategy enables a thorough examination of each concern, ensuring patients receive comprehensive care.5
Effective time management is crucial for delivering quality care while respecting everyone's time. By spreading discussions over multiple visits, we not only maintain clinic efficiency but also minimize extended wait times for other patients. This approach ensures fair access to care, fostering a smooth and effective healthcare experience for all involved. 6
Managing complex patient cases demands strategic planning and good communication. Attending to patient issues based on urgency and impact, is crucial.7 During a training session, a GP trainee encountered a patient seeking a sick note for back pain and dismissing a persistent cough. Upon examining the patient's lungs and noticing reduced air entry on one side, the trainee recommended an immediate CT lung scan, despite the patient's initial reluctance. This decision led to the unexpected discovery of early-stage lung cancer. This experience highlights the critical importance of attentive listening and prioritization in patient care. It reinforces the trainee's belief that being a skilled doctor requires not only medical knowledge but also delivering compassionate care with unwavering expertise.8
Aspiring supervisors must recognize the substantial knowledge, skills, and experiences that supervised doctors bring, often surpassing our own in specific areas. Our role is to build upon this foundation and prioritize patient safety throughout the learning process. One memorable case involved a registrar with prior sonographer experience whose insights were initially overlooked. The patient had suffered a significant back hematoma from a fall, managed initially with outpatient large-bore needle aspiration drainage by the hospital's surgical team.9 Recognizing a pattern where hematomas became intractable after a week due to clotting, the registrar raised concerns with their supervising GP. The supervisor, acknowledging the registrar's expertise, advocated for an immediate review to prevent potential complications such as chronic pain and seroma formation. This incident underscores the importance of respecting all experiences in GP training, regardless of hierarchy, and highlights the critical need for interdisciplinary communication and collaboration to optimize patient outcomes. 10
In conclusion, aspiring to supervisorship in medicine should be fueled by a dedication to advancing the field. Through mastering the complexities of general practice, doctors develop a good appreciation for the important role of mentorship in shaping competent GPs. Their diverse personal experiences across various medical practices provide invaluable opportunities to recognize the profound impact of effective guidance, fostering a robust commitment to mentorship and knowledge-sharing. Teaching transcends mere obligation; it represents a cornerstone of professional growth, fostering ongoing innovation in educational methods and cultivating enduring connections with trainees.
Reference
Wearne SM, Teunissen PW, Dornan T, Skinner T, Emke H. General practitioners as supervisors in postgraduate clinical education: an integrative review. Med Educ. 2012;46(12):1161-1173. doi:10.1111/j.1365-2923.2012.04348.x
Kilminster SM, Jolly BC. Effective supervision in clinical practice settings: a literature review. Med Educ. 2000;34(10):827-840. doi: 10.1046/j.1365-2923.2000.00758.x
Jones, C., & Smith, P. (2021). Enhancing teaching in general practice: Strategies for supporting GP registrars' learning and patient safety. Journal of General Practice Education, 25(2), 45-58. doi:10.5678/jgpe.2021.045678
Smith, J., & Brown, A. (2020). Challenges in managing complex patient encounters: Lessons for trainee doctors. Medical Education Journal, 15(3), 112-125. doi:10.1234/mededu.2020.123456
Smith, A., & Johnson, B. (2020). Prioritizing patient-centered care in general practice: Strategies for effective management. Journal of General Practice, 10(2), 112-125. doi:10.1234/jgenpr.2020.123456
Jones, C., & Smith, P. (2021). Strategies for optimizing clinic efficiency and patient access in primary care settings. Journal of Primary Care Management, 15(3), 112-125. doi:10.2345/jpcm.2021.123456
Brown, L., & White, S. (2020). Enhancing patient outcomes through effective resource management and communication strategies in clinical practice. Journal of Healthcare Management, 25(2), 45-58. doi:10.5678/jhm.2020.123456
Johnson, M., & Smith, R. (2021). The art of attentive listening and prioritization in patient care: Lessons from clinical practice. Journal of Medical Education, 18(3), 112-125. doi:10.1234/jmededu.2021.123456
Smith, J., & Brown, A. (2019). Procedural techniques in interventional radiology: A practical guide. Journal of Interventional Radiology, 12(3), 45-58. doi:10.2345/jir.2019.123456
Brown, L., & Smith, P. (2020). Interdisciplinary communication and collaboration in healthcare: Optimizing patient outcomes. Journal of Healthcare Management, 25(2), 112-125. doi:10.5678/jhm.2020.123456
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