Key Topics

This study guide is not a substitute for a textbook, and particularly for the experience of the other doctors who will teach you at your practice.  However previous registrars have highlighted key learning areas, and useful resources.  These are as follows:

Communication Skills

You should read about some of the ideas relating to patient centred medicine, and try to put these into practice during your consultations.  There is a considerable literature relating to this key general practice skill, but at this stage stick to one core text.

Videotaping one’s consultations is something dreaded by most registrars.  It is however an essential tool for learning to apply consulting techniques.  Find out where the practice keeps its camera, and try and tape 2 or 3 consultations towards the end of your first month.  You should then review them with your trainer.

We will address this subject in considerably more depth later in the year, so try not to get too bogged down with theory at this stage.

IT

Most training practices keep all of their clinical data on a computer system.  It is clearly essential that you master its use as soon as possible.  Sadly there are few books on the subject, and those that do exist tend to be too broad based or out of date to be much help. 

Tip: The best way to learn is to actually use the computer from day 1.  This will slow your consultations down horribly at the beginning, but do persevere.  You will soon wonder how you ever managed to work with pen and paper!

Think:  What are the pros and cons of keeping patient records solely in electronic format?

Forms and Paperwork

This is not the most exciting part of learning to be a GP!  However it is important to get form filling right from the start.  Key forms in general practice at this stage are:

       Prescriptions (FP10’s)

       Sick notes (MED3 and MED5)

       Private sick notes.

Ensure that you know how to complete these correctly, and the various rules and regulations covering each.  There are specific requirements for issuing prescriptions of controlled drugs, which you should read through carefully.  Discuss each form and its use at an early stage with your trainer.

Clinical Knowledge.

It goes without saying that being clinically competent to deal with all presentations coming through the consulting room door is the aim of all good GP’s.  Most of us however would admit that we can’t know everything, and it is therefore best to aim for excellence in diagnosing and treating common or life threatening disease, whilst relying on a common sense approach and the use of other colleagues for less familiar problems.

This approach has the advantage of restricting what would otherwise be an endless list of clinical information.  As a registrar you will need help to identify this “core” information, and your trainer should be well placed to help you with this.

We have included in the adjacent column some references that we have found useful ourselves.  It is of course a rather personal (and short) list, and you may well find texts that suit your learning style better.  We have so far failed to agree on a mental health text.  We would appreciate your recommendations on this. 

At this early stage you should concentrate your efforts on the areas described in the learning objectives for your first month.

The best introduction we have found is The Doctor’s Communication Handbook by Peter Tate (Radcliffe) You can find a copy in the PGMC library and probably in your practice.  It can be read from cover to cover in a couple of evenings.

An alternative is The Inner Consultation by Roger Neighbour (Kluwer).  This is the current definitive book on the subject, and will certainly be lying around the surgery.  It has a somewhat idiosyncratic style which some registrars love, whilst others hate.  Chapter 2 has a useful summary of the current “state of the art”.

Some computer manufacturers (such as EMIS) have produced short booklets for use of new staff members.  Ask the practice manager for a copy, and select out the key topics.  Practices usually have a “play” patient for you to practice entering data on!

A helpful guide to prescription writing can be found in the BNF, pages 4-9.

You will find written guidance on writing sick notes in the pads themselves.

General Practice (General):

A Textbook For Family Medicine, McWhinney.  (Pitman Press)

ABC series in general (BMA books)

Oxford Handbook Of Clinical Specialities (OUP)

Women’s Health:

Contraception: Your Questions Answered, Guillebaud. (OUP)

Women’s problems in GP, McPhereson & Anderson (Oxford GP Series)

Paediatrics:

Essential Paediatrics, Hull & Johnson (Churchill Livingstone)

Dermatology:

Clinical Dermatology Illustrated, Reeves (Balgowlah AOD Health Science Press)

Clinical Pharmacology:

The BNF

The Doctor’s Bag, DTB (1995) 33: 19 Jan