It is impossible to open this issue of the bulletin without pausing to acknowledge recent events and extending our sympathy to all those grieving the loss of loved ones. It is something we as healthcare professionals find ourselves doing more than many and something we all must learn to accept as part of our calling.
Caring for people in distress is what we do and although the national period of mourning is now over we find ourselves faced with the grim realities of the coming winter. We all know about the invasion of Ukraine, about refugees, the aftereffects of the pandemic, inflation leading to fuel and food poverty. We will be confronting all this as the health service seeks to recover from the effects of Covid.
For some of us, this will be the first winter carrying what can the heavy responsibility of caring and I ask you all to spare a thought for the new F1 doctors who have just entered the medical profession. Furthermore, I challenge you to do it without the phrase ‘cannon fodder’ coming to mind. We must not think like that although it is what I thought over thirty years ago as a ‘houseman’. However, as I near retirement, I realise that it is very likely that one of these 8000 new doctors may well be overseeing my care at some point in the next ten or twenty years. I thus have a vested interest in ensuring they are well trained and I ask established care professionals to go out of your way to welcome our new Foundation Doctors to the profession and support them; giving them clear guidance, correcting them when they are mistaken and, above all, being role models for them.
As stated in the 2021 Curriculum, Foundation Doctors need to work in the healthcare environment to train and most of their time should be spent there. Only when they cannot gain the skills they need should they be taken off the ward for other training. However, to learn in the workplace our less experienced colleagues need feedback from the professionals around them to develop. These professionals make up the PSG – use them, they are developing the doctors who will be running the service in ten to twenty years. Make sure they are equipped to do it well.
It’s not all one-sided, of course. The F1s themselves need to ‘get their hands dirty’ – a terrible expression in the context of the NHS; put themselves forward to care for patients and ask for feedback via SLEs for their portfolios. The key thing is to learn but, at the end of the year it is important to ensure that FDs are as capable as we need them to be and collecting evidence for their portfolio is the way to show they have reached this standard.
The GMC requires it and we should expect it too.
The recent curriculum survey still showed some unease about knowing how much evidence was ‘enough’. As senior professionals, this falls to the judgement of the CS and ES. Four limited SLEs in which the FD takes a history, examines a patient and presents all this on the post-take ward round and prescribes may be less valuable than one in which the doctor has distinguished themselves, understanding the patient’s needs, reviewing the evidence, formulating a plan, discussing options with the patient and delivering the appropriate treatment.
Medicine is full of uncertainties. Those with experience all understand this and it is up to us to ensure those we are training understand it too.
Supervisors must ensure they know the abilities of the doctors’ they supervise. It is vital they seek out and acknowledge the opinions of the PSG, review the evidence the FD puts in their portfolio and triangulate this with the standard of the curriculum2021. To pass they year, Foundation doctors need to provide evidence that shows they can do what the curriculum requires. Supervisors must review this evidence and use their experience to weigh it. To help guide this, FDs can use the summary narrative to explain why they feel they have fulfilled the ARCP requirements.
Please see the below useful links:
Finally, I’d like to draw your attention to the links on gambling awareness (please scroll to Are you aware of harmful gambling?). As doctors we need to care for the social and mental wellbeing of our patients and these resources have been developed following the suicide of a young man with gambling problems.
Tony Choules, Operational Advisor to the UKFPO
Opportunity to contribute to research
Medical Education Researchers based at the University of Nottingham, with support from the GMC and ASME, are investigating the cause and impact of post-Foundation Training Programme training breaks (sometimes referred to informally as ‘F3’ years) on subsequent career progression.
If you would like to volunteer to be a participant, please email email@example.com and the research team will then contact you to provide the Participant Information Sheet and Consent form for the appropriate research work stream. If you have any questions about the study, please email firstname.lastname@example.org
Oral Health Knowledge of Medical Professionals
A short survey has been developed to gain an understanding of oral health knowledge of recent UK Medical graduates. It should take no longer than 5 minutes to complete.
The aim of Mini Mouth Care Matters is to ‘put the mouth back in the body’ and develop mouth care for children and young people. The organisation want to bridge the gap between medicine and dentistry and support medical professionals in understanding common oral problems their patients may face.
Please answer these questions based on your current knowledge as these answers will help formulate recommendations for undergraduate training and learning resources for medical graduates. If you completed a dental degree prior to medicine please do not complete the survey.
Links and information
Foundation elearning programme – September 2022 update
The Foundation elearning programme has been developed specifically for Foundation doctors by the Academy of Medical Royal Colleges in partnership with Health Education England elearning for healthcare (HEE elfh), and is approved by the UK Foundation Programme (UKFPO).
The sessions listed below cover key areas in your curriculum on:
FPC 1: Clinical Assessment
FPC 2: Clinical Prioritisation
FPC 3: Holistic Planning
FPC 4: Communication and Care
FPC 5: Continuity of Care
The sessions can be used to enhance your competency in the assessment and management of a patient’s fluid status, the presentation and management of sepsis, and arterial blood gas sampling and interpretation.
- Assessment and Initial Management
- Re-evaluation and Monitoring
- Arterial Blood Gas Sampling and Interpretation
- Patient with a Reduced Level of Consciousness
- Pain Management
- Oxygen Therapy
- NICE IV Fluid – Assessment
- NICE IV Fluid – Principles and Five Rs
- NICE IV Fluid – Properties
- NICE IV Fluid – More Complex Scenarios
- NICE IV Fluid – When It Goes Wrong
The Foundation programme has a range of other sessions that might help you. Please log in to the programme page to view more.
You can sign on to the elearning with your login supplied by elearning for healthcare at any time during your foundation training.
Horus and Turas have deep links to elearning for healthcare sessions from the Foundation Curriculum and are therefore accessible to all trainees, making it quicker and easier to access the appropriate session linked to the curriculum.
Improve medicines safety, visit the SCRIPT Safety programme
The SCRIPT Safety programme aims to develop your knowledge and skills in prescribing practice, therapeutics and provides guidance on medicines management. The programme covers a range of topics and supports the World Health Organization (WHO) Global Patient Safety Challenge ‘Medication Without Harm’.
Each module in the SCRIPT Safety programme takes approximately 60 minutes to complete. All course materials have been authored by a team of expert healthcare professionals and are regularly reviewed and updated. You can learn more about this elearning programme by visiting the SCRIPT website.
New online learning: stopping the over-medication of people with a learning disability and autistic people (STOMP) online learning
HEE is pleased to launch, with NHSEI, MindEd and Experts by Experience, new online learning to help stop the over-medication of people with a learning disability and autistic people (STOMP).
There are 6 online learning sessions available for health and care professionals, carers, and family members. They explain the meaning of STOMP, discuss opportunities to speak up if they feel someone in their care is receiving inappropriate medication and highlight how they can access reliable information about medicines. Each session can be completed at an individual’s own pace taking approximately 30 minutes to complete. You may also find the stakeholder communication toolkit useful.
If you have any questions or would like to find out more, please email email@example.com.
Free CST Interview Course Webinar
The Annual CST Interview Course are delighted to be hosting a FREE WEBINAR for those applying to the CST Interview Course. It will be taking place on Wednesday 12th October 2022, 19:00 – 20:00 on Zoom.
It will be chaired by previous candidates of our course who scored 100% in the interview last year. We will be going over the interview process as well as tips and structures that helped our highest scoring applicants. We hope to help you secure your first-choice job in surgery!
For more information and how to register, please visit www.cstinterview.co.uk.
Guidance for Foundation Doctors on providing written feedback for colleagues
Please click here to access guidance for Foundation Doctors on providing written feedback for colleagues.
JASME (the Junior Association for the Study of Medical Education)
JASME (the Junior Association for the Study of Medical Education) is a Career Group of ASME. JASME aim to support medical students, students from allied health professions and those within two years of graduation from these courses to engage with and develop an interest in medical education.
We are delighted to be able to send this opportunity to you – we are JASME (Junior Association for the Study of Medical Education), a career group of ASME for students and early career trainees.
We have recently announced that we will be holding a conference in Nottingham on Saturday 15th October 2022. A key aim of this conference is to better reflect the cohorts we represent as a career group of ASME, and increase inclusivity within medical education, as well as welcoming a future generation of medical educators to conferences as early as possible.
National GUM Taster Day – 3rd October 2022, 0900-1630, virtual and face to face event
Please click here to view the flyer for more information on the event and how to sign up.
Please direct queries to firstname.lastname@example.org
UCLMS Evening seminar
UCL Medical School would like to invite all interested in medical education to join this FREE virtual evening seminar:
Who: Dr A Rich, Dr A Medisauskaite, & Dr R Viney, Research Department of Medical Education, UCL Medical school
Date: Tuesday 11th October, 5-6pm GMT
Organisers: Research Department of Medical Education, UCL Medical school
Topic: Mixed-methods exploration of medical students’ mental health
Description: Medical students have higher rates of mental health issues than non-medical students. There are lots of surveys of the prevalence of mental health issues in medical students, but they often concentrate on more common conditions such as anxiety and depression, but how common are other issues such as eating disorders and obsessive-compulsive disorder? We wanted to answer this question and explore what factors at medical school might cause the high rates of mental health issues in medical students. To do this we carried out three research studies, collecting both qualitative and quantitative data (i.e., mixed methods) in nine medical schools across the UK. This seminar will provide an overview of the three research studies. By the end of the seminar, you will have an understanding of the prevalence of different mental health issues in medical students and the factors in the medical school environment that can lead to or exacerbate these issues.
National poster competition for foundation doctors
Restore Research is running a national poster competition for foundation doctors (pre core/ IMT training) for National Burns Awareness Day 2022 (12th Oct 2022). The objective of the competition is for a poster to be created that will be disseminated across social media & our website to help educate the lay population on burns care & safety.
The prize includes a certificate for winning a national competition and £500 to put towards a course(s); conference(s) or such other use that will contribute towards the foundation doctor’s career development.
Are you aware of harmful gambling?
Harmful gambling is any frequency of gambling that results in people experiencing harm, which can range from poor mental health to suicide in extreme cases. It’s estimated 1.7 million people in England are gambling at levels of elevated risk of harm, with 3.6 million people in Britain negatively affected by someone else’s gambling.
Earlier this year saw the first ever Coroner’s inquest into a gambling-related suicide following the death of Jack Ritchie; a young man who took his own life after experiencing problems with gambling.
The Coroner concluded that gambling contributed to Jack’s death; describing the warnings, information and treatment available for gambling-related harms as ‘woefully inadequate’, highlighting as a particular concern the lack of awareness of gambling-related harms across the healthcare profession.
The Department of Health and Social Care (DHSC), Department for Digital, Culture, Media and Sport, and Department for Education provided a joint response to the concerns, setting out a range of actions to prevent this from happening again. More information can be found here: Jack Ritchie: Prevention of future deaths report | Courts and Tribunals Judiciary
To find out more about harmful gambling, including where to signpost someone who might be experiencing problems with gambling, visit the NHS Live Well site: Help for problem gambling – NHS (www.nhs.uk). NICE guidelines on identification, assessment and management of harmful gambling are currently in development – look out for this in 2024: Project information | Harmful gambling: identification, assessment and management | Guidance | NICE). DHSC continues to work with NHS England and other key partners to explore opportunities to promote awareness and improve training for healthcare professionals on gambling-related harms. Resources are available at HEE elfh Hub (e-lfh.org.uk). If you would like to know more about plans for training or have suggestions for how we can improve the system or what would be helpful to learn about, please email email@example.com.