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Primary Care Resources and Practice Education Toolkit

GP Community Teachers Handbook

For GP teachers looking for practical guidance and resources, please see the GP Community GP Teachers Handbook below.

View the GP Teachers handbook >

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Resources for GP teachers

Read our FAQs for GP teachers >

We have created a notice for patients, for display in the practice waiting room.

Download the notice here >

*We have self-directed learning ideas for students whilst on placement, which is good for covering short-term gaps in supervision. This isn’t yet available but is being worked on and will be uploaded here once it is ready.

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Teaching Year 1

This is most students’ first experience with clinical practice, and they really enjoy meeting patients and observing consultations. Students are encouraged to take histories and perform examinations (under direct supervision), which facilitates comfort in talking to patients. During this time students are asked to analyse consultations that they witness to use as examples for the student portfolio, which forms one of the assessments.

Year 1 introduction and placement aims

To prepare the students for working in the clinical environment. To facilitate the enjoyment of, and enthusiasm for, the practice of medicine. Themes for Clinical Practice Placement:

Opportunities to observe a range of doctor/patient consultations
A minimum of 50% of the sessions should be spent observing a GP
To learn the preliminary clinical and communication skills required of a doctor
Understanding how to build a relationship with a patient, opening a consultation, gaining rapport, and taking a medical history
Performing a basic physical examination
An introduction to defining problems
Principles used in reaching a basic diagnosis
To develop an understanding of and awareness of public health and the wider determinants of health

NB: this is not to imply all of this is covered in single placements. All placements in Year 1 are on a Tuesday afternoon, following the student’s morning teaching.

What students learn in Year 1

The Clinical and Community Practice (CCP) module has been developed to complement the other Year 1 modules:

Foundations of Health and Disease.
Heart, Lungs and Blood.
Nutrition, Metabolism and Excretion.

Teaching Year 2

Year 2 introduction and placement aims

Three immersion weeks in the academic year are dedicated to general practice. Students attend in groups, for three full days in an immersion week. Their six sessions in the practice are complemented by four sessions of aligned teaching at the medical school, designed to introduce learners to the principles of general practice and emulate the feel of GP training. Students must gain authentic experience in the clinical setting:

A minimum of 50% of the sessions should be spent observing a GP, which can include activities such as observed history taking and examination (depending on your judgement of the student’s readiness)
The remaining sessions can be spent observing patient-facing work with other members of the primary healthcare team

Themes for Year 2 GP placements

Clinical placements in Year 2 are orientated towards:

Understanding people, in health and illness
To further develop the clinical and communication skills required of a doctor
Social determinants of health and inequalities in healthcare
Developing an understanding and awareness of team-working and multi-professional roles in healthcare

What students learn in Year 2

The four principal themes of the Clinical and Community Practice (CCP) module are:

Health of people, communities, and populations
Clinical and communication skills
The wider team in promoting health and wellbeing
The life cycle

The CCP module has been developed to complement the other Year 2 modules:

Neuroscience and Behaviour
Reproduction and Endocrinology
Muscoskeletal and Immune Systems

We would like you to identify a patient that each pair of Year 2 students can interview and take a detailed history (two patients total for a group of four students). This can be directly supervised by the GP tutor or it can be done in a separate room if you have space and time to review the patient afterwards. It would also be useful for the students to either examine the patient under direct supervision or observe you examining the patient and identifying signs or important negative findings.

The students are asked to prepare a 15-minute presentation which they will jointly present to a GP facilitator at BSMS during the small group session on Friday, and answer questions.

View our case based discussion guidance >

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Teaching Year 4

Year 4 introduction and placement aims

BSMS students have spent short periods in General Practice during Years 1 and 2, learning about clinical skills, communication, and the NHS. In Year 4, students receive the following in-house teaching: four “Bookend days” and three “Simulated Surgeries”. Bookend days consist of classroom-based teaching at the Medical School – please see the attached timetable. Topics include minor illness for GP, mental health for GP, therapeutics for GP and consultation skills. BSMS students are taught consultation through our strategic principles approach.

The General Practice rotation in Year 4 is important as it provides an opportunity to spend consecutive days in practice, observe how problems evolve, reflect on the patient’s journey, and observe how the diverse members of the team contribute to patient care.

Year 4 Learning Outcomes

The purpose of the rotation is for students to become more familiar with the management of early presentations of illness, common chronic disorders, and emergencies in the community setting. A key component is recognising the role of the GP in addressing undifferentiated problems and negotiating a shared management plan with the patient.While we want students to learn about management plans in general practice, please remember that the supervising clinician must retain responsibility for clinical decisions made.

What to expect from the visits

Please carry out an induction, welcome and a meet of the team and run through of IT systems - students will bring their own NHS smart card for accessing computer systems
Student surgeries are the most highly evaluated element of the placement and this opportunity should be provided for a minimum of two sessions per week
Patients must give informed consent in advance of the consultation for a student to be present and have the right to decline without reason
Students acquire the skills and knowledge required to take an appropriate history, focused examination and management, the latter typically with an incremental approach
Involve students in varied activities, including supervised surgeries, home visits, out of hours and wider opportunities such as minor surgery, venepuncture and chronic disease clinics

We expect BSMS students will progress quickly in their ability to see patients independently and most students are expected to start consulting alone (i.e. history taking and basic examinations such as BP etc) within one or two days of starting. If you have concerns about your student’s competence or behaviour, please contact us immediately.

Explore the Year 4 student progression and consulting flowchart to understand the pathway and key points for consultation.

Student progression and consulting flowchart >

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Supporting and guiding learning in primary care

NHS Kent, Surrey and Sussex: Guide for Supervision in Primary Care

Workforce, training and education in Primary Care: General practice educator, assessor, coach or mentor

The General Medical Council (GMC) have set standards for providers of medical education and training. You can find guidance on education here and further information specifically about the guidance on undergraduate clinical placements.

The Royal College of General Practitioners (RCGP) and the Society of Academic Primary Care (SAPC) have collaborated to produce guidance on the design and delivery of general practice learning and teaching in UK medical schools. Two dedicated resources are now available, as outlined below.

Teaching General Practice where further information for community GP teachers is available on Page 10.

Learning General Practice is a digital textbook for clinical students, postgraduate trainees and primary care educators.

Sample placement timetables

In each of the quick reference guides we offer a sample timetable to suggest a format and ideas for scheduling the students while on placement. This can be adapted to suit the workforce within your practice and the availability of clinicians. We appreciate that every practice is different and that there may be modifications to the timetable once issued.

Module 101 (Year 1 Clinical and Community Practice)

Quick reference guide Y1 >

Module 201 Information (Year 2 Clinical and Community Practice)

Quick reference guide Y2 >

Module 402 Specialist Rotations Information (Year 4 General Practice Rotation)

Quick reference guide Y4 >

Additional Year 4 Teaching resources

As outlined in the section under ‘E-portfolio and Signoffs’ section, the required signoffs for Year 4 students are outlined in the PebblePad user guide.

View the PebblePad user guide here >

Year 4 students receive classroom-based preparatory GP teaching at the school in the three days preceding the placement start date, and one day after the placement. Topics covered in these ‘bookend’ teaching days are outlined in the timetable below.

View the GP bookend timetable >

For an example of what a GP Practice induction could look like, please see below.

GP Practice Induction Example >

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E-portfolio and logbooks

Students in Year 1 and 2 are required to confirm their attendance for clinical placements on the Phase One Rotation and Technical Attendance Logbook (PORTAL) app, which holds a record of their attendance using the placement location.

In Year 1 their portfolio contains thoughts and reflections on clinical and educational experiences. The portfolio comprises three assignments across the year marked by their small-group facilitators. The underlying theme is ‘reflective practice’. In Year 2 students are required to submit a case-based discussion in the form of a presentation or written work.

In Year 4, signoffs are via an online platform called PebblePad. Students are responsible for ensuring that they obtain the necessary signoffs. There are several required tasks which are outlined in greater detail in the Year 4 quick reference guide and outlined in the more extensive GP teacher's .

View the Year 4 quick reference guide >

View the GP teacher's >

See more about the PebblePad signoffs for General Practice Placements in the guidance document.

View the Pebblepad user guide here >

Supplementary and published information

BSMS students are taught consultation through the approach of strategic principles.

View the consultation dynamics guide >

An analysis of a student evaluation survey from when we had final year GP placements suggested that facilitating 'supervised independence’ was a hallmark of the inspirational GP tutor.

View the Supervised Independence guide >

Explore the Year 4 student progression and consulting flowchart to understand the pathway and key points for consultation.

Student progression and consulting flowchart >

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