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Rural-track training in Scotland The NES North of Scotland Deanery Gillian Needham Postgraduate Medical Dean

Rural-track training in Scotland The NES North of Scotland Deanery Gillian Needham Postgraduate Medical Dean. Healthcare education in Scotland. NHS Education for Scotland – NES Design and development Commissioning Provision. SERVICE. EDUCATION. WORKFORCE. Postgraduate Medical Education.

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Rural-track training in Scotland The NES North of Scotland Deanery Gillian Needham Postgraduate Medical Dean

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  1. Rural-track training in ScotlandThe NES North of Scotland DeaneryGillian NeedhamPostgraduate Medical Dean

  2. Healthcare education in Scotland • NHS Education for Scotland – NES • Design and development • Commissioning • Provision SERVICE EDUCATION WORKFORCE

  3. Postgraduate 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

  4. Our geography • 4 Scottish Deaneries

  5. Our geography • 4 Scottish Deaneries • The patch – 5 Health Boards

  6. Our geography • 4 Scottish Deaneries • The patch – 5 Health Boards • The peripherality

  7. 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

  8. 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

  9. 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

  10. Feedback from Foundation doctors who have spent time training in remote or rural posts between (August 2007 – July 2008) Western Isles General Hospital, Stornoway Foundation graduates’ views?

  11. FY trainees’ feedback

  12. FY trainees’ feedback

  13. “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)

  14. “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)

  15. Rural-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

  16. Rural-track specialty options • General Practice • Anaesthesia • Physician/Acute Medicine • General Surgery

  17. Rural 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 Fellows • Post-CCT year long option; competitive allocation

  18. Rural 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

  19. Rural 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

  20. Rural 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

  21. 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

  22. ….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-conference WPB = work place based CRCP = clinico-radiologico-pathological conference

  23. Rural-track training • Access • Content for context • Support

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