TCD/HSE Specialist Training Programme in General Practice

02 October 2017
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Email: gp.training@tcd.ie
Tel: 01 8962760

Prospectus 2014

Dept of Public Health and Primary Care, Trinity Centre, AMNCH, Tallaght, Dublin 24
Tel: 01-8963460/8962760 
Fax: 01-4031211 
Email: gp.training@tcd.ie

History

The Eastern Regional General Practice Training Programme Committee was set up under the auspices of the Irish Institute of General Practice in 1975 and the training programme began in July 1975. The scheme owes its existence to the trojan endeavours at this time of Dr Manne Berber, Dr Michael Flynn and Dr John Goggin. Dr Berber became the first course director from 1978 to 1988.

Initially, the annual intake of trainees was four and this gradually increased to 10 in 1981, to 12 in 2005 and 15 in 2010. A day release course for trainees and a trainers workshop both commenced in 1978.

The Irish Institute of General Practice ceased to exist in 1985 and from then, the Eastern Regional General Practice Training Programme Steering Committee was essentially a free-standing committee.

Dr Owen Clarke ably directed the programme from 1989 until 1995 when Professor Fergus O'Kelly succeeded him. Soon after this, the programme was absorbed into the Health Board structure and is now funded by the HSE. In July 2004, the programme moved from the Trinity Centre, St James's Hospital Complex to the Dept. of Public Health & Primary Care, Trinity Centre for Health Sciences, Tallaght Hospital. The name of the training programme then changed to 'TCD/HSE Specialist Training Programme in General Practice'.

Dr Fergus O'Kelly retired from the role of programme director in June 2013, after 18 years. Dr Jim McShane has been serving as programme director since July 2013.

About Us

This scheme seeks to create GPs of the highest calibre, who have excellent clinical skills in practice, and who will provide leadership in the specialty in Ireland in the coming decades. Graduates are encouraged to get involved in all aspects of general practice, and many of our trainees serve on ICGP and out-of-hours co-op committees. Three of our graduates currently hold Professorships / Chairs in General Practice in Irish Universities. Most importantly, we train GPs in the tradition of "unconditional positive regard" for the patient - recognising the importance of accepting each person who comes through the door as they are, and working with them over time in the context of their social environment, to improve their health. We do this in a collegiate atmosphere where our trainees develop close ties to Programme Directing Team members.

We have strong links with the Department of Public Health and Primary Care in Trinity College, and in July 2016 moved with them to new, purpose-built accommodation in the Institute of Population Health (IPH), Russell Centre, Tallaght Cross. The IPH houses the Trinity College Department of Public Health and Primary Care, the TCD/HSE GP Training Scheme, the Tallaght Cross Primary Care Centre (which is one of our Training Practices) and HSE community services. This exciting development means that we have ample teaching space for our Day Release programme, with state of the art tutorial rooms; communal eating space where all four years and the Programme Directorate can gather; and access to research support within the Department. All in a setting with great views, good coffee, and Wi-Fi.

Structure

The TCD/HSE Specialist Training Programme in General Practice Steering Committee holds overall responsibility for the running of the programme. The committee determines policies, makes appointments and ensures liaison is maintained between the many elements of the programme.

A course director and four assistant directors arrange the educational programme and the general organisation of the training programme. Administration support is provided by a HSE Primary Care Unit staff member. It is hoped that more assistant directors will be recruited to restore the number of assistant directors to six, in line with ICGP criteria.

Membership of the Steering Committee is comprised of representatives of:

The Irish College of General Practitioners, Trinity College Dublin, Irish Medical Organisation, Dublin Mid Leinster Area Health Board, Faculty of Public Health Medicine, Trainers, Trainees, Lay Representative, Hospital Consultant Reps (each of the major specialties are represented on this board).

The programme consisted of a three year course until July 2002. Trainees who commenced training on or after 1 July 2002 undertake a four year training programme. The first two years are spent in relevant hospital posts and the third and fourth years are spent in general practice under the supervision of a general practitioner trainer. 

Hospital posts

Since July 2005, trainees rotate through the six major specialties on four month attachments.

Rotations in the following specialities are available: general medicine, medicine of the elderly, palliative medicine, paediatrics, obstetrics/gynaecology, psychiatry and emergency medicine.

General practice posts

There are at present 33 general practice trainers affiliated with the programme. 

A trainee is appointed to a practice under the supervision of a trainer for each general practice year. The practices include group, partnership and single-handed practices located in urban and rural areas. Video-recording is an intrinsic part of the learning process. New trainers are recruited as the need arises. Additional trainers are to be recruited later this year.

General practitioner teachers

The general practitioner teachers and their practices are an indispensable resource to the programme by providing teaching practices for our 3rd and 4th year trainees. 

Allocation of trainees to hospital and general practice posts

All trainees entering this programme must accept that they may be assigned to any of the programme's hospitals or training practice posts.

The day release

Description

A release course is provided during the academic year throughout the four year programme. First year, second year, third year and fourth year trainees meet as separate groups with their own group leader. Combined meetings of all years are arranged from time to time. The release course for first and second year trainees is on afternoons only, while third and fourth year trainees enjoy a full day release course. 

Clinical dilemma

All groups gather together on Thursday afternoons and a presentation is made by one of the trainees on a clinical dilemma that they have recently experienced in the hospital or practice. The case is presented, the issues are highlighted and it is opened up to group discussion.

Learning process

Learning on the release course generally occurs through small group work. To enable this to be effective, each group member must be prepared to think and act in the interest of the group as a whole in preference to their own interest. Implicitly, one's earnest and honest contribution of self to the group is of paramount importance to effective functioning.

Clinical attachments

Clinical attachments may be arranged in the specialties in which trainees have been unable to gain satisfactory experience. Trainees are encouraged to identify their own learning needs in this matter. Access to dermatology, ENT, rheumatology and eye diseases are some examples of the clinical attachments that would be useful to first year trainees. They should avail of the opportunities presented to them when working in a general hospital.

Research

All trainees are required to complete a substantial practice based research project in their 4th GP phase of training. In 2009, the introduction of an audit became an active part of 3rd year. Research projects in 1st and 2nd year are also encouraged. 

Teaching for trainers

A trainers workshop takes place each month. Trainers also attend a trainers weekend in September and must attend a National Trainers Course every three years. Trainers, when recruited, must attend a New Trainers Course.

Assessment

In 2010, an on-line assessment package was introduced to allow assessment to be conducted in a paperless, easy "traffic light" system. All parts of the programme are regularly assessed as an intrinsic part of the training process. This ensures that all the activities of teaching and learning on the programme remain relevant to its aims and objectives. On this programme, it is the responsibility of trainees to ensure that all assessment documentation is completed.

Selection of trainees

It is the policy of the committee that not only should its method of short-listing and interviewing be fair, but that it should be seen to be fair.

Special consideration is given to applicants who:

  1. Have demonstrated an interest in general practice during their undergraduate and postgraduate years.
  2. Have academic distinctions.
  3. Have demonstrated an interest in research.

The final interviewing committee is appointed by the Steering Committee, and included in its membership are representatives from the Committee and the hospitals involved in the programme.

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