The Working Week

The Working Week and Planning Flexible Training for the GP Registrar

Full Time GPR Training Week
Planning a Part Time Week

Current RCGP training regulations require the GP Registrar to

• Complete specialist training in general practice totalling not less than three years full time employment, or the equivalent part time, in posts or programmes approved by PMETB.
   
• Complete all three years’ training within the SEVEN-YEAR PERIOD immediately preceding the date of formal application for a certificate under the Article 10 Order.
   
• Currently pass all the components of Summative Assessment or for those starting from August 2007, the nMRCGP.

The three year programme must include:

• At least 12 months full time employment (or its equivalent part time) as a GP Registrar, under the supervision of an approved trainer.
   
• At least 12 months full time employment (or the equivalent part time) in two List A hospital training posts approved for GP training in relevant hospital specialties.

• The mix of specialities in which an applicant has trained is important and all applicants are expected to demonstrate that they have trained in a balanced range of specialties relevant to their future career as a GP.

European Part Time Training Requirements

Part time or Flexible training may vary from full time by any amount but must at least be 50% of the equivalent Full Time Working week to count as valid training

Whole Time Requirement

Part-time GPR training must also include at least two periods of whole-time work, each lasting not less than one week, one in relation to the prescribed 24 months of hospital experience and one in relation to the prescribed 12 months FTE period of training in the approved GP Registrar post. 

This full week can of course include work and any designated educational activities and PMETB will require confirmation that it has occurred.

Often the first or Induction week is full time and this will cover this requirement in the GPR training.

The European Working time Directive (EWTD)

This applies to all workers and from August 2004 included doctors in training.

The provisions will be phased in, with a maximum hours’ requirement reducing from 58 hours in 2004 to 48 hours in 2009.

The Severn & Wessex Deanery has recommended that all GPR training should be compliant with the EWTD of 48 hours from August 2004.

Full Time GPR Training Week

The Full Time GPR training day time commitment is 40 hours made up of 10 designated sessions of usually 4 hours each though some flexibility should be allowed provided this continues to comply with the EWTD on continuous work arrangements.

In a Full Time Training Programme the following sessions should be timetabled

• Practice Based Sessions 7 to include a minimum of 6 clinical sessions and 4 hours education based work to include protected tutorial time of a minimum of 2 hours, other structured and opportunistic learning time or activities.
   
• Study Leave of 2 sessions to include time for the Day Release Course.
   
• Personal Study 1 session of planned development or additional skills training agreed with the GP Trainer. 
   
  • This should be recorded in the training log and it is used to meet other parts of the GPRs needs i.e.- study for exams, learning new skills, attend an OPD or hosp session, reading, Exam work or
     
  • EVEN more GP consultation training if this has been identified as a learning need.

Example of a full time week

Study Leave

The total sessions of study leave for a full time GPR are 47 days in 12 months or pro rata to include the GPR Day Release course or its planned equivalent.

Holiday Leave

The total holiday leave allowance for a full time GPR is 5 weeks in 12 months or pro rata if the post is split across more than one time frame or practice

Planning a Part Time Week

The attached tables (these are only a suggested guide) are to assist in planning a part-timers working time table and week.

A flexible approach to the weekly plan should be considered with possible options being:

• More time or sessions being committed during the GPR training workshop (DRC) term time but less when outside term but with an annualised salary based on the % agreed plan.
   
• Although a session should be 4 hours it is recognised that some sessions may be longer while others shorter, but the overall full-time working week should be 40 hours or the agreed % thereof.
   
• DRC Course Organisers like GPRs to attend every week to avoid disruption. A part-time GPR would be better to choose to attend every week for a year and then do other activities for the remainder of their training.
   
• If the GPR wants to continue going to the DRC beyond a “full academic year” it should only be on the basis of a specific identified learning or educational need and be part of the learning plan agreed with their GP Trainer or as an extra session on a voluntary basis and with the agreement of the Course Organisers.
   
• A GPR working 50% may also choose to go to the VTS during term time and have their Personal study sessions during the academic holidays.
   
• Some degree of flexibility around educational activities is acceptable providing it is at the appropriate percentage and supports the GPR’s learning needs.

Ways to consider the Week!

A Guide to Planning the GPR's Part-time Training

OR

This “guide” is to ease planning but also to encourage a pragmatic and flexible approach to planning a Part Time week.

Overlaps

If the change in timetable results in a potential over lap of two GPR’s or other trainees then this must be discussed with the Associate Director. 

Important considerations are

• That the surgery has suitable consulting room availability for two Trainees
• That while some joint teaching is beneficial each Trainee must have their individual protected teaching programme and time maintained
• And that the Trainee previously booked for this slot has been informed and agrees to the overlap.
   

Out of Hours

The S&W Deanery GPR working or training week now complies with the European Working week Directions of 48 hours and this should include the mandatory Out of Hours Training

See OOH document for further guidance on permitted hours, continuous working etc.

It is also expected that additional duty hours and on call commitment should be at a level of agreed % of those carried out by those in equivalent whole-time employment, or pro rata.

Length of Training

And Oh yes obviously the training period is extended!!

Please again use this table to plan extended training period and complete

>> PAY 1 if this is the initial application for Part Time training or
>> PAY 2 if this is an alteration to an existing agreed GPR post

Article 11 Order

If the total training programme takes longer than 7 years to complete, it will only be considered for approval by PMETB under the Article 11 Orders. It is however worth considering an appeal against this when the time has been extended for periods of maternity leave or exceptional circumstances have occurred.

Agreement

When planning or if considering a change to a Part Time GPR programme it is essential to review this and have the support of the Associate Director. 

If the time table also has an effect on the attendance at the GP Training workshops this must be discussed with the Course Organisers.

Contract

Please check this is altered in line with any changes in working arrangements and dates.

VTR’s

All individual GPR training periods require submission of separate VTR1 forms even if it was with the same GP trainer.  This applies to any change in the GPR training including changes from Full time to Part time etc.

The final VTR1 can not be counter signed by the Deanery until 6 weeks before completion of the full GPR training programme and a pass has been achieved in all components of Summative Assessment or equivalent modules.

SHO Part Time Training

This is governed by different guidelines please see Flexible Training: Guidance for GP SHOs

Moira Linden
July 2006