General Practice clinical placements at Bristol Medical School

Details of the placement

General Practice (GP) clinical training at Bristol Medical School consists of a range of primary care placements offered to students in all five years of their degree.

During the first year, the aim of GP placements is to introduce students to the clinical setting over six or seven half-day sessions in one GP practice. This continues with five or six half-day sessions in the second year, where there is a focus on students developing communication and examination skills.

GP placements in the third-year comprise 18 full days, running fortnightly across the whole year. These employ a range of learning methods such as online tutorials, real and simulated patient consultations, group workshops and workplace-based assessments. This then evolves again in the fourth year where students attend GP placements for one full day per week for 18 weeks.

Finally, in the fifth year, students have a nine-week apprenticeship with the focus on consulting with patients independently and practising decision making. It includes a quality improvement project, sessions with allied health care professionals, and weekly small group teaching.

Such a wide variety of experiences ranging from dieticians to physios to paramedics and nurses alongside the opportunity to consult nearly every week without fail, with the opportunity to consult ourselves.
Medical student
2021

Good practice and innovative elements

  • GP tutors email the students in advance of their first day with details including, arrival and finish time, who to ask for when they arrive, how to get to the Practice, parking and public transport arrangements, arrangements for lunch, dress code, plan for day one, lead GP teacher(s), and an introduction to the Practice handbook.
  • There is a strong emphasis on pastoral support for the medical students. The students receive a pastoral check on day one of the placement to see if there are any significant health or social issues they would like to share that might be triggered during the placement, for example, teaching relating to cancer, suicide or miscarriage. It is then discussed how these can be managed during the placement.
  • There is a proactive rather than a reactive approach to inclusivity that the medical school and GP practices have worked hard to develop. Small but significant additions help students feel a sense of belonging and settle quickly into what could be a bewildering setting. For example, students are asked to write their name on the staff board when they first arrive, they are given name badges and are introduced to all the practice staff on day one.
  • Student support plans (SSPs) are a key part of the placement’s strategy. These are created with full participation from the student and sent to practices in advance so that they are aware of any specific learning or medical needs. The SSPs are managed by a central team at the medical school and disseminated on a strict need-to-know basis. The school proactively encourages any issues to come up during placements rather than in end of placement feedback.
  • The medical school offer all students the opportunity to feed back after a few weeks on placement. This gives the opportunity to fix issues during the placement rather than retrospectively.
  • Cultural and religious values are respected in how placements are organised. For example, the medical school has worked with students in the Muslim society to get advice and guidance for Ramadan, including timing of prayers and rest breaks in rooms away from food. Locations of placements are also considered following a confidential survey, for example, this could highlight the need for a placement to be located closer to a mosque.
A really well organised placement, the level of patient exposure was fantastic and the team were incredibly welcoming and enthusiastic which made all the difference to us.
Medical student
2022

Positive outcomes

  • One of the main positives of the placements are that the GP teachers are very motivated and well supported. For example, teachers are provided with high quality resources and new teachers are given the opportunity for a check-in midway through the placement to ask any questions.
  • Students also have excellent levels of support. In the fifth year there is a ratio of two students to one supervisor, which students appreciate. They also gather with students from adjacent practices one afternoon a week for ‘cluster-based teaching’ (CBT) with an experienced tutor. CBT allows for enhanced pastoral support, with tutors able to quickly identify wellbeing concerns.
  • In the later years, students receive individual feedback weekly, and feel like they are positively contributing to the workload of the practice. Students have the responsibility of seeing patients and conducting their own consultations which positively impacts their confidence and development.
  • The Primary Care team has a system in place called Significant Event Analysis for Education (SEAFE) where clinical and administrative staff can report areas of education concern or good practice. Examples of items reported and rectified include a dermatology teaching session which only had Caucasian skin types as examples, and a session about domestic violence which was triggering to some students.
I felt very well supported at this surgery. I think it was a good introduction into what a GP is like, and I felt I was able to develop my consultation skills in a safe environment.
Medical student
2023