Histopathology: key to the diagnosis

Histopathology: key to the diagnosis

National Framework for Induction (2010)

Information prepared by:

Dr A Green, Dr E Byrne, Mrs S Cossins

Background

• Many ST1s starting Histopathology training have limited previous exposure to histopathology

• Those experienced in histopathology are likely to have moved to a new department

• New trainees may have never worked in the NHS before

• Histopathology school leads and trainers are required to provide induction for all new ST1 trainees


Aims of this Presentation• PMETB/GMC and the MMC both set standards required

for induction of specialist trainees.• Our audit demonstrated generally good provision of

induction in line with these standards (see attached abstracts)– This audit will be repeated in Autumn 2010

• This Framework aims to facilitate and standardise national ST1 induction.

• To cut down on the amount of time trainers need to prepare for induction.


GMC/PMETB RequirementsFrom: Generic standards for specialty including GP training. September 2009, updated April 2010. GMC

Domain 6 (‘Support and development of trainees, trainers and local faculty’).http://www.gmc-uk.org/Generic_standards_for_training.pdf_31300576.pdf

‘Every trainee starting a post or programme must access a departmental induction to ensure : – they understand the approved curriculum – they understand how their post fits within the programme– they understand their duties and reporting arrangements – they are told about departmental policies– to meet key staff. ’


GMC/PMETB Requirements‘At the start of every post within a programme, the educational supervisor......must discuss with the trainee:– the educational framework– support systems in the post– the respective responsibilities of trainee and trainer for learning.’.

‘This discussion should include the setting of aims and objectives that the trainee is expected to achieve in the post.’


MMC Requirements

From: Modernising Medical Careers. A Reference Guide for Postgraduate Specialist Training in the UK. The Gold Guide Third Edition June 2009.

http://www.mmc.nhs.uk/pdf/Gold%20Guide%20--2009.pdf

Section 8: Being a Specialty Registrar and an Employee

‘At a minimum this should include:......thorough induction to both the employer and to the specific specialty training unit.

This should include, for example:

– introduction to key team members and their roles,

– clarity about any of the geographic areas where a trainee might need to work,

– a working understanding of the equipment which might be required

– access to and requirements for the use of protocols and guidance documents

– supervision arrangements,

– out-of- hours arrangements...’



ST1 Induction 2010

Local/Regional Induction

• Brief description of location of hospital(s)– ST1 (internal rotation)

• Confirm base hospital

– ST2-5 (rotation within deanery)

• Distances and travelling times

• Transport arrangements eg shuttle between sites etc


Departmental Induction• Physical orientation• Organisational orientation – how do I fit in the team?• Introduction to key team members• Explanation of terms and conditions of service• How structured MMC training will be provided• Clear outline of the job and it’s requirements• Access and introduction to protocol and guidance documents• Information on organisation’s history etc• Health & Safety • IT and communications arrangements• Clinical governance, complaints handling, risk mgt.


Terms and conditions• Hours of work – 40 per week

– No pay banding

• Annual leave– Entitlement and availability of forms– Who authorises/records/monitors

• Study leave – Refer to Deanery regulations

• Entitlement and availability of forms • Funds available per annum

• Sick leave– Reporting instructions– Self and GP certification


Education and Training• Educational supervisor

– Role and name • Introductory programme

– Structure and timescale– Timetable of educational events

• Departmental teaching days/times eg. Black box


Education and Training (2)


•Portfolio

− LEPT

•Appraisal and assessments

–End of attachment appraisals

–WBAs (DOPS, Cbd, ECE) 6 of each, during training year (before ARCP).

–MSF – February/March

–OSPE

–ARCP (date)

Royal College of Pathologists

• Requirement to Register with RCPath– Training and learning record– On-line portfolio

• Curriculum– Stages to CCT– Minimum datasets


RCPath Events

• OSPE– March/April 2011 (confirm on College website)– Entry form on RCPath website – check

regularly


Dept workload

• State in broad terms recent departmental workloads– Above or below national norms


Principle service responsibilities

• Clinical services– Rotas, ensuring these do not conflict with

educational activities

• Clinical on-call commitments;– None in ST1 training year

• Objectives and targets– Service experience learning experience


Teaching responsibilities

• Give brief details of any commitments to provide undergraduate training– Format and frequency– Opportunities to learn how to teach and

monitor performance


Research & Development

• Define specific areas suitable for projects

• Ensure trainees understand principles of audit

• Encourage to present case reports

• Scientific meetings/publications

• Journal clubs


SOPs

• State availability/location of SOPs for:– Laboratory organisation– Laboratory technical procedures– Clinical management

• LEAN (if applicable)

– Principles– Effects on the department and your way of

working


Local Facilities

• Trainee accommodation & equipment

• Transport and parking

• Location of Postgraduate Centre

• Library

• IT facilities

• Canteens

• Shops


Management training

• Describe arrangements locally for gaining experience in laboratory management

• Describe training courses or initiatives in which trainees can participate;– Courses on www.nhshistopathology.co.uk eg

Presentation Skills, Enhancing PM skills….– HTSB ST1 rep (audit involved)


HTSB Events

• Introductory Block Teaching Week– Bristol (13th - 17th September 2010)

• Academic Training Day– RCPath, London, October 2010

• Regional block teaching weeks– Dates and frequency

• Mock OSPE– February 2011


‘Non-core’ activities

• PathSoc and BDIAP membership

• Pathological Society presentation

• Case presentations for www.histopathnet.org – Dates will be emailed out individually

• Other learning opportunities – E-learning www.e-lfh.org.uk (pending)


Overseas doctors

• Additional material for doctors new to NHS in UK– Tax– National Insurance– NHS history and structure– Training Schools’ history and mgt structure– Life and work in the UK


Books and journals etc…

• Basic undergrad – Underwood• General – Robbins• Diagnostic – Rosai, Sternberg etc• Systematic – guidance from teams• Review – Progress in Pathology, Recent Advances

in Histopathology• Journals

– Diagnostic– Academic / experimenta– Special interest


‘Take-home message’

• Take responsibility – You are responsible for your training and its

documentation

• Assessments have to be passed to progress to Y2-5


‘And finally…


Enjoy your training!’

References


Generic standards for specialty including GP training September 2009, updated April 2010. GMC.

Modernising Medical Careers. A Reference Guide for Postgraduate Specialist Training in the UK. The Gold Guide Third Edition June 2009.

Documents

Histopathology: key to the diagnosis