Now that I have settled into my first F2 job, I can’t help but think back to last year and my first few months as a doctor. Obviously, you can never really know how something is going to turn out, but I think 2020 has blindsided us all even more than anyone could have predicted. It’s been a challenging year, full of uncertainty, and change.
Albeit, the show much go on, and there is plenty that I wish I knew as an F1. Some things practical, some things philosophical, some things that I never knew I would have to know.
So here it is, something to make your F1 life easier.
Things I wish I knew about the E-Portfolio
The E-Portfolio is what is going to get you your licence to practice. It is how a panel asses you at the end of your first year as a junior doctor, so it’s really important.
Somehow this information slipped passed me and I learned the hard way, creating for myself a lot more work!
I’m going to tell you exactly how to WIN the E-Portfolio in Foundation Year 1.
Aside from all the obvious things like “complete 12 months of F1”, “satisfactory supervisors report”, achieve a pass in the PSA exam, do ILS training… There are some specifics to satisfy.
You need to complete all the curriculum outcomes, which means having evidence to map to each outcome, this evidence can take many forms. What I didn't do, is look at the curriculum to decide what to include - I ended up wasting time on lots I couldn't include, and had lots of gaps to fill. Learn from my mistake, look at the curriculum(See below for a summary of the curriculum).
Core Procedures
There are 15 core procedures – You need all 15 signing off! Get them done as soon as possible and don’t be afraid to chase people if they haven’t electronically signed it.
TAB
In your first placement, bring in lots of baked goods and take the emails of staff who you work with, as you work with them. That’s nurses, PA’s, pharmacists, ward clerks, HCA’s, domestics… everyone. Keep this list safe, because you will need it for your TAB. This is a survey that the MDT (your colleagues) takes about YOU. Scary. Not really. That’s that the cakes are for. Having a little list of email addresses ready to use will save you lots of time and chasing. Trust me, your first placement will fly by, and you should get all your responses back before moving on to your next rotation.
Quality Improvement Project
Sometimes, it’s just not possible to complete a QI project. It can be a lot of work, especially for an F1! Good job you don’t need to do one.
What you do need to do is “take part in QI” but this includes completion of the national GMC trainee survey and any end of placement surveys. You could draw up ideas for QI, help someone out with and on-going QI project, obviously if you get the opportunity and want to do your own QI, go for it, that’s fantastic, but don’t feel too stressed about it.
Mini CEX (at least 6)
A Mini CEX is a mini clinical evaluation exercise. It’s a workplace based assessment where you are observed in an encounter with a patient, and the observer provides feedback.
You need at least 6 in total, so aim for 2 per placement as a minimum.
DOPS (at least 3)
Direct observation of procedural skills. Essentially, you are observed preforming a procedure (could be a core procedure, or something else like a vaginal speculum) and the portfolio has a structured checklist for giving you feedback from the supervisor, about your interaction with the patient when performing a practical procedure.
You need at least 3 in total, so aim for 1 per placement.
CBD (at least 6 a year and 2 per placement)
Case bases discussion. It is a discussion for teaching purposes of a clinical case that you have been involved in. Some consultants like to wing it, others want you to formal present a case. I would advise finding out early on what your consultant expects of you.
You need at least 6 in total, so aim for 2 per placement as a minimum.
DCT (one a year)
Developing the clinical teacher. This can be either teaching or a presentation, but your assessor or the person giving you the feedback on your portfolio needs to be experienced in teaching or assessments. A way to get really good feedback, is to invite someone from the postgraduate department (who provide you with your generic skills teaching) or work alongside the undergraduate department at your hospital.
You only need one for F1.
Teaching and Learning
I suggest you record these sessions as you go, as you might forget what you’ve been to and how many hours it was. It’s easy to do this on your phone, so just start collecting those hours. You need to record at least 30 hours of Generic Foundation teaching, then at least 30 hours of other teaching.
Reflection
What can I say? Reflect, reflect, reflect! When mapping (in May), map the reflections last. They look great, and you have to do a couple at least per placement, but the other parts of your portfoilio provide much better quality evidence.
And then you are done!
This all has to be done by mid May, for ARCP in June. DONT PANIC! You can do this! This isn’t a whole lot of work when it is spread out over the next few months, but the trick is not to keep leaving it... eventually it will come back and bite you. Trust me, I've made every mistake in the book (but I still passed).
Useful resources: Instagram, medical flash notes app, the BMJ, Dr Diary App
Useful websites: teachmesurgery.com, passmedicine, GP Notebook
Useful courses: E-learning for healthcare
Curriculum Content
Section 1 Professional behaviour and trust
Acts professionally
Delivers patient centered care and maintains trust
Behaves in accordance with ethical and legal requirements
Keeps practice up to date through learning and teaching
Demonstrates engagement in career planning
Section 2 Communication, team-working and leadership
Communicates in a variety of settings
Works effectively as a team member
Demonstrates leadership skills
Section 3 Clinical care
Recognises, assesses and initiates management of the acutely ill patient
Recognises, assesses and manages patients with long term conditions
Obtains history, performs clinical examination, formulates differential diagnosis and management plan
Requests relevant investigations and acts upon results
Prescribes safely
Performs procedures safely
Is trained and manages cardiac and respiratory arrest
Demonstrates understanding of the principles of health promotion and illness prevention
Manages palliative and end of life care
Section 4 Safety and quality
Recognises and works within limits of personal competence
Makes patient safety a priority in clinical practice
Contributes to quality improvement