The senior registrar educational contract
The employment contract for senior registrars is the same as for GP registrars with the same holiday, sick and maternity leave. The practice is reimbursed in the same way as ordinary GP registrars and the GP trainer is entitled to a trainers grant ( unless they are also training a GP registrar). It is recognised that the expectations of a senior registrar in terms of contribution to the practice are very different to a normal GP registrar and the educational contract should clarify expectations from both the senior registrar and the trainer's point of view. If the special interest is supervised by someone else it is advisable to have a second educational contract for that part of the training. The following are issues that may need to be addressed; Starting and finishing dates, with arrangements for flexible training ( if required). Specific learning objectives ( in the form of a PDP) General practice part Special interest part Weekly timetable negotiated to include a balance of general practice and special interest. Clarify service commitments (these should reflect educational objectives) Patient care and numbers/supervision of new procedures Hospital contract if treating patients in NHS hospital (for NHS indemnity - needs organising before start of SR training) Expectations regarding duty or on-call rotas (this should be kept to a minimum to retain flexibility) Paperwork responsibilities Notice required to cancel or alter surgeries or clinics (normally 1 month). Continued attendance at some hospital clinics may prove not to be educationally useful and programmes need to be reviewed on a monthly basis. Patients seen in surgeries or clinics - occasionally the type of patient may need to be stipulated e.g many SRs feel they need more experience in GP of patients with multiple pathology and/or chronic disease. The arrangements for organising this with the receptionists and the balance of these cases with others should be negotiated. Teaching on these cases may involve videotaping and therefore longer appointment times. Clarify teaching and learning Tutorials and supervision timetable agreed - suggested 2hrs protected time per fortnight in general practice. Special interest may involve supervised clinics, special procedures and other formal teaching opportunities. Supervisors should meet senior registrars for one-to-one teaching to monitor progress, give feedback and make further plans for learning. SRs normally receive excellent teaching from other members of the team such as practice managers, nurses and SpRs/GPwSIs in hospital departments. Expectations of the Senior Registrar in terms of preparation for tutorials, self-assessment of progress and keeping records of learning including a PDP. Study leave - an important part of SR training (see guide) Arrangements for agreeing study leave should be discussed to include; Normal notice required (usually 1 month) Clear administrative procedure for booking the leave Reasonable balance between study leave and normal SR schedule ( up to 30 days in a six month period would be reasonable) Purpose of the study leave should support PDP Regular study leave for the learning set and residential courses should be booked as far ahead as possible Projects/teaching SRs do agree to complete projects/audits/teaching on behalf of the practice or hospital department. Clear expectations should be agreed on both sides. The following should be remembered: These can be good opportunities to learn project/change management  and/or teaching but learning is increased by regular supervised reflection. The arrangements for this should be stipulated The project/teaching should only be undertaken if it supports the individual SR's learning objectives - some SRs have taken on complex projects in order to "help" a hospital department or practice and have found it difficult to extricate themselves. Objectives, deadlines and resources required should be written down and reviewed regularly Research requiring ethics committee approval may not be feasible in the six months Review, feedback and appraisal Arrangements for regular review of educational objectives, assessment and feedback on performance need to be agreed in advance. The review should also cover the educational value of every aspect of the timetable. Plans for learning and/or the timetable may need to be adjusted. Arrangements for 360 feedback from colleagues/patients towards the end of training o Appraisal - expectations regarding collation of revalidation folder, SR report and GP appraisal should be clear. Issues of poor performance by Senior Registrar should be fed back to the senior registrar and discussed with the GP trainer and Marion Lynch in the first instance.