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Training practices see themselves as fortunate to have a SR and the Deanery gets regular requests from practices anxious for the opportunity. An SR is a valuable asset to a practice – many have already done a year in the practice, have integrated into the team and are familiar with the practice systems. Patients value their care and are developing long term relationships with them. They have successfully completed most of their assessment hurdles and have the potential to give a substantial clinical contribution to the practice.
However, training practices need to be aware that the relationship between a Senior Registrar and the practice is very different to a normal GP Registrar. SRs will spend 50% of their time away from the practice and their commitment to the practice and patient care is necessarily secondary to their educational programme which is based on their personal learning plan. Practices need to see themselves as a learning resource for the SR. If SRs use their time in the practice to see patients, do an audit or run a workshop then the practice benefits. However the SR may feel the priority for his learning is outside the practice and the practice may be disappointed not to see much of them.
The practice should be cautious about including the SR in a duty rota as this reduces flexibility but at the same time it is reasonable to ask the SR not to change surgeries with insufficient notice. In practice, SRs usually wish to be helpful and pull their weight as part of the team and it is important that a balance is found. Issues about continuity of care, messages and responsibilities need to be clearly addressed as with any other part-time clinician. The negotiation of a learning contract as described above is an important learning experience for the Senior Registrar. Many SRs are planning a portfolio career and need to learn about how to balance their responsibilities to their primary health care team and continuity of care of patients.
It is strongly recommended that when a SR starts their six months that the purpose and arrangements are carefully explained to the whole team, particularly the receptionists. SRs should remember that absence from the practice normally indicates time off and they may wish to inform the team what they are doing in the rest of their week!
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