The First G P Term : a curriculum for the first three months which the intending practitioner spends in general practice

摘要

"THE FIRST G P TERM", a curriculum for the first threeudmonths which the intending practitioner spends in generaludpractice, addresses three questions: why is there a needudfor such a curriculum; how should it be constituted, andudhow should it be presented?udThe need for this curriculum is explored in terms of theudbackground education with which medical graduates approachudgeneral practice. Medical science learned in Universitiesudand Teaching Hospitals requires adaptation and additionaludcompetencies have to be acquired if the doctor is to becomeuda general practitioner. In this process, the first threeudmonths in general practice is critical. Patterns ofudeffective practice need to be established at the outset,udpatterns which will last a lifetime with continuing refinement.udAmong the comparatively modest literature aboutudeducation for general practice, I have been unable to finduda comprehensive curriculum for this significant transitionudfrom hospital to domiciliary practice, the first G P term. The body of the curriculum addresses the other twoudquestions; how and what to learn? Throughout, I haveuddrawn on my own experience of over twenty years in generaludpractice education as scholar, tutor, and administrator.udThree considerations are common to the whole dissertation:udwhat is the present state of affairs; what alternatives areudfeasible; and why do I prefer my particular choice?udThe curriculum is presented in nine sections. These are:udthe 'school' of Teaching Practices;udScholars and their scholarship;udTutors and teaching;udManagement and co-ordination of the curriculum;udthe syllabus; evaluation of expectations, progress and outcomes;udcontinuing medical education;udan overview of these components;uda summary of recommendations.udIn each of the first seven sections as listed here, audpattern is followed; namely, what selection is made (ofudTeaching Practices, Scholars, Tutors, Managers, syllabus,udmethods of evaluation and continuing education), on whatudbasis, and how might this be improved; what expectationsudare involved and to what extent are these met ?udConsideration of the most cost-effective alternative is audrecurring theme. Ways of learning, particularly the implementation of selfdirectedudcontract learning, are central to the dissertation.udThe selection of the most appropriate syllabus is studied,udto facilitate the transition from hospital to generaludpractice, avoiding the already known and the irrelevant.udEvaluation is built in to every aspect of the curriculum,udalong the lines of illuminative evaluation (Parlett &ud1 Hamilton, 1972) .udThe central features of the curriculum, together withudrecommendations for change, are drawn together inudconclusion. Appended to the dissertation are documents inudcurrent use during the first G P term.