Training Matters Issue 2

Training Matters Issue No. 2 November 2020 Medical Happy New Training Year! Education New ways of working • New ways of learning Centre  01923 217 7436 Dr Ashley Reece • Director of Medical Education your time in the Trust and  [email protected] get the most out of the learn- W the patient to do next steps of ing opportunities on offer Dr Ashley Reece hat will the new train- care. Not all specialties (or doc- here. Keeping ‘well’ in our Director of Medical Education ing year bring? We hoped it tors) can work like this but we thoughts and feelings has would not be a second wave of are adapting where we can. Our been so important and I wel- Dr Michelle (Shelley) Jacobs Coronavirus which has swept colleagues in General Practice come Chloe Gill’s contribu- Postgraduate Clinical Tutor across the world changing the have embraced virtual consults tion to this newsletter. Many way we do things...but alas it too. Teaching has been deliv- of you will have seen things David Goodier did. Although I don’t like done differently in other in- Medical Education change and am stuck in my stitutions and we welcome Manager ways, I have to say some of the that differential experience ‘new normal’ has been liberat- and encourage you to share Alex Paice ing. No-one imagined the speed what you have seen work Deputy Medical Education and relative ease we would well elsewhere. We don’t Manager move to doing ’virtual’ meet- know how the Winter will ings on Teams and Zoom, or pan out, but we know we how those nouns have become ered on line in webinars, record- have the lived reality of the verbs. But it has freed up peo- ed sessions and at social dis- past 6 months’ to draw on. ple to connect across organisa- tance with learners in the room, We learnt a lot during that tions in a way that would have faces half covered. So it is differ- time and despite being stuck been more difficult in the ’old ent, a new way for a new train- in our ways we are definitely world’. Clinics are now mostly ing year. We welcome new col- changed for the better for it. virtual following a model of leagues who have joined obtaining the history, and plan- #TeamWestHerts in recent [email protected] ning some tests before seeing months, we hope you enjoy Keeping training going... INSIDE THIS At the beginning of October Health Education East of England shared 9 documents relating the education ISSUE: and training principles during the Covid resurgence. In short, the mass redeployment of junior doctors is unlikely to happen in a second wave in order to ensure training programmes can continue and be com- Keeping training go- 1 pleted. The following are summary principles in those documents: ing  The planned rotations of trainees during the 2020-21 training year (including associated formal induc- New Faces 2 tions) should continue to be expected to happen New Roles  Redeployment of trainees in response to a pandemic surge should be Remote working in 3 a. planned for by the service and only occurs where there is both service delivery and educational support Simulation b. discussed and agreed with the Postgraduate Dean in advance of any change, c. staged, Supporting Locally 4 d. considered in consultation with the trainees involved, Employed Doctors e. proportionate to the clinical need, f. of the minimum duration necessary to support essential service response, Wellbeing tips for the 4 g. supported by appropriate induction and supervision, 21st Century h. for a set period of time and not extended without further agreement of the Postgrad ate Dean to mini- mise cumulative disruption to training for individual trainees.  Formal Education should continue to be provided for trainees during a pandemic surge.  Clinical experience and training must continue.  Trainees should be released for any recruitment and selection activities.  Senior staff should be supported and released to contribute to recruitment and selection, teaching, examining, annual reviews (ARCP) and quality management activities. I am delighted to report the Junior Doctor Covid Redeployment plan devised by Dr Sundeept Bhalara and Dr Kaenat Mulla for the 2nd wave was paraded an example of good practice by the Locality & Postgradu- ate Deans in HEE East of England and shared across the region.

Page 2 New Faces! New Roles! Medical Newly appointed colleagues & those in new roles introduce themselves... Training Contacts New tutor roles in the MEC team Programme Directors Dr Michelle (Shelley) Jacobs has been appointed as Postgraduate Clinical & College Tutors Tutor Undergraduate Tutor As Postgraduate Clinical tutor I am part of the senior Medical Education team (University College London) supporting the DME, Medical Education manager and other MEC staff. I have particular Dr Raj Shah interests and involvement in training and refreshing training for Educational [email protected] supervisors, careers advice for junior doctors, LTFT trainees and SuppoRTT (Supporting trainees who are returning to work after a break from clinical practice). Programme Director (St George’s International Dr Raj Shah is the new Undergraduate Tutor for UCL Medical Students Medical School) Mr David Gaunt I am Dr Raj Shah, a Consultant in Anaesthesia. I am absolutely over the moon to have [email protected] been appointed as the new Undergraduate Tutor at West Herts. I have a huge interest and passion in medical education – an area which I have always been heavily involved Foundation Years 1 in throughout my career. As Undergraduate Tutor, I am always approachable and Dr Latha Thangaraja eager to share my personal experiences in medical education with you. Together, I [email protected] hope you and I can ensure our trust can continue to deliver high quality teaching to our UCL medical students! I cannot wait to meet you all in person soon! Dr Shruthi Konda [email protected] Mr Vimo Arumuham is the Locally Employed Doctors’ (LED) Tutor Foundation Years 2 Working closely with the Director of Medical Education and other Clinical Tutors, my Dr Deepan Vyas vision is to set up a system of quality metrics to oversee LED training and appraisal, with [email protected] systems to monitor trainee progress, provide pastoral care and to facilitate develop- ment of LED trainers. If you categorise yourself as an LED and would like more infor- Dr Claire Shine mation or indeed would like to be involved in the development of our own Trust strate- [email protected] gy for LEDs please do get in touch. Locally Employed Doctors’ Dr Ariella Midgen has started as our Education Fellow on 1st August (LED) Tutor Mr Vimo Arumuham I'm the new Medical Education Fellow at Team West Herts, focusing on clinical skills, [email protected] simulation, and the undergraduate programme for UCL and SGU students. I have participated in and developed medical education programmes ever since I was an FY1, and have presented Less Than Full Time (LTFT) these nationally and internationally, as well as being awarded an Excellence in Medical Tutor Education Award from UCL for my achievements earlier this year. I am also East of England's Dr Michelle (Shelley) Jacobs Regional Representative for Trainees in the Association for the Study of Medical Education, so [email protected] I'm keen to help other trainees take advantage of all that medical education has to offer Anaesthetics New colleagues in the admin team Dr Rupinder Kaur [email protected] Esengul Tum has joined the team as the GP Trainee Co-ordinator Emergency Medicine I was previously working at The Royal United Hospital in Bath as a PA for the women and Dr Rajesh Vasiraju children’s matrons and I have a Bachelors in History (Hons) from The Open University. I [email protected] recently moved to Watford to be closer to friends and family in London and was lucky enough to be able continue my career in the NHS at West Herts, and hope to become a true Medicine asset. Dr Shruthi Konda [email protected] O&G Mr Leya Sanu [email protected] Ophthalmology May Haden is the new UCL Undergraduate Co-ordinator Miss Faye Barampouti [email protected] In recent years I have worked as an English Language Teacher in China and graduated from Goldsmiths, University of London with a degree in Educational Studies. I hope to Paediatrics grow the Undergraduate program here at Watford General and build on my experience Dr Nirmala Costa-Fernandes working in higher education. nirmala.costa- [email protected] Radiology Dr Uday Mandalia [email protected]

Remote working in Simulation Page 3 DLoeinsgsthtinhgas dnifferently Full TimeBruce Kerr • Simulation manager Dr Ratna Makker • Simulation Clinical Director West Herts Initiative in Simulation presentation with ‘pause points’, unanimously that they felt the “ Education and Research (WiSER) where aspects of the scenario same way as the participants in was approached by Health could be discussed and “learning that face-to-face high fidelity The WiSER Education East of England (HEEoE) nuggets”, such as oxygen simulation is the preferred method team had res- in mid-2018 to provide simulation administration in emergencies and of delivery, but remote simulation ervations...We training for International Medical the oxygen dissociation curve, has a place in the current climate. were not only Graduates in order to prepare would be discussed by faculty We would also argue that remote pleasantly sur- them for work in the NHS. These located in the WiSER debrief room simulation may have a part to play graduates were a mixture of at Watford General Hospital. The when face-to-face delivery is not prised with British and foreign nationals that PowerPoint presentations were possible for other reasons; bad how well the had trained abroad and were now prepared specifically to emphasise weather (e.g. snow), simulation sessions ran applying for jobs in the UK. learning outcomes demonstrated suite equipment failure, from a tech- by each of the scenarios. accessibility difficulties, large nical point of participant numbers etc. view, but more The remote simulation was trialled The session was held on 12th importantly August 2020 and 17th August how well re- with two staff grade FY1 doctors 2020 . ceived by the participants two weeks before the first Faculty: this innova- Mr Bruce Kerr tive, remotely scheduled IMG date. They attended Ms Mary Holding facilitated sim- Mr Sunil Parmar ulation session a face-to-face high-fidelity Ms Kanwaljeet Sandhu Dr Tejas Ingle was. simulation in the morning, followed Dr Ratna Makker by a remote simulation which they With special thanks to:  Dr Ariella Midgen attended from home via Zoom in  Dr Stephen Joseph  Associate simulation fellows in the afternoon and were then asked the WISER programme. Successful two-day programmes for feedback. The feedback was  WiSER simulation programme were run in July 2018 and July excellent. Overall, the session participants for allowing us to use footage of their scenarios. 2019, where the IMGs were worked extremely well, achieving [email protected] offered one day of “soft skills” the agreed learning outcomes and training incorporating the technology was fit for purpose. adaptability, critical thinking, The feedback from the participants empathy, integrity, optimism, was that although they preferred being proactive and resilience and the high-fidelity simulation in the “ one day of high fidelity simulation morning, they felt the remote training in the simulation suite. simulation was an adequate Numbers attending the simulation replacement if social distancing sessions were 10 in 2018 and 18 was necessary. The WiSER team over two consecutive days in had reservations as to whether 2019, divided into a group of 10 remotely facilitated simulation and a group of 8. would be achievable and effective. Due to the COVID-19 pandemic it Having decided on learning became clear that the 2020 IMG session would not be able to be outcomes and chosen simulations delivered in the same way, as social distancing would not be that would achieve these outcomes possible for debriefing with the numbers involved. Therefore, the remotely with the aid of well- decision was made to facilitate a “Remote Simulation”, where a constructed PowerPoint Zoom meeting would be scheduled and participants would presentations, we were not only watch 3 pre-recorded simulations embedded in a PowerPoint pleasantly surprised with how well the sessions ran from a technical point of view, but more importantly how well received by the participants this innovative, remotely facilitated simulation session was. The faculty agreed

Page 4 Supporting our L.E.Ds Mr Vimo Aruhuman • Locally Employed Doctors’ Tutor I try and avoid acronyms and abbreviations. I am founder member of the A.A.L., the Anti-Acronym League. Yet medicine is lit- tered with them. This one, LED, is what the non-training, Locally Employed Doctors are known as. We have significant number in the Trust and while they are not on a formal training g programme, they still have significant education, training, learning and development needs. In the Spring we appointed Vimo Aruhuman, Consultant Urologist, as our LED Tutor. Here he explains a bit about this group and his role in supporting them. AR The Non-training Non-Consultant group of Doctors number and conditions. Crucially, most of these jobs are usually subject to close to one fifth of the 250,000 total Medical Workforce. In local departmental scrutiny only, with no oversight either at Medical the past this group had no overarching categories and were Education Centre or Trust level. They can be quite variable in ap- largely comprised of a heterogenous assortment of terms such pointment length and concurringly, the Trust is not mandated to as Trust Doctor, Clinical Fellow, Trust Foundation Doctor and provide educational oversight. Associate Specialists. Over recent years, these terms have In the 2019, the GMC surveyed all those in Locally Employed posts. become outdated and the ensuing roles have evolved to 2 The headlines were that this group did not feel listened to, felt mar- broad terms: ginalised, undervalued and overlooked. It recommended a complex  Specialty and Associate Specialist (SAS) Roles (middle grade national and local strategy with the trifecta of support, recognition and development. This would be underpinned by the creation of an level and up) LED Tutor role.  Locally Employed Doctors (below middle grade to FY1- equivalent) Locally employed doctors (LEDs), are a diverse group that are We are trailblazing as the role of the LED Tutor is the first within our employed directly by Trusts and work exclusively within the region and will provide quality assurance of learning environments acute sector. Their contracts are not subject to national terms and educational provision for LEDs. [email protected] Wellbeing tips for the 21st Century Dr Chloe Gill • Foundation Year 1 Doctor 21st century challenges and practical tips to member that the medical tively to your life, unfollow! heighten well-being Despite often being the ones to diagnose any profession has some key • Time critical: Track your time spent on your issues, medical health professionals can be be- set with their own mental health problems. We perks of the job that phone and slowly reduce it. Putting your phone face a unique host of challenges and I have iden- tified common themes in the 21st century that I boosts wellness; autono- away during dinner and eventually an hour of believe are reversible causes of mental distress, along with practical tips to overcome this. my, respect and admira- screen free time before bed. Slow and steady. Loneliness and disconnection from others tion from the public, • Pay attention: Become aware of situations The feeling of loneliness often feels unjustifia- ble. Most of us have friends or work colleagues team environment, highly that make you happy and why, find more of we interact with throughout the day, and mem- bers of our family. However, loneliness is a prac- skilled profession with these. Become aware of situations that induce tical pain signal that is subconsciously telling us to go back to how we originally evolved to live- variety and excitement. However, we work in a negative emotions and question why, engage together. My suggestions to help with this: highly stressful environment; a medical hierar- less with these. • Weekly reunion: Call someone that you have not caught up with in a while on the way home chy that can sometimes be undermining or over- • Exercise: We have become conditioned to from work. • Act of kindness: Bake for your team, hold a whelming; and compact inflexible rotas. think to exercise is to induce a desirable body door open or buy someone a coffee when they're exhausted. Kindness is remembered. The key message? When you go home stressed- effect. Reframe this thinking, exercise to feel • Social huddles: Make the effort to eat in the busy canteen, plan to watch a TV show with a it's valid! good. Take the stairs at work, join classes you family member or walk to your car after work with a colleague and engage in conversation. Boosting wellness at work: find fun (online!), walk with people to recon- Take everyday opportunities to socialise. • Smile and wave: Make time to go outside for a • Reflect and Rinse: Take 5 minutes at the end nect. Make exercise fun, not a chore. short while, perhaps to your local shop or on a dog walk, and say hello to the people you come of the shift to reflect on challenges AND high- across. Simple, short interactions help you feel are a part of a community. lights of the day. Then rinse with a shower, The Natural World Working Life change of clothes and morph back into yourself- We are the first species to disperse from our I think we all wish we could just work 9-5, what a dream! More than ever we are contacted leave your health professional role at the door. natural habitat. We have built an indoor life- outside of work with emails and WhatsApp mes- sages - can we switch off? Its important to re- • Others’ eyes: During a hard day try and see style with very little outdoor space, we are yourself through your friends’ and family's eyes. spending more time in cities and on our sofas, • Be proud of yourself for your contribution to and the majority of our work spaces are in- today and give yourself a break, make a cup of doors. Why do we go for a walk when we are tea when you want and sit down when needed. feeling stressed, or seek out a beach when we • Time off: Get your annual leave in early! want to relax? Our natural state of thinking • Switch WhatsApp/email notifications off after happens best when we are outside, and this is work. Stay fed: Bring a snack/ meal in you're because it is where our natural habitat lies. If excited to eat! we are away from our natural habitat, how can Be kind to each other- simple. we expect to feel at peace? Values In conclusion, in order to take care of ourselves, Happiness exists in greater forms than likes on we must strive to get back to basics and not social media or having the best trainers. Try and allow the demands of the 21st century to sweep identify areas in your life you invest a lot of time us away. Nevertheless, in the event of feelings in, i.e. social media, which you would not be of anxiety and depression, we would do well to thankful for if your life ended tomorrow. Your recognise that these are signals that something energy is your currency, spend it wisely. is missing, and to subsequently listen to our • Tailor your content to you: Treat social media needs and implement more self-care. like your magazine, what would you like to see [email protected] more/less of? Anything that does not add posi-