Author Archive | RuralGP.com

Aberdeen Uni showcases pilot Rural GP exposure for first year students

Aberdeen University Medical School have just released this video to report on a project which enabled first year medical students to experience rural general practice.  A new initiative by the University, made possible by a donation from Mr Joe Officer, saw 14 first year medical students taken on a two day adventure to Cairngorm national park and the surrounding area, to speak to those working in rural practices and to see first-hand the benefits of living and working in the countryside.

It’s increasingly recognised that career advice is essential for the earlier stages of medical school.  Role modelling and creating career aspirations early on can be hugely helpful to students who are thinking about their future career options.  As exposure to rural general practice tends only to be available in the later stages of medical school, this project highlights some of the reactions of students who were given the opportunity to learn more about Rural GP earlier on in their careers.

It’s pretty eye opening just how much can be done in a rural setting when you have a purpose built GP hospital

Kudos to Aberdeen University for recording the experience in such a vibrant and professional manner, and to the students for giving such articulated reflections and comments through the video too.  Maybe this is something that could be rolled out on a wider level?

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Elective Report: Isle of Arran 2017

Hannah & Louise

Hannah Kennedy and Louise Black are two third year medical students at Glasgow University, who have just completed a 4 week elective in rural GP on the Isle of Arran.  They kindly agreed to have their elective report published on RuralGP.com…

Our time was split between the five practices that make up the Arran Medical Group, as well as the small community hospital in Lamlash. This allowed us to experience a wide range of rural clinical practice in both primary and secondary care settings. We attended GP surgeries led by various doctors, many of whom also have interests in other specialties, including dermatology and gynaecology. We also had the opportunity to sit in on nurse-led clinics. This meant that we were able to see a range of clinical presentations, as well as practice history taking and clinical examinations. Going on home visits also allowed us to get a flavour of the island community.

Time spent at the Arran War Memorial Hospital was divided between the A&E, the four inpatient wards and outpatient clinics. Taking part in daily ward rounds and seeing patients on the ward provided an opportunity to practice clinical skills and examinations. The size of the hospital also meant that we could get to know patients and follow their care journeys through from admission to discharge. Attending a discharge planning meeting gave us a useful insight into the challenges involved with discharge and social care in a rural setting.

Emergency care on Arran was a highlight of the elective. Accident and Emergency consisted of one bed – a lot different to what we are used to! We got the chance to see patients as they arrived at A&E and fill out casualty cards, which was a first for both of us. This allowed us to practice presenting patient cases and form a list of differential diagnoses, which we found very useful. We also got to experience evenings and weekends on-call. During this time, we witnessed our first emergency helicopter transfer, which was very exciting. It was interesting to learn about the factors that contribute to the decision on whether or not to transfer a patient to the mainland, including weather and availability of transport.

Other things that were useful to observe were consultations at care homes, social work meetings and AMG team meetings, where topical issues were discussed in the group.

As well as experiencing a variety of clinical practice, we also had plenty of time to explore what the island has to offer. On our first day we were sent round the island on a treasure hunt, to get our bearings and see some of sights such as Brodick Castle and the ruins at Lochranza. Arran is a beautiful place with an endless number of walks; a few of which we enjoyed were the Machrie Moor Standing Stones, North Glen Sannox and Goatfell, the highest point on Arran! We also enjoyed spending sunny days at the beaches around the island and eating a lot of tasty Arran Dairies ice cream!

 

 

Doing our elective on Arran has given us a great insight into what rural medicine is like. The small, close-knit island community was something neither of us had experienced before. We noticed that this raises issues in medical practice, for example in terms of confidentiality, however, it means that doctors know their patients well and so there is a greater level of patient trust and care provision. Something that stood out for us was the enthusiasm of the AMG team to improve the healthcare for the people on Arran, despite the limited availability of resources on the island. We felt really welcomed by all members of the team during our time, which has added to our positive experience. Overall, an enjoyable and educational elective and an experience both of us have benefitted from.

For future students looking to organise a placement on the Isle of Arran, we have created a “Pros and Cons” list of the elective and “Top Tips” to help you prepare:

Pros Cons
Made to feel part of the AMG team Hospital can be quiet at times – but this can give you more time to explore or catch up on work in the library
Flexible timetable – have the opportunity to see and do things you want to Expense of travel and accommodation
Variety of experiences available within placement – from lifeboat and mountain rescue training to GP surgeries to specialist clinics Poor weather can sometimes limit outdoor activities
The opportunity to get involved with practical skills

 

Transport around the island can be tricky without a car – as buses don’t come frequently and practices are quite spread out
A lot of outdoor activities on offer on the island
The island is busy during the summer with many events held in each village – something else you could get involved in

Top Tips

  • Organise accommodation well in advance.
  • Be prepared for a more relaxed style of placement.
  • Grab the opportunity to get involved in placement as the AMG team are keen for you to make the most of it.
  • Walking boots, suncream and midge spray are essential!
  • If someone tells you a walk will be leisurely, do not believe them, you are in for a trek.
  • Try Arran Dairies ice cream.
  • Make the most of sunny days and time off by exploring.

We’d like to thank David Hogg for organising our elective and making it possible and the whole of the AMG team for looking after us.

All photos by Hannah & Louise.
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What matters in remote & rural practice? Your input requested…

RuralGP.com has just received this request from Elizabeth, who is seeking contributions to research that she is carrying out into the needs of remote & rural practice in Scotland.  If you are able to assist, please contact Elizabeth directly…

My name is Elizabeth Lemmon, I am a PhD student based at the University of Stirling and currently undertaking an internship at the Scottish Government within the Health and Social Care Analysis Team. The aim of the internship is to carry out some research into remote and rural general practice in Scotland in an attempt to better characterise them in terms of their activities and the challenges they face. I’m currently pulling together data which are publicly available on general practices to improve the evidence base and identify where further data analysis are needed.

I am contacting you to ask if anyone would be interested in sharing their experiences within remote and rural general practice and highlight any areas which you feel are priorities or which need further research?

I understand that there is currently work taking place within the Scottish Government on the Primary Care Evidence Collaborative which is developing a 10-year evaluation framework for primary care transformation. The work I will be doing during my internship on remote and rural practices will help to identify priorities for data, research and analysis and ensure that rural issues are included.

Any feedback is much appreciated!

Elizabeth Lemmon
Scottish Graduate School of Social Science Intern
Health and Social Care Analysis
Scottish Government
Email: Elizabeth.Lemmon@gov.scot
T: 0131 244 3469

 

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Highland innovations in eHealth

Thanks to RGPAS member Dr Richard Weekes for highlighting some fantastic work going on in NHS Highland to innovate eHealth applications aimed at improving access to healthcare in rural settings.

Here’s an introductory video showcasing some of the projects…

…an STV news item about the PILLCAM project in Ullapool to provide easy access to endoscopy facilities – using some very novel technology…

… and more about bringing endoscopy to rural communities…

… and the RAPID project to overcome connectivity challenges in rural Scotland…

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Next EMRS CG VC meeting on Friday

The next EMRS ScotSTAR Clinical Governance meeting is due to take place on Friday 12th May, at 1.30pm.

These meetings take place at the EMRS base next to Glasgow Aiport, and VC links are invited (via the NHS Scotland VC Network) from rural practitioners (GPs, nurses, paramedics) across Scotland.

The team values input and opinion at these meetings from rural practitioners. Combining the insight of both referring site clinicians and retrieval teams into the intricacies of missions audited creates a fantastic learning environment. Attendees come away from these meetings enthused and encouraged to provide the highest possible levels of care for our patients.

The meeting on Friday brings a few cases under the longitudinal audit microscope. The EMRS team have chosen two of the most challenging cases, one primary and one secondary retrieval and opinion will be welcomed in dissecting out the details so that we can learn from combined experience.

To join the meeting, contact Anne Cadman (details in agenda below) with your VC details.

Download the agenda for this meeting

The above text was modified from an email sent out recently by Dr Randal McRoberts, Consultant at EMRS and lead for the Clinical Governance meetings.

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Update from the Scottish Rural Medicine Collaborative

The Scottish Rural Medicine Collaborative (SRMC) is a programme funded by the Scottish Government’s GP Recruitment and Retention Fund. The programme – chaired by Ralph Roberts (Chief Executive of NHS Shetland) – is about developing ways to improve the recruitment and retention of GPs working in a rural setting across ten Health Board areas in Scotland – Grampian, Highland, Orkney, Shetland, Western Isles, Dumfries & Galloway, Ayrshire & Arran, Fife, Tayside and Borders. Also involved are NES, NHS HR Directors, RCGP Scotland and Rural GP Association. They are now looking for assistance from the rural health community in Scotland……

The SRMC Programme Board have agreed that the programme will work in the six project areas outlined above and are looking for the following people to support this work:

  • A Programme Clinical Lead which will be funded 2 PAs (0.2 WTE) per week towards backfill for the post holder and will work across the whole Programme.
  • Project Leads for Project 2* (Rural GP Recruitment Yearly Wheel), Project 3* (Rural GP Marketing Resources) and Project 6* (Rural GP Recruitment Support). More details about these individual projects are available in Appendix 1 in the linked document below. They would be particularly interested to hear from HR Managers or Practice Managers.
  • Project Team Members for all projects. They would be particularly interested to hear from HR Managers or Practice Managers.

Please note your interest by Monday 22nd May 2017.

To find out more about these opportunities please contact either:

Download more information here (PDF)
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RRH Guide to Getting your work Published

One of the sessions at #ruralwonca was delivered by some of the team at the Journal for Remote & Rural Health.  I was really sorry to miss it, due to presenting in another session, but my tweeted request to make the advice available online was answered quickly and the presentation is now available – see below.

The journal team are keen to encourage and motivate rural healthcare professionals to share their research, and seem genuinely interested in helping budding writers to put pen-to-paper or finger-to-keyboard.

There is a lot of great innovation and problem-solving going on in rural practice.  Rural healthcare professionals tend to know their communities well, are used to dealing with limited resources, and some of the best examples of teamwork are to be found in rural settings.  However ‘being academic does not come easy to everyone, and the process of writing up evaluation and research can sometimes feel tedious and time-consuming.

However, it is now easier than ever to find interested journals, and there seems to be a drive to make the steps to getting work published more accessible.

Watch the presentation below for the RRH team’s top tips on getting your research out to a wider audience.  You can find the guidelines for authors available here.

Also, on the theme of research, here’s a great project that aims to enable rural doctors to develop their research activity through pragmatic and direct support.  Delivered by the Faculty of Medicine at Memorial University in Newfoundland, it’s called the ‘6 for 6’ programme.  Click here for more details or watch the video below.

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RuralGP.com at #ruralwonca

Today marks the start of the 14th WONCA World Rural Health Conference, being held in Cairns, Australia.

The programme is set to contain a fantastically diverse range of research and workshops covering everything from improvements in patient care, to developing new and effective ways to collaborate across boundaries in rural health.  You can follow the events on twitter using the #RuralWonca hashtag, and already there has been a huge number of comment and links

View the WONCA Rural Conference programme

So far, the vibe at #RuralWonca has been great… benefitting from Cairns hospitality (boosted by a dynamic and helpful team from ACRRM) and a stimulating range of input from stalwart experts in rural medicine, to young, enthusiastic students and young doctors.

Thursday saw a full day of proceedings for the WONCA World Working Party for Rural Health – with the annual Council meeting held in spectacular surroundings of a seminar room looking directly onto rainforest.  As well as hearing about events from the last year, and sorting out logistics for yet another busy year ahead, there was debate about how best to support member organisations and do everything possible to support the growing number of student and young doctor organisations.  The highlight of 2018 is set to be the 15th World Rural Health Conference.  Crumbs, we haven’t even started the 14th conference yet, but for a taster of what’s in store – in New Delhi – see the video below!

Friday brought the World Summit on Rural Generalist Medicine.  The concept and importance of rural generalism in health ecosystems is reaching high levels of resonance now within Australia (where political support for recognising this is higher than ever), and much further afield in both ‘developed’ and ‘developing’ nations.  It is clear that empowering rural generalism within healthcare systems has never been more important, with absolute needs to train future doctors in medical complexity, meet the demands of an ageing population and achieve the levels of health service efficiency that are often more easy to find in the generalist setting.

The Summit also saw the launch of the Japanese Rural Generalist Programme: a major achievement and indicative of the direction that other countries are likely to go too, not least through the inspiration that these developments bring.

You can follow tweets from the Summit meeting using the hashtag #RuralGeneralist

And now for the main event.  This looks set to be a stimulating and busy few days ahead, bringing together an enthusiastic and dedicated group of international confreres giving the opportunity to recognise and drive forward international innovation and collaboration in rural health.  We hope to feature a number of interviews and reports on RuralGP.com over the next few days, like we did with the last conference in Dubrovnik, between a very packed and interesting programme of events.

Follow the WONCA World Rural Health Conference on Twitter:

#ruralwonca

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What happens when Deep End goes Rural?!

Many readers will be familiar with the Deep End project, originating in Glasgow but which has spread far and wide in describing the work of GPs working in areas of urban deprivation.  The original project brought together 100 general practices serving the most socio-economically deprived populations in Scotland.  The project team has carried out a fantastic amount of work to highlight the impact of inequalities on prevalence of medical conditions and access to healthcare.

So what happens when a Deep End GP (or a GP and GP trainee, to be precise!) travel out for some time in a remote island practice?  Dr Maria Duffy and Dr Elizabeth Dryden did exactly that, when they travelled to Benbecula to spend a week with rural GP Dr Kate Dawson… and produced this short video of their experience…

 

You can follow the Deep End project on Twitter – see below.

We look forward to the sequel!

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