Dr David Lam, Port Lincoln, SA
Dr David Lam believes that GPs in Training (GPiT) are the lifeblood of the rural healthcare system. While rural recruitment and retention can be challenging - especially in a pandemic - it is important to support GPiT as best you can. If you put the time and effort in, they are more likely to stay.
This case study shares some innovative ways to support GPiT during the COVID-19 pandemic and beyond.
Rural training provides a unique opportunity to learn at any career stage. Dr Lam says: “There’s no one else around. You don’t have the luxury to put a patient in an ambulance and within 5 minutes they’re in a hospital full of doctors. You have to deal with it yourself. So, the hands on experience that you get is unparalleled. Plus, the ratio of GPiT to teachers is lower than the city and you can have greater access to one-on-one tuition and mentorship.
I got into teaching by accident. I found that sharing my own experiences of failure as well as the wins highlights key take home messages helped GPiT fill in gaps in their knowledge. A lot of important teaching information isn’t readily available in textbooks, it’s experiential. There is an old saying that if you have a patient in your room, avoid telling them more than 3 things because they won’t remember them when they leave. I believe teaching is the same. Keep it brief, include up to 3 take home messages and avoid long lists of information.
In Port Lincoln we had GPiT coming and going. In a 5 year period, myself and my two registrars that recently Fellowed are the only doctors who have stayed in the region. We had to sit down and consider how to make teaching more engaging.
In rural areas, supervisors are time poor and have to balance the clinic, hospital, emergency department, teaching and their families. Registrars have to balance this and exam study. On top of this there is the unpredictability and interruption of emergencies which can lead to burnout and leave little time to focus on teaching.
We created a protected weekly teaching timeslot. We call it ‘church’ and it is the one hour a week where we get GPiT together and learn around the table. Not because it’s a religious service but because everyone is welcome and it is a “sacred” unmovable weekly event. The understanding between me and the other Fellows in my practice is that when I’m teaching, they are covering me for emergencies and taking my calls. I also recommend having a syllabus. We created a syllabus based on the chronic conditions that you need to know inside out that make up the majority of general practice, rather than purely relying on GPiT to bring us cases.
With face-to-face workshops postponed during the COVID-19 pandemic and hands on procedural experience reduced by patients staying away due to social distancing, the idea of the “GP Lyf Hacks” podcast was appealing to cover the same ‘take home’ summary based on evidence and cases I personally encountered. The podcast format is portable and convenient for learning interruptions and those driving long distances. The episodes are 20 minutes long and have an integrated social media supplement for visual learners. Each podcast comes with summary slides to follow along and the posts can be used for quick reference to jog the memory. The podcast is available for FREE at soundcloud.com/gplyfhacks.
It’s important to know your audience and it’s a great time to consider how you may be able to incorporate online options into your teaching practices and how you might be able to do something a bit differently.”
Dr David Lam and his colleague
Dr David Lam and his GPs in Training during their weekly protected teaching time
Dr David Lam with colleagues at Lincoln Medical Centre in Port Lincoln South Australia
Dr David Lam’s top tips
- Incorporate your own personal experiences into your teaching. A lot of important information isn’t readily available in textbooks and can be experiential.
- Set a weekly time slot for protected teaching time with GPiT and stick to it. A variable time dependant on who is free doesn’t work because there are always excuses.
- Have someone covering you and your GPiT for emergencies while you are in your weekly teaching timeslot so you can make sure that you stick to it.
- Don’t rely on the “just bring me cases” model. Set a teaching syllabus for GPiT to keep teaching on track, link in to cases they may have come across and to stimulate discussion.
Consider the best way to engage your audience. Avoid long lists of information and focus on a few key take home messages. During the COVID-19 pandemic, podcasts can be a great way to reach rural GPiT due to their format and length.