Part A: practice organization Part B: practice management Part C: pharmacy Part D: medical records Part E: investigations

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1 for 2017 and 2018 candidates Luk Kam Hung 30 January 2016 Three out of Four segments: Clinical Audit or Research Consultation Skill Assessment Practice Assessment Please check the College website/ FP links Part A: practice organization Part B: practice management Part C: pharmacy Part D: medical records Part E: investigations Session I Peer visits, two Practice Management Package (PMP) reports Part A (practice setting) Part B (clinic management) Part C (pharmacy and drug labeling) Session II On site assessment by College appointed examiners The random check Part CII (dangerous drugs management) Part D (medical records) Part E (investigations)

2 Form a peer group; seek approval by Specialty Board now Then: Complete two PMP reports at appropriate time with peer group members Prepare Attachments Answer List of questions Submit: The two PMP reports Attachments Answers to List of questions Application Form to College when you apply for the following year s Exit examination (deadline of application usually at the 1 st working day of November) Peer Group Application Form A group of three candidates Choose one of the group members as the contact person Come from at least two different medical practices/ clinics Fill in the peer group application form; send back to College as soon as possible for approval; no later than 29 February 2016 (Monday) Inform Specialty Board Secretariat as soon as possible if: Unable to find a group / unable to form a three members group

3 Each of the peer group members must be registered and approved by Specialty Board before proceed with the peer visits/ prepare PMP reports. Otherwise the candidate s peer visits and hence the PMP reports will be regarded as invalid for Exit Examination The contact person should re-submit the peer group application form to Specialty Board for re-approval as soon as possible on any changes in group members composition e.g. member withdraw from / new member joining an approved group Can start arranging your peer visits after your group has been approved Visits each others medical practices at mutually convenient time The three group members, and one of the members clinical supervisors expected to be present in each peer visit The minimum required participants in any peer visits: candidate (host) + clinical supervisor + one peer group member College may ask on your peer group visits time and dates; may arrange observers (FM trainees/ trainers) to join you visits Every candidate should host two Peer visits, at least six months apart You should be working at the medical practice for at least three months prior to hosting each of your peer visits Please note the second PMP visit: should take place in the venue where the candidate going to have Session II of PA, Exit Examination should be within the six months of the application deadline of the (first attempt) Exit Examination The two PMP reports could be done in different medical practices if you changed your workplace The two PMP reports are prerequisites to apply for Exit Examination in the following year Pass or Fail in the PMP report: Determined by the clinical supervisor Expect the second PMP report at least rated overall pass

4 Practice Management Package (PMP) Rating Form (Version 2014) All the participants discuss the candidate s practice According to the Practice Management Package (PMP) rating form The clinical supervisor should grade and sign on a copy of the PMP rating form PMP report No hurry to submit to the PMP report to the College after each visit Keep the clinical supervisor signed PMP report, as a reference for your continuous improvement in practice management Send the two PMP reports to College when you apply to sit for the full Exit examination Board of Vocational Training and Standards (BVTS BVTS) request higher trainee to submit clinical supervisor s practice visit report once every six months the activity s nature is similar to the peer visit; but report format is different from PMP Can complete the both reports by your clinical supervisor in the same visit Update (as of Jan 2016): BVTS is considering to accept PMP report = higher trainee s clinical supervisor s practice visit report Please refer to BVTS announcement later

5 Planning your practice assessment, Exit Examination Date Remarks Peer group formation Before 29 Feb 2016 Submit your Peer group information as soon as possible for approval Peer practice visits Any time after the peer group approved by Specialty board 1 st PMP report Suggest done before 31 March To match with higher trainee practice visit report, BVTS Workshop for candidates going for coming full Exit examination 2 nd PMP report At least 6 months from 1 st visit Prepare cases for Part D (attachment 11) and Part E (attachment 12) August Suggest done before 30 September Start from ~ 2 nd week of September to deadline of Exit exam application Details of each of the segments, important deadlines, exam logistics will be formally announced To match with higher trainee practice visit report, BVTS (6 weeks before the Exit exam application deadline) Think carefully if you have other important plans from now to 1 st quarter of next year, which may affect your : Preparation for the Exit examination/ practice assessment (Session I) Availability during the Examination period (Session II) Examples: Change to work in another medical practice/ clinic Maternity leave Personal health reasons Inform Specialty Board as soon as possible Submit the 2 PMP reports and Exit examination application Deadline on ~ 1 st working day of November Deadline of Exit exam application The Board will only consider very exceptional reasons regarding Exit Exam, PA segment From 1 Dec to Middle of March of next year Candidates will be assigned to either period A or period B exemption of examination period/ deferring deadlines Checklist format In peer visit: hosting candidate gives running commentary, while guiding all the participants around the medical practice Check against the box for the respective items of Part A/B/C : pass present, appropriate : fail not present, inappropriate N/A: not applicable to the medical practice Items with * are essential for a pass in each of the Part A/B/C respectively Section C27 to C33 (dangerous drugs): Not compulsory for completing the PMP report Still recommended to discuss in peer visits Yes or not found in the practice: a particular set-up an instrument a system etc. know how and show how : For some N/A items, demonstrate know how As expected of a competent general practitioner managing a general practice clinic Not necessary to seek for a completely checked list; can give pass even if some of the boxes in the list are not (Except those marked *) Global grade at the end of each Part A/B/C, and at the end of PMP report(a, C, E, N)

6 At the end of Part A, B, C; and also end of the form, give a global grade: Pass Fail Grade (Check one box only) A C E N Description Mastery of most components and capability Satisfactory standard in most components Demonstrates several major omissions and/or defects (Area with * with deficiency) Unsafe practice Appendix A to L Attachment 1 to 13 Lists of Questions that need to submit answers Items in the list marked with * are essential, is expected for pass; otherwise the whole respective Part (A /B /C) should be fail (E or N) Put down constructive comment to your colleague; especially if you give for particular items QA1, QA2 QB1, QB2 QC1, QC2, QC3 Certain items in the PMP rating form marked by the side with (Appendix ) The Appendices are information given to candidates; can be found in College Website: // hkcfp.org org.hk/upload/documents/exit/pmp_ratingformappendix hk/upload/documents/exit/pmp_ratingformappendix.pdf pdf Uses of these Appendix A to L: As references to the principle of the respective items Help the candidate to develop the required protocols (the Attachments) Help the candidate to answer questions in peer visits and in Session II Certain items in the PMP rating form marked by the side with (Attachment ) Required information/ clinic management protocols that the candidate needs to: Present at peer group visits or Session II (Attachments 1 to 11) Submit by writing at the time of application to sit for Exit examination (all the 13 attachments) Requirements of the Attachments: Attachments_2016F.pdf Please keep the Attachments Short and Simple!

7 For the peer visits and PMP report completion, Attachments 1 to 11 are required it is okay some of them are not ready at the first peer visit, but should be all there at second visit. No need to prepare Attachment 12 and 13 at peer visits! Attachment 12 and 13 are for Session II should be prepared at a specified period prior to Exit examination application--- will be announced in the coming candidates workshop (around August) Regarding the clinic protocols: Write up your own if no pre-existing/ satisfactory protocols Contemporary, evidence based Realistic, in use Candidate expected to understand rationale and actual execution of the protocols Certain sections along the PMP rating form are stated (Candidate please attach your answer to Q ) The list of questions can be found in College Website: // hkcfp.org org.hk/upload/documents/exit/pa hk/upload/documents/exit/pa-questions_ Questions_ F.pdf Candidate provide answers by writing; precise and concise For QA2: about improvement(s) initiated by the candidate Submit the written answers when apply to sit for the coming year s Exit examination May be cross checked verbally by examiners at Session II (random check) Suggest to present and discuss your answers with the peers at the PMP visits New item added from 2014: General Clinic Design: A12 Set up/ measures to prevent communicable diseases A5: Elderly/handicapped facilities Try to modify the setting to accommodates such needs A7: name card of doctor Not a must if you work in the public sector What are the uses, problem linked to giving doctor name card to your patients? A8: follow up card Preferred to make it available A9: home visits If yes briefly describe your operation If no how to manage out of clinic hours patient consultation needs A10 10: Sign Board comply with law requirement Check the Appendix A of the PMP to brush up your knowledge A16 16: Registration and insurance documents displayed Business registration (private practice) Insurance for the medical practice; not your MPS

8 A19 19: Prolong waiting protocol (Attachment 3) Write it up now if no existing protocol to follow Ask help from other candidates, whom passed Exit etc Made for your practice, realistic Know it well and how it should be executed A20 20: Emergency handling protocol (Attachment 4) Principle as above Consider various emergency situations Must have items * in consultation room A34 34: *Visual and auditory privacy A35 35: * Hand washing facilities Within the consultation room A36 36: * Examination bed Allow you to examine the patients properly: abdominal, pelvic examinations Not getting in these will fail in Part A (rated E or N) Diagnostic equipment: A37 to A49 Treatment Area/Minor Procedure & Operation: A50 to A54 Emergency Care: A55 to A60 Routine Environmental Cleaning: A61, A62 Blood and Body Substance Spills: A63 Disinfection: A64 to A67 Sterilization: A68 to A70 Pay attention to the requirement of each item Make sure to fulfil the * items Use the Appendix as a reference Write up the required Attachments Written answers to List of questions B7: Recall system Appointment cases Others (E.g. Pap smear screening) Accounting B8: Daily account kept B9: Proper receipts & copy kept If accounting managed by another person: expect candidate a general knowledge on the real operation B10 10: Adverse incident report system & follow-up Try not to assume we are bullet proof from adverse incidents Develop your own system if no existing one, explain to visiting peers/ clinical supervisors/ examiners Might save you in the future! B17 17: *Log book of investigations ordered and results received B21 21: *Call-back system Sick leave B22 22: *Security of sick leave certificate B23 23: *Record/Copy of sick leave certificate issued

9 Safety B32 32: *Disposal of medical waste (Appendix F) Appendix F helps you know how Show how to your peers/ examiners Amend your practice if necessary B33 33: * Needle stick injury protocol (Attachment 11) B34 34: * Handling and disposal of sharps (Appendix G) B35: Safe blood taking procedure B36: Occupational health &safety awareness C1 to C26 Pay attention to the requirement of each item Make sure to fulfil the * items Use the Appendix as a reference Appendices H, I, J Written answers to List of questions QC1, QC2, QC3 C27 to C33 (dangerous drugs) Not compulsory to check this section at your peer visits / to complete the PMP report Preferred if you could discuss with your peers: to prepare for the Session II of the Practice Assessment, Exit Examination More details will be announced in another Exit candidate workshop in August At least two Examiners will visit your clinic From start of December to middle of January; or from middle of January to end of March Include: Random check on a selected section from the candidate s PMP report/ Session I Part CII (dangerous drugs management) Part D (medical records) Part E (investigations)