Suggested PDPs for GP Training Rotations – GP Trainees

• Master three conditions: Eczema, Acne, Psoriasis
• Regularly ask about Psychosocial – irritants/job/make-up/sun exposure etc
• Attend a Skin Cancer clinic and assess as many moles as possible
• Get experience with a Dermatoscope – lots of GP practices now have these
• Get used to asking about low mood/confidence with skin
• Review the different types of available moisturiser
• Attend a Paediatric Dermatology clinic
• Attend a Skin Allergy clinic, understand patch testing etc
• Steroid creams: understand potency ladder and fingertip units
• Spend time in theatre if have plans to work in minor surgery or aesthetics

• Develop an efficient, focused approach to Recurrent Falls
• Talk to MDT members and find out how they work in the community eg social services, OT
• Develop a method for assessing Polypharmacy
• Attend a Stroke clinic (new, review and rehab)
• Get used to asking about low mood/confidence with skin
• Get used to doing psychosocial assessments for older people – home/stairs/cooking/washing etc
• Understand benefits and social care for older people eg attendance allowance
• Develop an investigation plan for ‘confusion ? cause’
• Find out about wills/advanced directives/powers of attorney etc
• Work out which Dementia screening tool you find easiest
• Review Adult Safeguarding detection and management

• Fully understand the different methods of diagnosing Diabetes
• Develop an understanding of stepwise Type 2 Diabetes management
• Attend Insulin-starting clinics to understand key counselling points
• Attend a Paediatric or Young Person’s Diabetes clinic
• Develop a simple approach to managing TFT results
• Attend a complex thyroid disease clinic
• Understand key diagnostic features of Cushing’s, Conn’s and Addison’s
• Develop an approach for assessing Gynaecomastia
• Develop an approach to assessing hypo and hypernatraemia
• Develop an approach to assessing hypo and hypercalcaemia

• Understand audiogram patterns and how to explain
• Attend a few SALT (speech and language therapy) assessments
• Practice removing ear and nose foreign bodies
• Attend a fast track ‘suspected head and neck cancer’ clinic
• Review sore throat ‘scoring tools’ eg Centor, FeverPAIN
• Familiarise with tonsillectomy indications/pros and cons/complications
• Perfect an efficient approach to assessing ‘dizziness ? cause’
• Practice Hallpike and Epley manoeuvres (BPPV)
• Understand Rinne’s and Weber’s tuning fork tests inside-out
• Attend paediatric ENT clinics if possible

Watch my video ‘5 things I learned from my ENT rotation as a GP trainee’ here.

• Constipation: understand medical management options and when one is more appropriate than another
• Develop and efficient approach to assessing recurrent abdominal pain
• Become comfortable with IBD flare-ups including steroid treatment
• Attend Upper and Lower GI suspected cancer clinics
• Fully understand lifestyle counselling for Dyspepsia and IBS
• Familiarise yourself with Hepatitis A, B and C
• Attend a Paediatric Gastroenterology clinic
• Read and understand as many CT abdomen reports as possible
• Understand Familial Bowel Cancer including referral, tests, genetics
• Fatty Liver disease: know how to manage/advise/monitor

• Regularly request feedback on documentation – what to write, how much detail etc
• Print and review annual check templates for major chronic diseases
• Print out and review your local antibiotic prescribing protocol early on
• Find out as many local services as possible – TOP/counselling/GU clinics etc
• Attend Diabetic clinics to master Diabetes management steps
• Understand the different inhalers used in Asthma and COPD
• Engage in MDTs and find out what attendees do – OT/physio/district nurse/matron etc
• Write a list of key numbers and stick on your desk eg hospital switchboard, local safeguarding lead etc
• Develop a method for assessing ‘tired all the time’
• Review all NICE urgent referral guidelines for suspected cancer

Watch my video ‘3 things I learned in my first GP Rotation’ here. 

• Make a chart early of all work-place based assessment needed in ST3
• Look at your portfolio curriculum coverage and make a plan to cover all
• Become confident with chronic disease management eg Asthma/COPD/Diabetes/Angina etc
• Review key referral guideline points eg Suspected Cancer, CKD, Paeds etc
• Audit last 10 suspected cancer referrals for outcome and learning points
• Audit last 10 antibiotic prescriptions against local/national guidance
• Write a list of key numbers and stick on your desk eg hospital switchboard, local safeguarding lead etc
• Print and review annual check templates for major chronic diseases
• Print out and review your local antibiotic prescribing protocol early on
• Make use of other learning opportunities eg LMC/ICB/federation meetings

• Become comfortable with taking a sexual history
• Practice explaining contact training to patients
• Learn first and second-line treatments for Chlamydia and Gonorrhoea
• Become familiar with features of ascending infection eg PID, Orchitis
• Review different types of HIV test available
• Practice explaining HPV to patients eg with genital warts
• Understand features and treatment of vaginal Candida infection
• Formulate a simple approach to assessing PV discharge
• Review risk factor history for HIV, Hepatitis B, Hepatitis C
• Attend a consultant clinic for more complex cases

• Understand the different types of Leukaemia
• Review Myeloma presentation and diagnosis
• Get used to normal values: Hb, MCV, MCH etc
• Review different types of Haemolytic Anaemia
• Attend a Lymphoma and Leukaemia clinic
• Review management (dietary sources and medical) of low Iron, B12 and Folate
• Familiarise yourself with the blood tests in a ‘clotting profile’
• Attend a bone marrow biopsy so you can counsel patients
• Understand blood groups and blood transfusions
• Develop an approach to bruising/bleeding ? cause

• Stroke and TIA: understand secondary prevention inside-out
• Develop an efficient examination process for upper and lower limb neurology
• Develop an efficient examination process for cranial nerves
• Review important dermatomes and myotomes
• Peripheral Neuropathy: create a process to assess for causes
• Attend a Paediatric Neurology clinic
• Attend an EEG and an EMG to be able to explain what happens to a patient
• Review Epilepsy medication counselling
• Read as many CT and MRI head reports as possible – familiarise with normal
• Attend a Parkinson’s Disease clinic

• Understand routine antenatal screening (bloods/scans)
• Practice counselling for amniocentesis/chorionic villus sampling
• Become confident in examining the pregnant abdomen
• Regularly check medications in the BNF (get used to what is safe in pregnancy)
• Get used to assessing bleeding in early pregnancy
• Get used to PV/speculum examination (what is normal)
• Attend a Urinary Incontinence clinic
• Attend complex Contraception/HRT clinics
• Attend a Menorrhagia clinic
• Attend a Gynae Cancer clinic

Watch my video ‘8 things I learned from my O&G rotation as a GP Trainee’ here. 

• Fully understand the NICE ‘Suspected Cancer’ referral guidelines
• Review all UK National Cancer Screening programmes
• Gain confidence in writing syringe driver prescriptions
• Review all steps of the WHO analgesia ladder
• Understand local and national support organisations eg Macmillan Team
• Develop a system for assessing pain in cancer
• Review staging methods of various cancer types and how to interpret them
• Understand how to manage common Chemotherapy side-effects
• Understand how to manage common Radiotherapy side-effects
• Attend a variety of biopsies to understand how to counsel about them

• Formalise a quick GP–focused eye examination technique
• Understand eye red flags… which warrant admission to ophthalmology
• Attend a Diabetic Eye clinic and recognise retinopathy changes
• Practice pre-and post Cataract surgery counselling
• Attend a Glaucoma clinic to fully understand the variety of medications used
• Join a Paediatric Eye clinic – squint/amblyopia etc
• Understand simple conservative measures eg hot compressions/lid massage
• Witness laser eye treatment to explain what happens if a patient asks
• Become familiar with eye problems linked to other conditions eg thyroid eye disease
• Do not finish without being 100% confident with an ophthalmoscope

• Become an expert in carrying out baby checks
• Plot as many growth charts as you can
• Become comfortable with calculating paediatric drug doses
• Master taking an immunisation/birth/development history
• Get used to paediatric observation values eg HR/RR etc
• Review common paediatric infections eg pertussis, croup
• Understand the NICE ‘traffic light system’ for assessing fever in a child
• Understand Child Safeguarding recognition and procedure
• Attend a Paediatric Asthma clinic
• Attend a Paediatric Dermatology clinic

• Practice writing up as many syringe driver prescriptions as possible
• Familiarise yourself with common medications used for nausea
• Develop an approach to assess Pain in Palliative Care
• Review the WHO Analgesia Ladder
• Review home Palliative Care: what is available for patients/carers
• Attend Palliative Care MDT meetings to understand various community roles
• Practice converting oral analgesia doses to syringe driver equivalents
• Understand local and national support organisations eg Macmillan Team
• Go on some domiciliary Palliative Care visits to understand Home Palliative Care
• Understand financial/practical aspects eg DNAR/DS1500/wills etc

• Fully understand and practice Mental State examinations
• Familiarise yourself with carrying out an efficient risk assessment
• Review monitoring of Psychiatric medication eg Lithium
• Understand your local crisis/urgent psychiatry team structure
• Work out which confusion/dementia screen you prefer
• Familiarise key points of the Mental Health and Mental Capacity Acts
• Try and attend a CBT session so you can describe it when referring
• Try and do some home visits with a CPN (community psychiatric nurse)
• Get comfortable with switching antidepressants
• Take up Prison/Liaison Psychiatry/CAMHS opportunities

• Fully understand Staging of Chronic Renal Failure
• Understand Renal Replacement Therapy and appropriate patient counselling
• Develop a plan to manage GFR results in Primary Care
• Attend a Renal Biopsy and understand post procedure counselling
• Read and become familiar with as many renal ultrasound results as possible
• Develop a simple method for remembering nephrotoxic drugs
• Attend a Paediatric Renal clinic
• Review Primary Care referral criteria for Chronic Renal Failure
• Understand initial investigations and management of AKI
• Review the Urine dip – what could each result mean eg proteinuria

• Fully understand current Asthma guidance: diagnosis and management
• Understand home oxygen: how to refer and how to manage
• Read as many CT chest and bronchoscopy reports as possible – what is normal?
• Become comfortable with oral steroids for respective flare-ups eg Asthma/COPD
• Inhaler and spacer techniques – practice explaining to patients
• Attend a suspected Lung Cancer clinic
• Attend a Paediatric Respiratory clinic (especially for asthma)
• Become familiar with smoking cessation options and counselling
• Spirometry: how to carry out and how to interpret
• Attend a CPAP session to understand how it works

• Fully understand long term antiplatelet management post stroke
• Review long-term stroke complications and follow-up questions
• Attend a Stroke MDT and understand how community follow-up
• Become familiar with post stroke Physiotherapy
• Attend TIA Clinic and become confident with referral criteria
• Review posterior circulation stroke presentation and differentials
• Review Secondary Prevention lifestyle guidance
• Review stroke risk factor management eg AF
• Understand SALT assessments and management options
• Review and become familiar with as many CT Head reports as possible

• Attend at least one clinic for each joint (knee/hip/shoulder etc)
• Develop efficient examination techniques for all major joints
• Get used to discussions about knee and hip replacements (pros/cons/counselling etc)
• Understand as many self-help tips for common conditions as possible eg tennis elbow/planter fasciitis
• Fractured NOF (neck of femur) – understand post surgery issues/complications
• Become confident with Ottawa x-ray rules (knee/ankle/foot)
• Attend a couple of Physio sessions so you can advise what happens when referring
• Get used to analysing MRI reports (neck/spine/knee etc)
• Attend a Paediatric T&O clinic if possible
• Attempt joint injections if interested in doing as a GP in future

Nail these PDP goals, and you should be well on the way to becoming a fully competent GP trainee.

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