GP CPD – Essential for a successful career
How to get smarter at collecting gp cpd credits, and enjoy your cpd activities!
Taking part in GP cpd (general practice continuing professional development) is a necessity for all family physicians and medical GPs in order to practice. But more than that I believe it’s the foundation for maintaining good medical practice throughout our careers. Do you agree? Do you enjoy cpd ? Do you see it as a chore or an opportunity? How much variety do you plan into your general practice cpd activities? Are you aware of the wide variety of offline and online gp cpd courses, gp updates and primary care cpd conferences that exist today? How do you maintain a healthy balance regarding your personal choice of gp cpd topics and cpd activities? How can you be smarter and more efficient, and save precious time and money with your efforts collecting gp cpd points? All of this and more will be discussed and covered in this article and subsequent linked articles.
What is general practice cpd and what are the gp cpd requirements?
General practice continuing professional development is the name given to the career long discipline of keeping up to date with relevant advances in the understanding and treatment of medical conditions and diseases that are relevant to primary care. Indeed there is a requirement to keep abreast of best medical practices and the latest evidence based guidelines to help maintain the standard of care given to patients in the primary care setting. This requirement forms part of the annual appraisal process and five yearly revalidation in order to maintain a licence to practice medicine in the UK.
As primary care physicians we are required to show evidence of a minimum of 50 gp cpd credits per year (or 250 over five years) for our appraisal and revalidation. Similar requirements exist in countries elsewhere in Europe and beyond. This regular investment of time in educational activities which help to continually update general medical practitioners is also referred to as continuing medical education (cme). Many colleagues use the terms interchangeably.
Importance of medical cpd for general practitioners
Not only is there the professional requirement to collect gp cpd credits for our annual gp appraisal folder and assessment, but we need to keep up with cpd for our own sakes. Indeed without continually developing and updating our knowledge as medical professionals we can easily fall behind in so many areas. I’ve got personal experience of this.
When I started working as a freelance gp locum, after leaving a full time practice partnership, the new stark reality of no paid sick leave, no paid annual leave, no sickness insurance ie no work means no pay, meant I often missed out on gp cpd meetings and general practice conferences as I didn’t wish to take time out of a working day. Even a ‘free’ gp cpd conference half or full day event meant losing a half or full day’s pay, so there was a real financial cost to me personally.
And in the evenings I had a family, and anyway was tired and didn’t like the idea of driving off to a pharma sponsored local gp cpd meeting, never mind lacking the energy or enthusiasm. In that first eighteen months as a locum I barely scraped together enough gp cpd credits. I was helped in large part by gp cpd points which were assigned to my efforts developing an online physiotherapy video website which thankfully counted towards my cpd credits total, and got me ‘over the line’.
Missing regular local gp cpd meetings and national primary care cme conferences over that time seemed to cause me to perceive I was losing touch and falling behind, which became a stress in itself. Once I got back to doing some personal self-directed learning for my cpd, and attending several days of general practice cpd symposia and conferences I felt much better about things.
But how much of this feeling of getting ‘out of touch’ was a distorted perception or psychological and to what extent was I ‘not keeping up’? I’ll never know. It probably doesn’t matter but the effect was that I felt I wasn’t able to do the best for the patients I saw. I don’t need this additional and unnecessary stress.
Importance of gp cpd for patients
This leads onto the second main point I’m keen to highlight here, the patients we see have a right to a reasonable standard of care from me or any primary care practitioner. How can I possibly deliver a ‘reasonable standard of care’ if I’m out of touch and out of date with current perceived best practices in primary care management of the spectrum of medical conditions and scenarios we face each week in our work.
Having sat on the other side of the desk so to speak, as a patient myself, a few more times than I wish in recent years, I’ve certainly hoped and expected the doctor seeing me is ‘on the ball’ and ‘at the top of his game’. This expectation increases when I’ve had reason to accompany my mother or my wife as the patient which has happened on several occasions in recent times.
There is research suggesting that physicians who do not invest adequate time in relevant and appropriate gp cpd activities to help stay ‘up to date’ tend to be at higher risk of prescribing inappropriately. Such doctors also exhibit a tendency to over or under investigate their patients, and can over or under refer to secondary care for more specialist assessment. As a result there is greater chance of these patients not receiving appropriate care, and also likelihood that limited NHS resources are used inefficiently or inappropriately, hence indirectly compromising other patients access to the same limited resources.
GP cpd ideas and how to choose your cpd activity
A great way to target personally relevant cpd for general practice is to keep a daily /weekly record of PUNs (patient unmet needs) and DENs (doctors educational needs) during day to day work. These will crop up during consultations and can be added to a list ad hoc. This list can be used to target self-directed learning as a great form of personal cpd. I’ve taken to using a text document on my computer’s desktop screen at work, to record PUNs and DENs as they occur. However my enthusiasm for this was dented as I worked in different practices and kept starting a new document on each screen I used. Not to be defeated I had to change my system, and use a ‘memory’ stick thingy to save the document that I could attach and detach from whichever computer I was working at.
Another very useful way to target your gp cpd choices is at the time of your last appraisal. And a third way I’ve heard suggested is quite counter-intuitive. This method encourages the colleague to deliberately select topics they are not seemingly interested in, especially at primary care cme conferences where there may be three or four parallel learning streams to choose from. Apparently there’s a tendency to stay within our comfort zones and naturally not venture out of them when it comes to cpd topics unless we make a conscious effort to do so. I tried this at a ‘Pulse Live’ event a couple of years ago and was pleasantly surprised afterwards, despite being somewhat cynical beforehand.
GP cpd courses – online or offline?
I prefer a mix of both online gp cpd courses and offline gp cpd meetings. Attending organised physical gp cme /cpd meetings for gp updates also allows the valuable opportunity for catching up with colleagues, and networking, and there’s usually also the opportunity to ask questions of the speaker. Primary care cme conferences require travel. Travel time to and from the venue means there’s a time cost even if the meeting is otherwise a ‘free’ gp cpd meeting. The other issue with free gp cpd courses and meetings is the sponsorship aspect. Many primary care cme conferences and symposia are sponsored by the pharmaceutical industry, and even though according to their own regulatory body this is ‘arms-length sponsorship’ ,often the speaker is chosen by or is a preferred speaker for that sponsoring organisation. I know many colleagues who prefer not to attend pharma sponsored meetings. I also know many others who have no problem with pharma sponsorship at all, and still others who feel somewhat uncomfortable about the pharma sponsorship, but set those misgivings to one side for the sake of ‘free’ gp cpd credits.
Joining and taking part in a self-directed learning group (SDLG) is another option for physical meetings for gp cpd but there needs to be someone willing to do the organising and cajoling to get group members to attend. Often group members will take turns sharing clinical cases for discussion or presenting on a topic they have researched. There also needs to be a system for ensuring the information shared or presented is accurate / up to date. The success of small group self-directed learning depends very much on the appetite and willingness to contribute of it’s members. Other benefits go beyond cpd and many SDLG members develop social relationships and gain social support which is known to be a key asset for their individual psychological resilience to stress .
When it comes to online gp cpd there are a variety of e-learning opportunities for the savvy gp. Many websites have gp cpd online modules, usually written material, followed by mcq assessment. The quality can vary, but the same applies to physical meetings, some are free and some paid, and you will wish to check how ‘up to date’ the online learning resource is – just because it’s online, doesn’t necessarily mean it’s up to date. Webinars or webcasts are a more recent and growing subset of online gp cpd options. General practitioner cpd webinars are described in more detail below, and seem to combine the convenience of online learning, that can be done at home (no travel time /costs), along with the advantages of a traditional cpd speaker meeting (listening to an expert and interacting with live surveys, poll questions and the ability to ask questions and get answers). Webinars for online gp cpd seem to be an exciting addition to the online learning options for gps as they are a truly interactive online cpd learning experience.
The smartest most efficient gp cpd method
I suppose logically the smartest way to collect those valuable gp cpd points in terms of time efficiency would be to avoid any wasteful travel time and discipline myself to do regular self-directed learning from home for cpd and cme and take part in online gp cpd activities. However personally I much prefer live and interactive online learning with web based seminars, or ‘webinars’ as they are called for my online gp cpd.
With cpd webinars for gp updates I’m attending a virtual speaker meeting and in effect have a front row seat (but without any awkward self-consciousness) so can easily see any slides used. Just as importantly on a live webinar I can type in questions as they arise and get them answered.
Another big plus with using webinars for collecting gp cpd credits is that I’m not travelling to or from any physical meeting venue, so I’m less likely to be late, less stressed, more relaxed, and generally in a better frame of mind for learning. Webinars are location independent for attendees, using internet and an audio enabled device (smartphone, i-pad, laptop or desktop computer) so I can do it from home ensuring I sit in my preferred comfy seat, with a beverage of my choice!
General practice continuing professional development is a requirement to practice as a doctor and also a necessity in order to keep abreast of medical developments and advances and so do the best we can for our patients. We benefit hugely from cpd as do our patients. Likewise the risks associated with not taking part in cpd activities is significant, again both for doctor and patient. There are many gp cpd choices, both in terms of topics and a number of different ways of accessing and taking part in cpd, both online and offline. In order to be useful for an individual clinician the cpd needs to be relevant to personal needs and type of work undertaken. Recording PUNs and DENs is a very useful habit, but only if one then uses them for directed cpd efforts. This would appear to be an ideal cpd method to follow. Accessing interactive web based seminars (webinars) for cpd has many advantages over traditional gp cpd meetings, not least savings in travel time and costs. This emerging platform for general practice cpd is not yet widely known or appreciated, but shows much promise.