College and associate college tutor network regional spotlight series – Wales

Facts and figures for Wales – December 2020

In Wales:

• Wales have seven health boards and 17 teaching hospitals
• There are currently 160 internal medicine trainees for years 1 and 2 (IMT1 and IMT2) in Wales. When the IMT3s rotate and start in August 2021 we will have a full programme of 230 trainees in core medicine. There are approximately 310 higher medicine trainees in Wales
• We have four regional advisers (RAs), 15 CTs and 24 ACTs
• Over a third of RCP members in Wales identify as BAME
• Currently we have one chief registrar, but there is the opportunity for others to be recruited
• The overall winner of the Turner-Warwick lecturer scheme in 2020 was Dr Alexandra Phillips, IMT1 at the University Hospital of Wales, Cardiff
• We are using RCP resources to hold meetings with CTs and ACTs, RCP regional representatives and HEIW (head of school and the specialty training manager) every 6 weeks throughout the COVID-19 pandemic. These online meetings allow the sharing of ideas and initiatives to help support each other during the pandemic.

Here are a few examples of good practice in Wales:

• With the input of local ACTs, a series of induction videos are being created to support new IMTs in Wales. These videos will cover a variety of topics relevant to IMTs in Wales, to include the eportfolio, assessment and the ARCP process.
• Two initiatives to support running simulation exercises: Firstly, in conjunction with hospitals in England, Morriston Hospital in Swansea Bay Health Board has created a multi-platform model to support online procedural skills for IMTs. Secondly, a website created by consultants at Cwm Taf Morgannwg University Health Board provides a database of suitable simulation scenarios to enable good quality simulation sessions to be easily run with a minimum of specialist equipment. Scenarios are based on the IMT curriculum and have been submitted by a variety of healthcare practitioners including trainees. A poster presentation on this project won a highly commended award at the Society of Acute Medicine spring meeting in Amsterdam, 2018.
• We have pioneered a programme for regional training by working with the RCP trainee reps and ‘The Core’ (an online tool to support IMTs in Wales). The ‘Call the medical registrar’ session moved online in 2020. Created to help support doctors in the transition to becoming the medical registrar, the 2020 session was attended by 175 doctors throughout the UK.
• ‘The Core’ was created in 2016 and is used to support IM trainees in Wales with hospital-specific information and resources to aid training. It has won multiple awards and prizes for its creators.
• Through the joint RCP and Society of Physicians in Wales (SoPW) annual abstract competition, trainees are encouraged to submit an application and poster presentation. This year, many posters involved initiatives in individual health boards for managing the impact of COVID-19. You can download the 2020 abstract booklet here. Examples of poster presentations awarded highly commended in the online 2020 iteration of the competition include the following:
  • Avoiding overuse of inpatient cardiac telemetry
  • A prospective audit on compliance with perioperative safety checklists for venous thromboembolism prophylaxis: a closed-loop audit
  • Signed, sealed, delivered; but who’s your doctor?
  • Inter-departmental, multidisciplinary COVID-19 patient simulation exercise, ‘Pandemic plans made at the pub’
  • Communication challenges during COVID-19: what can we do better?
  • Knowledge and self-perception of competence in dermatology among interim foundation doctors in Morriston Hospital
  • Impact of COVID-19 on cardiology services in Nevill Hall Hospital and reimagining the service in new normal
  • The impact of face-to-face pulmonary rehabilitation on the recovery of patients who have been diagnosed with severe COVID-19 requiring non-invasive and invasive ventilation
  • ‘Face time’ for the first time – video communication between relatives and junior doctors in the COVID-19 pandemic
  • Improving consent form completion for skin surgery
  • A new communication tool introduced on medical wards during COVID-19: a quality improvement initiative
  • A novel approach to an organised teaching programme during the COVID-19 pandemic
  • Cheat sheets for medicine – negotiating the challenges of redeployment

The winners for 2020 were:

First place - Dr Sacha Moore, Royal Gwent Hospital

Second place - Dr Madhu Kannan, and Dr Kate Edwards, Aneurin Bevan UHB

Third place - Dr Samuel Telfort, Dr Charlotte Gilbert and Dr Devu Nair, Princess of Wales Hospital

Best COVID-19-related presentation - Dr Katey Beggan and Dr Aine Jones, Princess of Wales Hospital

How Wales responded to COVID-19:

Since the start of the COVID-19 pandemic we have been involved in a number of initiatives to support the response, including:

• Development of a variety of teaching sessions to support trainees, both in theory, their usual jobs and in their redeployed roles. These included the creation of trainee-led, 10-minute teaching sessions in a COVID-safe environment and supporting safe teaching sessions during COVID-19 pandemic.
• In conjunction with the Bevan Commission, Hywel Dda University Health Board is developing a platform to bring together the variety of wellbeing and mental health support initiatives to support NHS staff in Wales. The intent is to refocus and publicise these resources, and to bring them to the attention of staff earlier.
• Health boards, associate college tutors (with the support of other trainees) have been involved in creating junior CoVID-19 rotas that support safe staffing levels on the wards while also dealing with the added pressures of significant increases in patient numbers.
• Development of resources for redeployed doctors to support them in medical specialties. Examples include ‘Cheat sheets for medicine’ and ‘Handbook of medical emergencies’.

Our new regional spotlight series focuses on different regions and aims to share issues and examples of good practice raised among college tutors and associate college tutors (CTs and ACTs).

A problem shared helps everyone to improve training and support all of our tutor community.