What to expect from CBM: Fifth year

Written by Dr Annie Ellis F1

I really enjoyed my 5th year CBM placement. I think at first it can be quite scary, as its probably the placement holding the most responsibility throughout the whole 5 years and on most of your CBM days there are no other students to hide behind. On the flip side, it’s also the one that feels most like being a doctor and in that respect is very exciting! On the group CBM days, it’s a great time to learn from your colleagues and from their experiences in placement as they can differ quite a lot depending on the practice structure and your GP tutor.

My 5th year group CBM GP was great at letting us practice roleplay scenarios. We did so many we stopped being nervous to do them and it gave us a safe space to practice difficult conversations or how we would tackle tricky consultations. She even brought in her 2-year-old daughter so we could practice examining a small child without the pressure of being in a consultation, which was much appreciated!

Here are my top tips for getting the most out of 5th year CBM, hope they’re useful!

• Get there early; turning up a few minutes early will give you chance to log on to the computer (there may well be IT issues you didn’t account for) and it helps avoid starting the first patient late, which could have a knock-on effect for the whole day.

• If a patient comes in with multiple issues, don’t be afraid to tell them you can only address one today; it is better to solve one problem properly. Even with half an hour to see each patient, you’ll be surprised how quickly that goes!

• Be thorough; spend at least 15-20 minutes seeing your patient before you call the GP in to review them – they won’t mind you taking your time as they will be more impressed when you haven’t missed things.

• Try and be active when an investigation clearly needs to be done; for example, if someone is complaining of dysuria, you probably don’t need the GP’s permission to ask the patient to do a urine sample – get it done before calling the GP in.

• Ask for feedback from your patients; there are feedback forms you can hand out to your patients and these can be useful to help you find out areas to improve.

• Try to follow your patients up; for example, if they have come in with depression and will need following up after 2 weeks, ask your GP if they could be booked in with you. It is better for the patient to have consistency, but it also is more satisfying for you.

• Make the most of your lunch breaks; the timetable at GP means you should have a gap of at least a couple of hours in the middle of the day. I personally really enjoyed home visits so I tended to join whichever clinician was going out to the patient’s homes and care homes. Equally, it can be a great quiet time to get out those revision notes or textbooks.