The University of British Columbia

• Practical Issues with Your Residents

Welcoming a Resident to Your Office

Review Items for New Residents

The following items are suggestions of topics you may wish to discuss with your resident before beginning a rotation. If both the preceptor and resident understand the expectations of the rotation it will significantly reduce the chances of misunderstanding. Residents who clearly understand what is expected of them feel more comfortable in their rotation and are much less likely to display unprofessional behaviour.

Consider contacting your resident and arranging a meeting at your office or another comfortable setting where you won’t be rushed or distracted.

1. Introduce yourself

(and any of your colleagues who will be working with the resident)

Tell the resident how you and you colleagues would like to be addressed informally and when with patients and staff. Discuss any dress expectations you may have. You may remind the resident that your staff are an important part of your clinic team and should always be treated with respect. Residents should always use “please and thank you” when dealing with staff; a habit not always recognized in some cultures.

Consider giving the resident a list of names (and possibly pictures) of the physicians and staff at your clinic.

• Tell the resident about your particular interests and activities and those of your colleagues.
• If your colleagues have special interests or skills, be sure the resident is aware of any added opportunities.
• Explain the hours that the resident will spend with you and each of your colleagues through the week. Outline how holidays or absence for illness are managed.
• Discuss what can be learned from the office staff and how the resident can use “gap times” profitably to learn about scheduling, billing, doing referrals etc.

2. Get to know your resident

• Ask about your resident’s background. Possibly ask about his or her family, outside interests and involvements.
• The resident may wish to produce a poster with his or her picture and any information he or she feels appropriate to be displayed for patients to introduce themselves.
• Are there problems that they have had in previous rotations they would like to address? Are there areas of experience they feel they have missed? Have they felt they needed more feedback than they received? How do they like to receive feedback?

3.  Arrange an office visit

(before the resident starts)

• This can be done on a day before they start or on the starting day if appropriate time is allowed.
• This allows an unrushed proper introduction to staff and colleagues.
• Gives time to familiarize the resident with the office (lunchroom, washrooms, their work areas, emergency supplies etc.)

4. Discuss arrangements

(these may be needed for extra experience desired by the resident or not available through your practice)

• Do you do obstetrics or should the resident arrange to do half days with a community primary care obstetrics clinic?
• Are there half day longitudinal experiences the resident would like to have during the rotation?
• Would the resident be interested in a half day experience with other health care providers in your community such as pharmacy, optometry, physiotherapy, palliative care, home care nurse, diabetic clinic etc.

5. Define expectations

• Hours in the clinic:
  • when is the resident expected to arrive and until what time is he or she expected to stay? Is the resident expected to be in to review consultation letters and lab work before seeing patients?
  • If a resident is ill or late who should they call? And when?
• How will the resident take call for regular call and obstetrics? How is back up call arranged and how does the resident report about calls taken?
• How will the resident participate in hospital rounds, house calls or other work outside the office such as nursing home visits?
• Are there any other meetings or activities you expect (or invite) the resident to participate in?
• If the resident is in a situation where he or she needs your help how should they interrupt you? A knock on the door? Intercom? Wait for you to leave the exam room, except in emergencies?

6. Participation in Small Group Sessions

• If you participate in a Small group learning program, is the resident welcome to attend during his or her rotation? (often a very good experience for your group and the resident)

7. Review Objectives

• complete the objectives section at the beginning of the formal evaluation form
  • Be sure you understand the resident’s specific objectives for the rotation such as areas in which they feel weak and are looking for more experience. Possibly make a list of these objectives for your colleagues so they can also watch for opportunities to involve the resident.
  • Review with the resident the objectives you have for each of your residents in this rotation.
• Schedule a midterm and final evaluation meeting. Emphasize the importance of the midterm evaluation to your resident. If there are problems or concerns it is important that they are clarified and the resident knows what improvements need to be made by the end of the rotation. You should assure the resident that feedback will be regularly given throughout the rotation. A resident must be made aware of problems early in the rotation so he or she has an opportunity to take corrective measures. A poor evaluation should never be a “complete surprise”

8. Observations

• The resident should be aware that the College of FPs requires that they have 32 recorded observations over their 2 years of residency, 8 or which are video recorded. Discuss with the resident how they would like to be sure this is being done
• Consider observing the first patient of the afternoon (if appropriate), once a week as an official recorded observation. A regularly scheduled observation ensures they are done regularly.
• Review the observation forms
• The resident is responsible for arranging the equipment for his or her videotaped observation sessions.

9. Teaching styles

• We all have different teaching styles. Think about your teaching style and discuss it with the resident. Ideas you may wish to broach:
• I like it when learners:
  • Ask questions at the end of the day when we have more time to discuss them
  • Read up on topics before asking me questions
  • Ask me any questions at any time, so long as it doesn’t injure patient confidence.
• I encourage the use of PDAs but not during the patient encounter or while I’m talking with you
• Discuss “graduated responsibility” and teaching techniques with the resident. As the resident’s clinical skills improve he or she will require less supervision and should be given more responsibility. Teaching techniques should change as this progress takes place. Discuss with your resident how you will interact with them as they progress through the rotation. (You may use the “One minute preceptor” as a teaching technique regularly at the start of the rotation but deal with many patients with only a chart review towards the end of the rotation)

10. Patient List

(CFPC requirement)

• The resident should have a list of 10 patients for whom they assume primary responsibility during their rotation.
• Discuss how you will chose these patients. They can often be chosen by the resident as the rotation proceeds. Chronic conditions such as diabetes, CHF, renal failure and depression are good choices.
• Decide with the resident how you will ensure that he or she sees and deals with reports and other information pertaining to these patients. (How do you avoid these reports being filed without the resident seeing them?)

11. Review of resident set up in the office

• You may wish to review the document “Setting up your office for a resident” on the website.
• Be sure the resident knows where his or her working space is, where they can safely store their belongings, which computer they will be using, where patient information being held for them is being placed, etc.
• Review how your charts are set up. If you have an EMR the resident may need to come in for a short “seminar” to learn how to use it before their rotation begins.

• Having your resident work for you as a locum after graduation is a good opportunity for the resident and a “perk” for you. It is important that the resident is offered the locum is such as way as to ensure that the resident does not feel disadvantaged in his/her evaluation if he/she does not accept the offer.
  

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