It has become increasingly apparent that concern is being expressed by trainees and trainers about the effects that the COVID-19 pandemic will have on the required outpatient experience within Internal Medicine Training (IMT).
While the delivery of out-patient care has certainly changed in many areas the basic capabilities that are outlined in the updated Rough Guide to Internal Medicine Training are still pertinent although patient encounters may not be directly face to face. Remote consultation may count towards acquisition of clinical CiP4 and as outlined below in this extract from the Rough Guide there are many features that may be experienced both in face to face and remote consultations. Indeed, it may be seen that this document anticipated the increased involvement in telemedicine which has now become far more commonplace as the pandemic has developed.
Trainees may not have been able to experience 20 out-patient clinics this year but at the ARCP this should be reflected in the outcome given and there should be adequate time in the rest of the IMT programme to acquire the relevant capabilities. Review at the next ARCP will determine how well the trainee is progressing and what further experience may be required.
For those that have been and will be able to take part in virtual outpatient clinics it is suggested that any assessments undertaken should include the educational objectives that are pertinent for a traditional outpatient clinic but could also include:
- To understand specific aspects of confidentiality and privacy associated with remote consultation and practical aspects including the organisation of relevant tests
- To understand the decision making involved in virtual outpatient clinics, including the need for and place of review
- To be able to manage unexpected events within a remote consultation e.g. unexpected symptoms or signs
- To be able to communicate and empathise with patients in a virtual/remote setting.