BMJ Qual Improv Report 6: doi:10.1136/bmjquality.u221836.w8226
  • BMJ Quality Improvement Programme

Improving Outpatient Clinic Experience for Core Medical Trainees

  1. Catherine Zhu
  1. Royal Free Hospital
  1. Correspondence to Natalie King natalie.king14{at}
  • Received 12 December 2016
  • Revision requested 3 February 2017
  • Revised 21 February 2017
  • Published 27 March 2017


Outpatient clinic experience is an important component of core medical training. Trainees are expected to attend up to 40 clinics, with a minimum requirement of 24, over the two-year programme. 1 Yet on a local and national level they have reported difficulties with attending even the minimum number of clinics, largely due to ward commitments and service demands. 5 A survey of local core medical trainees revealed a baseline mean clinic attendance of 0.5 clinics per month, with only 13% of trainees having attended the minimum number of clinics. The project aimed to increase the mean clinic attendance to one clinic per month, which would enable trainees to meet their curriculum requirements.

Clinic attendance data was collected from core medical trainees at two-monthly intervals, to coincide with rotation changeover. The problem was initially discussed at our local medical faculty meeting and interventions were proposed. Firstly, an up to date clinic timetable was distributed and consultants encouraged to invite their trainees to clinic. Subsequently a clinic booking system was implemented, to enable trainees to arrange protected time in which to attend outpatient clinics. This intervention was unsuccessful in improving clinic attendance. A revised system of pre-allocating protected clinic time was therefore devised and implemented, which resulted in an increase in clinic attendance figures to above the target. Trainees have been allocated clinic days for the rest of the year, which should enable them to meet their curriculum requirements.

Through the use of PDSA cycles, we were able to rapidly determine the effect of our interventions and make improvements that have led to an increase in trainee clinic attendance. This is a sustainable model that could be easily implemented by other hospital trusts for core medical trainees.

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