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Need help with getting through your preregistration year and revising for the registration assessment? Read on...

As a brand new preregistration year kicks off, Eamonn Joseph McArdle provides advice to new trainees on how to plan their training year and be prepared for the final assessment

Many trainees believe the best way to approach cross-sector or rotational placements is to write a check list stipulating what it is you wish to gain, learn and improve on during this learning opportunity

Many trainees believe the best way to approach cross-sector or rotational placements is to write a check list stipulating what it is you wish to gain, learn and improve on during this learning opportunity

The preregistration year is a vital year for all aspiring pharmacists. For many pharmacy graduates it may be the first time they have stepped inside a pharmacy other than during a university placement or as a customer. With this in mind, this article offers trainees some advice and tips on how to navigate this tricky year successfully.

The main difference between this year and those spent studying pharmacy at university is the time constraints. It is difficult at times to juggle the competing demands of work and study.

Time management and organisation are vital in the preregistration year. The often used phrase “Proper prior planning prevents poor performance” has never been more true than during your training year, with so many new experiences and areas to focus on and assimilate.

There are many areas requiring attention if you are to achieve the most from your training year. These areas can be found within the General Pharmaceutical Council’s preregistration manual as set out within the syllabus. It is important that you understand and cover the syllabus. It is easier if you break this down into manageable chunks. 

Performance standards

The performance standards are set by the GPhC and are required to be met successfully on completion of the 52-week training programme. They are listed alongside guidance within the GPhC preregistration manual. In total there are 76 standards set across three categories.

  • Personal effectiveness
  • Interpersonal skills
  • Medicines and health

To achieve competence, each standard must be met at least three times. However, some may be more obscure than others and, in essence, more difficult to “claim”. Thus, in order to ensure each one is met sufficiently, you should aim to spread the workload across a prolonged period and can do this as follows:

  1. Begin to show you can meet certain standards right away. From day one you will experience situations in which you may claim evidence. An early start will allow you to spread your workload, thereby reducing pressure as the registration assessment draws closer.
  2. In everyday practice you will come across a variety of situations which you may use as evidence to prove your competency in a certain niche area as laid out by the GPhC. Therefore, use a diary to log experiences and situations. This serves as a reminder of what standards have been achieved and, as you claim each standard, it enables you to tick this off. This also gives you an ongoing sense of achievement, which helps sustain morale. 

Cross-sector placements

In my experience as a former hospital preregistration trainee, my community cross-sector rotation was a key time that enabled me to gather knowledge in areas I would not have otherwise been exposed to and the converse would be true of those training in community and rotating to a hospital. Planning ahead is essential if you are to gain the optimal benefit from what are vital cross-sector rotations.

Many trainees believe the best way to approach cross-sector or rotational placements is to write a check list stipulating what it is you wish to gain, learn and improve on during this learning opportunity. It may be the only occasion during which you get to focus on areas you maybe feel slightly less confident on. Personally my community cross-sector “to-learn” list included an array of different topics, including:

  1. Over-the-counter age limitations and referral points
  2. Responsible pharmacist protocol and procedures
  3. Emergency hormonal contraception

Reference sources

Familiarity with reference sources is vital because these will inevitably crop up in the registration assessment in some respect. The three main reference sources used throughout the year are:

MEP

Revising the Royal Pharmaceutical Society’s ‘Medicines, ethics and practice’ guide can, at first glance, seem mundane and a little tedious. But there are ways around this. One method is to compile simple quizzes organised by a fellow trainee on a weekly basis focusing on certain areas such as Controlled Drug regulations.

BNF and BNFC

The reference sources stipulated for use within the open book paper are the British National Formulary and the BNF for Children. A key factor in scoring well on the open book paper is the ability to locate information from within the reference sources in an efficient manner. To do this it is imperative that you understand how to navigate and source information.

Tagging the BNF is one way to ease navigation. Using colour coded labels you can tag certain areas and pages, as well as highlight and annotate specific information that is deemed to be important. See BNF tag list panel for more details. It is also useful from my own experience to read the BNF.

 

 

BNF and BNFC

Below is what I tagged in my British National Formulary and BNF for Children. You may of course add to this what you wish because it is not an exhaustive list:

•    Palliative care section (especially conversion of morphine to diamorphine)

•    Vaccines section

•    Interactions section

•    Liver disease section

•    Renal impairment section

•    Pregnancy section

•    Breastfeeding section

•    Intravenous additives section

•    Cautionary and advisory labels section

•    Nurse prescribers formulary section

•    Dentist formulary section

•    Weight conversion chart

•    Dressings, urinary products and stoma care

•    Misoprostol and women of child-bearing age

•    Aminosalicylates and blood disorders

•    Hypertension guidelines

•    Summary of antibacterial therapy table

•    Summary of antibacterial prophylaxis table

•    Anti-tuberculosis drugs

•    Potencies of topical corticosteroids

•    Oral contraceptive pills

•    Guidelines for management of hyperkalaemia

•    ACBS (borderline) products

•    Helicobacter pylori eradication table

•    Target international normalised ratio ranges

•    British Thoracic Society guidelines for asthma

•    Post-immunisation pyrexia guidelines


Other important BNF and BNFC points worth noting and learning fall under the following the sub-sections:

-    CSM warnings and advice  eg, asthma and beta-blocker use

-    Hepatotoxic drugs eg, sodium valproate

-    Drugs that colour urine  eg, rifampicin colours the urine red-orange

-    Drugs that may cause agranulocytosis  eg, carbimazole

 

Study days

Although you be may be undertaking a placement year in a different area of pharmacy from your peers, it is important to ensure that you are able to use their opinions and views.

Study days offer a brief respite from the working aspect of the training year but are just as important in your development. Often there will be regional study days that trainees will attend, focusing on an array of skills, from calculations to minor ailments, and more. At these sessions you meet trainees who will be keen to brainstorm ideas and help each other. Setting up a network of peers or a focus group is one way in which you can enhance your preparation for the registration assessment.

The purpose of focus groups is to bring any of your own areas of perceived weakness to the table and allow a peer to teach you the problem area. Many trainees find focus groups particularly useful with regard to calculations, which require a great deal of understanding.

The preregistration year is a time during which we make a transition from university student to accountable professional. There are times throughout the course of the year that may seem difficult and stressful, but the end product — registration — is truly rewarding.

I hope this article has helped you understand the breadth of the knowledge required in relation to the preregistration year and that you all achieve the utmost from the year to move forward to the next stage of your career.

 

 

Aides-memoire

With so many drugs to remember, especially with regard to interactions, it can be useful to arrange drugs into simple aides-memoire. These can be personal to you. However, there are plenty of current existing ones which can be useful.

Two of the big classes of drugs that will be tested on during your registration assessment are enzyme inducers and enzyme inhibitors. In order to remember which of these certain drugs are we can use two simple aides-memoire:

Drugs which are enzyme inhibitors: ICE VIDEOS

IMIDAZOLE                                                            VALPROATE                                        

CIMETIDINE (CIPROFLOXACIN/CICLOSPORIN)            ISONIAZIDE

ERYTHROMYCIN                                                       DISULFIRAM

ETHANOL

OMEPRAZOLE

SULPHONAMIDES

Other enzyme inhibitors include amiodarone, metronidazole, fluoxetine and verapamil.

 

Drugs which are enzyme inducers: RPSGB SNEC

RIFAMPICIN                        SMOKING (NICOTINE)

PHENYTOIN                        NEVIRAPINE   

ST JOHNS WORT                ETHANOL (CHRONIC)

GRISEOFULVIN                   CARBAMAZEPINE

BARBITURATES

 

 

Five Tips for success

1)    Keep a diary — organisation is essential

2)    Remember the key is in “P” — plan early and practise regularly

3)    Never be afraid to ask questions — they may prove your most efficient learning tool

4)    Be proactive

5)    Preregistration training is a milestone year, so smile and make sure you enjoy it

 

Eamonn Joseph McArdle is a newly registered pharmacist

 



 

 

 

Citation: Tomorrow's Pharmacist URI: 11125167

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