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Shropshire Vocational Training Scheme's (VTS) traditional structure of peer-delivered teaching had received poor feedback from trainees. There is good evidence in the literature for stakeholder engagement in training design and participation in small group learning and case discussion as a bedrock of GP learning in the VTS. We introduced three new initiatives to improve half-day release (HDR): 1. collaborative course design; 2. reflective, case-based learning with flipped learning resources; and 3. peer-facilitated, small groups. The aim was to marry trainees' desire for clinical context with the need to comprehensively cover the professional knowledge, skills and attitudes of the 'Being a GP' Royal College of General Practitioner's curriculum.The new collaborative model has improved feedback, facilitated high-level small group reflection and resulted in a smooth transition to virtual HDR during Covid-19. We now have a cohort of highly motivated facilitators, with the opportunity to develop leadership skills, and a bank of complex clinical cases developed to facilitate useful, trainee-led, case-based discussion.Our model is deliverable in other VTS areas and could enhance trainee experience of HDR. Future challenges will be maintaining facilitator training, quality control for cases and discussion and how to ensure our near-peer facilitators successfully become future leaders in primary care.

Little has changed in much of general practice for the last 20 years, despite the evolution of PCTs, CCGs, STPs, and PCNs. COVID-19 has shown us innovation can happen quickly with the money and shared agenda to drive it. It’s proved we can be flexible and successfully collaborate across localities. As a 20-something millennial GP trainee, the sudden talk about the future of primary care is exciting. I once heard a futurologist say, ‘Don’t ask “what will it look like down line?” ask “what do you want it to look like?”’ I may not yet be in a position to orchestrate significant service redesign, but I can tell you what I would like my work place and career to look like. It may come as a surprise, but I’m not entirely against partnership responsibility. I like leading projects, discussing improvements to patient care, and understanding financial management …

OBJECTIVES: To explore the relationship between academic performance, extracurricular activity, and quality of life at medical school in the UK to aid our understanding of students' work-life balance. METHODS: A cross-sectional study, using an electronic questionnaire distributed to UK final year medical students across 20 medical schools (4478 students). Participants reported the hours of self-regulated learning and extracurricular activities undertaken each year at medical school; along with their academic decile (1 = highest, 10 = lowest). Self-reported quality of life (QoL) was assessed using an established screening tool (7 = highest, 1 = lowest). RESULTS: Seven hundred responses were obtained, across 20 participating medical schools, response rate 16% (700/4478). Factors associated with higher academic achievement were: graduate entry course students (2 deciles higher, p < 0.0001), more hours academic study during term and revision periods (rho=-0.1, p < 0.01), and involvement in teaching or research. Increased hours of study was associated with lower QoL (rho = -0.13, p < 0.01). CONCLUSIONS: Study skills may be more important than duration spent studying, for academic achievement and QoL. Graduate-entry students attain higher decile scores despite similar self-reported duration of study.

Background Endoscopy activity has been increasing in the UK for many years. However, the increasing demand is currently disproportionate to delivered capacity. This, in combination with mandatory efficiency savings, presents an ongoing challenge in the effective continued delivery of diagnostic endoscopy services. Recent developments New initiatives in the field of endoscopy that may impact on resource include: faecal immunochemical test, straight to test referral systems, nurse endoscopists, home enemas and split dose bowel preparation. Future potential System review and improvement is paramount to ensure the diagnostic pathway is of a high clinical quality, efficient, patient focused and sustainable.