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Direct Observation of Procedural Skills (DOPs) are created to offer you constructive feedback on your ability to perform procedural skills required to for general practice. They are a mandatory component of your Workplace Based assessment component of your MRCGP exam. DOPs can be performed any time during your 3 year training. 

It is recommended to be carried out continuously within your rotations particularly performing relevant procedures depending on speciality, i.e. smear during gynaecology rotation or prostate examination during a urology rotation. Some doctors may inadvertently leave them for their final year to be performed. From experience it is advisable to perform as many as possible during the hospital setting rather than leaving them for your extremely busy final year. If you have been deemed to lack sufficient competent in a particular area, there is no harm to repeat the DOP again later in your training to show that you have improved within that field. 

Mandatory procedures
There are 8 compulsory procedures required prior to completing your MRCGP training. These include:
Female and male genital examination including prostate and cervical smears cannot be performed on a manikin and requires a real patient with consent. These can be performed with A&E or within general practice. Consider asking GPs or the practice nurse at your practice to invite you to carry out these procedure when they encounter a patient requiring it. You may want to consider contacting the local cytology clinic or GUM clinic to sit in and perform them there.

DOPS optional procedures
There are 11 other optional procedures that are recommended to perform that can provide additional evidence of your  clinical experience and exposure to a variety of procedures. These include:
  • Aspiration of effusion
  • Cauterisation
  • Cryotherapy
  • Curettage/shave excision
  • Excision of skin lesions
  • Incision and drainage of abscess
  • Joint and peri-articular injections
  • Hormone replacement implants
  • Proctoscopy
  • Suturing of skin wound
  • Taking skin surface specimens for mycology

GP trainees are required to seek out different observers for each DOPs performed. Within the hospital setting they can be Consultants, experienced registrars, staff grade doctors or nursing staff. Within general practice they may be your GP trainer, other GPs or nurses with the appropriate experience. You are not allowed to request your peers i.e. other GP trainees to observe you perform DOPs and you should avoid colleges who train in other specialities of similar training level.

How long should it take?
It is suggested that the DOP should take no longer than 10-20 minute with approximately 5-15 minutes for the actual assessment and at least 5 minutes for the feedback