The Structure of GP Training in the UK

Author(s):  
Ramesh Mehay ◽  
Mike Tomson ◽  
Iain Lamb ◽  
James Meade ◽  
Malcolm Lewis
Keyword(s):  
The Uk ◽  
2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702773
Author(s):  
Kimberley Banner ◽  
Hugh Alberti ◽  
Jane Stewart

BackgroundRecruitment into general practice is falling and many training programmes in the UK have unfilled training posts. In 2016 NHS England pledged to increase the number of graduates entering GP training to 50%. However in 2017 only 15.3% of foundation year 2 doctors commenced general practice.AimThis work aims to understand medical students’ perceptions of a career in general practice, and how this may affect their career intentions.MethodAs part of a larger, longitudinal study at four UK universities. First and fourth year students were invited to a focus group to discuss their perceptions of a career in general practice. The recordings were transcribed and content analysis was performed.ResultsThe perceptions discussed could be broadly grouped into three categories. ‘The GP’ highlighted students’ ideas of the GP as someone who was dedicated, could create rapport, and wanted a family life. The ‘Job of the GP’ indicated students were positive about the continuity of care the job offered, but felt the work was isolating and paperwork heavy. Finally, external factors such as denigration and the ‘GP land’ concept also had an impact on students’ perceptions.ConclusionFurther work is needed to understand how these perceptions develop, how this may impact students career intentions, and how this research could be used to improve GP recruitment. This data will form part of a wider longitudinal study, the results of which will be analysed for themes and personal narratives of the students.


BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101034
Author(s):  
Emily Fletcher ◽  
John Campbell ◽  
Emma Pitchforth ◽  
Adrian Freeman ◽  
Leon Poltawski ◽  
...  

BackgroundThere are ambitious overseas recruitment targets to alleviate current GP shortages in the UK. GP training in European Economic Area (EEA) countries is recognised by the General Medical Council (GMC) as equivalent UK training; non-EEA GPs must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained GPs. The CEGPR may be a barrier to recruiting GPs from non-EEA countries. It is important to facilitate the most streamlined route into UK general practice while maintaining registration standards and patient safety.AimTo apply a previously published mapping methodology to four non-EEA countries: South Africa, US, Canada, and New Zealand.Design & settingDesk-based research was undertaken. This was supplemented with stakeholder interviews.MethodThe method consisted of: (1) a rapid review of 13 non-EEA countries using a structured mapping framework, and publicly available website content and country-based informant interviews; (2) mapping of five ‘domains’ of comparison between four overseas countries and the UK (healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation). Mapping of the domains involved desk-based research. A red, amber, or green (RAG) rating was applied to indicate the degree of alignment with the UK.ResultsAll four countries were rated ‘green’. Areas of differences that should be considered by regulatory authorities when designing streamlined CEGPR processes for these countries include: healthcare context (South Africa and US), CPD and revalidation (US, Canada, and South Africa), and assessments (New Zealand).ConclusionMapping these four non-EEA countries to the UK provides evidence of utility of the systematic method for comparing GP training between countries, and may support the UK’s ambitions to recruit more GPs to alleviate UK GP workforce pressures.


2019 ◽  
Vol 69 (685) ◽  
pp. e578-e585 ◽  
Author(s):  
Sharon Spooner ◽  
Louise Laverty ◽  
Kath Checkland

BackgroundThe capacity of the UK GP workforce has not kept pace with increasing primary care workloads. Although many doctors successfully complete GP specialty training programmes, some do not progress to work in NHS general practice.AimThis article explores the training experiences and perceptions of newly qualified GPs to understand how their education, training, and early experiences of work influence their career plans.Design and settingA qualitative study of doctors in their final year of GP training (ST3) and within 5 years of completion of GP training (F5).MethodParticipants across England were recruited through training programmes, First5 groups, and publicity using social media and networks. Open narrative interviews were conducted with individuals and focus groups. Audiorecorded interviews were transcribed, and a thematic analysis was supported by NVivo and situational analysis mapping techniques.ResultsFifteen participants engaged in individual interviews and 10 focus groups were carried out with a total of 63 participants. Most doctors reported that training programmes had prepared them to deal confidently with most aspects of routine clinical GP work. However, they felt underprepared for the additional roles of running a practice and in their understanding of wider NHS organisational structures. Doctors wished to avoid unacceptably heavy workloads and voiced concerns about the longer-term sustainability of general practice.ConclusionStrategies to attract and retain enough GPs to support delivery of comprehensive primary care should consider how doctors’ early career experiences influence their career intentions. A coherent plan is needed to improve their preparation and increase confidence that they can achieve a professionally satisfying, effective, and sustainable career in NHS general practice.


2021 ◽  
pp. BJGP.2021.0230
Author(s):  
Lucy Martin ◽  
Almuth McDowall

Background: With a continued crisis of increasing workload and reduced workforce in General Practice, supporting resilience is a key strategy for sustaining the profession for the future. Aim: How do GPs perceive professional resilience and what workplace factors influence it? Design and setting: A UK based qualitative study of the perspectives of GPs currently practicing in the UK with least five years’ experience after completion of GP training. Method: Participants were recruited using convenience sampling, including social media forums and underwent semi-structured interviews (n = 27). Data were analysed using thematic analysis. Results: Participants offered definitions of and influences on resilience which largely fit with existing research but in addition may result in GPs being perceived as obstructive, or that resilience may be a ‘surface act’. GPs agree that the current focus on methods of improving resilience does help support them but there is significantly more to be done in this field. Social media activity aiming at GP support may be counterproductive. Reduction of clinical working hours is a common strategy to improve resilience. Conclusion: That GPs feel to improve resilience they need to work fewer clinical hours may have huge implications for a workforce already in crisis; and ultimately for the healthcare of the UK population. Urgent research is needed to formulate a bespoke assessment for measuring GP resilience to assess potential interventions and identify GPs at risk of mental ill-health or leaving the profession.


2017 ◽  
Vol 67 (657) ◽  
pp. e248-e252 ◽  
Author(s):  
Hugh Alberti ◽  
Hannah L Randles ◽  
Alex Harding ◽  
Robert K McKinley

BackgroundIt has been suggested that the quantity of exposure to general practice teaching at medical school is associated with future choice of a career as a GP.Aim To examine the relationship between general practice exposure at medical school and the percentage of each school’s graduates appointed to a general practice training programme after foundation training (postgraduate years 1 and 2).Design and setting A quantitative study of 29 UK medical schools.MethodThe UK Foundation Programme Office (UKFPO) destination surveys of 2014 and 2015 were used to determine the percentage of graduates of each UK medical school who were appointed to a GP training programme after foundation year 2. The Spearman rank correlation was used to examine the correlation between these data and the number of sessions spent in placements in general practice at each medical school.ResultsA statistically significant association was demonstrated between the quantity of authentic general practice teaching at each medical school and the percentage of its graduates who entered GP training after foundation programme year 2 in both 2014 (correlation coefficient [r] 0.41, P = 0.027) and 2015 (r 0.3, P = 0.044). Authentic general practice teaching here is described as teaching in a practice with patient contact, in contrast to non-clinical sessions such as group tutorials in the medical school.DiscussionThe authors have demonstrated, for the first time in the UK, an association between the quantity of clinical GP teaching at medical school and entry to general practice training. This study suggests that an increased use of, and investment in, undergraduate general practice placements would help to ensure that the UK meets its target of 50% of medical graduates entering general practice.


BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen18X101640 ◽  
Author(s):  
Emily Fletcher ◽  
Anna Sansom ◽  
Emma Pitchforth ◽  
Gerens Curnow ◽  
Adrian Freeman ◽  
...  

BackgroundAmbitious overseas recruitment targets have been set by the UK government to help alleviate the current GP shortage. European Economic Area (EEA) doctors can join the UK’s GP register under European law. Non-EEA doctors must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained doctors. CEGPR applications can be time-consuming and burdensome. To meet overseas recruitment targets, it is important to facilitate the most efficient route into UK general practice while maintaining registration standards and patient safety.AimTo develop a methodology to map postgraduate GP training and healthcare contextual data from an overseas country to the UK.Design & settingDesk-based research and stakeholder interviews.MethodFour stages were undertaken: 1) developing a data collection template; 2) conducting a case study (using Australia as a test case); 3) refining the data collection template; and 4) creating a mapping framework. The case study used the 2016 curricula for the UK and Australia.ResultsFive ‘domains’ were identified: healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation. The final data collection template comprised 49 mapping items across the domains. The methodology incorporated the application of a red, amber, or green (RAG) rating to indicate similarity of data across the five domains. Australia was rated ‘green’ for training pathway, curriculum, and assessment, and ‘amber’ for healthcare context and CPD and revalidation. The overall rating was ‘green’.ConclusionImplementing this systematic methodology for mapping GP training between countries may support the UK’s ambitions to recruit more GPs, and alleviate current GP workforce pressures.


BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018520 ◽  
Author(s):  
Hugh Alberti ◽  
Kimberley Banner ◽  
Helen Collingwood ◽  
Kymberlee Merritt

ObjectivesFailure to recruit sufficient applicants to general practice (GP) training has been a problem both nationally and internationally for many years and undermining of GP is one possible contributing factor. The aim of our study was to ascertain what comments, both negative and positive, are being made in UK clinical settings to GP trainees about GP and to further explore these comments and their influence on career choice.MethodologyWe conducted a mixed methods study. We surveyed all foundation doctors and GP trainees within one region of Health Education England regarding any comments they experienced relating to a career in GP. We also conducted six focus groups with early GP trainees to discuss any comments that they experienced and whether these comments had any influence on their or others career choice.ResultsPositive comments reported by trainees centred around the concept that choosing GP is a positive, family-focused choice which facilities a good work–life balance. Workload was the most common negative comment, alongside the notion of being ‘just a GP’; the belief that GP is boring, a waste of training and a second-class career choice. The reasons for and origin of the comments are multifactorial in nature. Thematic analysis of the focus groups identified key factors such as previous exposure to and experience of GP, family members who were GPs, GP role models, demographics of the clinician and referral behaviour. Trainees perceived that negative comments may be discouraging others from choosing GP as a career.ConclusionOur study demonstrates that negative comments towards GP as a career do exist within clinical settings and are having a potential impact on poor recruitment rates to GP training. We have identified areas in which further negative comments could be prevented by changing perceptions of GP as a career. Additional time spent in GP as undergraduates and postgraduates, and positive GP role models, could particularly benefit recruitment. We recommend that undermining of GP as a career choice be approached with a zero-tolerance policy.


2000 ◽  
Vol 111 (1) ◽  
pp. 78-90 ◽  
Author(s):  
C. R. M. Hay ◽  
T. P. Baglin ◽  
P. W. Collins ◽  
F. G. H. Hill ◽  
D. M. Keeling

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