Letters

Don't GPs have to be good clinicians any more?

EDITORI agree that the selection of doctors is far from perfect, but I am concerned that the emphasis shown by Patterson et al on key competencies for general practitioner registrars in Career focus will encourage the selection of politically correct candidates with little clinical acumen.¹

Of the 11 key competencies quoted, only one, remarkably, related to clinical skills. The other 10 competencies, all management related, could easily have been condensed into two or three. Aren't professional integrity, coping with pressure, and empathy and sensitivity personal attributes in the same way as motivation and flexibility are? Aren't organising and planning skills, legal and political awareness, problem solving, and communication skills also part of team involvement and managing others? And what on earth is conceptual thinking? In this new world of general practitioner training I am already feeling deficient.

I see a similar trend in my own hospital's training days in the vocational training scheme, and I am concerned that the general practitioners of tomorrow will become clinically weakened as a result. I have noticed a similar trend in my own specialty, where the exit exam is now dominated by management and research, with only a quarter of it given to clinical acumen.

Surely clinical skills and expertise are more important now than ever; this worrying trend must be checked before it takes over the undergraduate curriculum as well.

Adrian Fogarty, consultant in accident and emergency medicine. 
Royal Free Hospital, London NW3 2QG afogarty{at}btinternet.com