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LEARNING IN PRACTICE: Jan Illing, Tim van Zwanenberg, William F Cunningham, George Taylor, Cath O'Halloran, and Richard Prescott Preregistration house officers in general practice: review of evidence BMJ 2003; 326: 1019-1022 [Abstract] [Full text]

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PRHOs and SHOs in General Practice

Stephen M McGrath   (20 May 2003)

Re: PRHOs and SHOs in General Practice

Simon Fountain-Polley   (21 May 2003)

PRHOs and SHOs in General Practice 20 May 2003
Stephen M McGrath, SHO Trafford General Hospital, Davyhulme, Manchester, M41 9BE Send response to journal: Re: PRHOs and SHOs in General Practice	Editor I think any move to encourage General Practice experience in the basic training of all doctors should be welcomed by all concerned. My own experiences (case report?) probably rate poorly in terms of strength of evidence (compared to the paper by Illing et al) but when I was undertaking a General Medicine post following a GP placement some of my collegues never seemed to be amazed by the enthusiasm with which I described the speciality. I often found myself fighting the GP corner when there were mutterings about the perceived quality and validity of a particular admission. I would remember fondly the way certain patients would keep booking in to see me even though I would regularly leave them studying the wallpaper whilst I sought advice from one of the partners. The way in which I had to almost re-learn to take a history was a very humbling experience. Supporting the type (and great number) of patients who never even grace a hospital but who have some very important needs was an education in the much wider roles of doctor and patient. I had to employ restraint in ordering arguably unnecessary tests, develop and trust my clinical impressions in new ways, and nurture levels of mutual co- operation and management planning with patients that I'd not experienced before. Many juniors will tell you a job in A&E is invaluable but having done both posts I for one will argue the equalling deserving case for General Practice. The obvious problem is a curent lack of placements. I'm also not convinced that the NHS (trainee numbers) can afford to let too many junior doctors escape into the community for six months; many SHOs are still working on a Band 3 basis. We can but hope. Competing interests:   None declared
Re: PRHOs and SHOs in General Practice 21 May 2003
Simon Fountain-Polley, SHO Paediatrics UHW, Cardiff, CF4 4XW Send response to journal: Re: Re: PRHOs and SHOs in General Practice	Editor Having undertaken a pre-registration house officer year involving General Practice, it was interesting to see the outcome of Iling et al's article. My time in General Practice influenced and enhanced my training. It has given me an insight into the problems faced by GP's, and so hopefully improved my daily dealings with them. Probably the most important aspect of the General Practice post was the luxurious amount of time spent with patients. The beauty of GP placements is that if I wanted to take a history for an hour, I could. At no other time in my relatively short career have I been able to really explore a person's problems, and then examine any or all of their systems in detail. A doctor's communication, history-taking , and examination skills can only benefit from this; and it provides a breathing space to practice all those attributes and techniques that are learnt in medical school. General Practice placements would benefit all doctors - whatever their career intentions. Competing interests:   None declared