European GPs raise profile

BMJ 1994; 309 doi: (Published 05 November 1994) Cite this as: BMJ 1994;309:1186
  1. T Richards

    All doctors should have postgraduate training in general practice before they start higher training schemes, says a European consensus report on future training in general practice. Those who then wish to become general practitioners will have to undergo a further three years' training, half of which should be in general practice.

    The duration of this mandatory exposure to general practice is not specified, but doctors could be asked to do a preregistration job in general practice in addition to the traditional ones in medicine and surgery.

    The consensus report on guidelines for general practice training was drawn up at a conference last month in Copenhagen led by the European Union of General Practitioners in collaboration with the World Health Organisation of Family Practitioners and other European academic general practice organisations.

    The impetus for the guidelines is the fact that next year the European Commission's Advisory Committee on Medical Training will be looking at how member states are implementing the European Union directive on specific training for general practice and reporting back its findings to the European Council together with suggestions on how the directive should be updated. First drawn up in 1986, the directive comes into force next January and stipulates that all doctors working as general practitioners in national security systems must have undergone a minimum of two years' full time training in general practice (29 October, p 1163).

    Although Britain has a three year training scheme, it has not met another requirement of the directive that each country must state to which of its general practitioners who have not been vocationally trained (this includes assistants and locums) it is going to give “acquired rights” to continue to practise. “Britain is not alone in waiting until the eleventh hour before letting us know about this,” said Laxmy Reilly, secretary to the advisory committee. “Six other countries have not yet made their intention clear either.”

    Different approaches to training reflect different attitudes in the role and standing of general practitioners in the different health care systems of Europe. Programmes currently range between 0-5 years, with Sweden, Switzerland, and Norway having the longest training requirements.

    Immediate reaction to the report has been positive. “I think it has great potential for improving the training and education of GPs throughout Europe, and this is an essential step towards raising standards of care,” said Dr Philip Evans of the international committee of the Royal College of General Practitioners.

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