Vocational training schemes in south London have been improved

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7037.1039b (Published 20 April 1996) Cite this as: BMJ 1996;312:1039
  1. Richard Savage,
  2. John Hitchens,
  3. David Misslebrook
  1. Course organiser, Guy's and St Thomas's vocational training scheme Course organiser, King's vocational training scheme Course organiser, Lewisham vocational training scheme South London Organisation of Vocational Training Schemes, St Thomas's Hospital, London SE1 7EH

    EDITOR,—Course organisers for vocational training schemes in general practice in south London have spent the past three years developing initiatives to deal with the problems described by Tess Harris and colleagues.1 The four training schemes in south London (Guy's, King's, Lewisham, and St Thomas's) have cooperated to form the South London Organisation of Vocational Training Schemes; we have been supported by Lambeth, Southwark and Lewisham Health Commission and have obtained funding for educational initiatives.

    The dearth of trainers, especially now that we are appointing more registrars in general practice, is more than compensated by the trainers' enthusiasm and skill and the quality of training that they offer to those who want to work in the inner city.

    We have used funding provided for educational initiatives within the London Implementation Zone to purchase protected time for education. We have provided more variety, flexibility, and community focus for hospital based training in general practice. We have created innovative posts that address problems of inner cities—for example, homelessness and drug misuse. We have been able to extend training based in general practice within the three year scheme when necessary.2 Research by the South London Organisation of Vocational Training Schemes has shown that many registrars do not feel ready to enter general practice after vocational training (C Vaughan, personal communication). We provide a fourth year of training in the form of a vocational training associate scheme, which addresses registrars' further learning needs while giving them time to gain experience and confidence in practice. This initiative, in its second year, has also been able to support 34 local practices under stress.

    These changes have allowed us to recruit a full complement of high quality registrars to our schemes and increase the number of locally trained doctors becoming principals in south London. The training issues have become too complex to be solved by appending general practice training to hospital training. We look forward to the results of the evaluation of our innovations. These results will inform the debate about developing excellent training for general practice that will supply highly trained general practitioners for inner cities into the next century.


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