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Fire the Medical Schools Council if you want more GPs

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6245 (Published 28 October 2014) Cite this as: BMJ 2014;349:g6245

Rapid Response:

The cross political party aim to increase the number of doctors working as GPs in the United Kingdom comes from a real drive of care in the community (along with predictable rhetoric to obtain votes). In the wake of recent high profiles campaigns from the BMA “Your GP cares campaign” (1) and the RCGP “Put Patients First” (2) some of the challenges facing general practice are becoming widespread known by the public. The workload of GPs has increased, with relative income decreasing. A recent BMA quarterly tracker survey (3) revealed that 72.8% of GPs think their workload is unmanageable and that GPs had lowest scores for work life balance and morale than any of the other doctors who responded. This is a difficult climate to be a GP supervising medical students attempting to encourage them into this field of medicine.

As Mr Wakefield wrote it has been reported that the UK Government aims to have around 50% of medical graduates working as GPs however a smaller percentage of medical students actually plan a career in general practice. (4) Across the United Kingdom that there are many more training jobs numbers in general practice than other specialities and for the first time ever an extra third round of GP recruitment occurred in England in 2014 aiming to fill training posts – despite this extra round some training jobs in general practice remained vacant. (5)

As a GP with the privilege of supervising medical students on an ad hoc basis during their primary care attachments (often one to one teaching) I am left in a slight quandary when discussing their career choices. I estimate that approximately 50% of the medical students I teach are completely undecided about their career path and roughly 20% mention they want to (or have not ruled out) becoming a GP. This is of course purely my recollection of what medical students reported verbally to me (they may have an agenda to make their placement easier) however it leaves me as a supervisor in a difficult position about guiding them to maximise their career opportunities.

If an undergraduate is undedicated about their career path and asks my advice I mention the above facts and suggest they consider tailoring their CV away from general practice. This advice is solely based on supply and demand - if a speciality such as general practice has many more training jobs relative to other specialities and is struggling to recruit to these training jobs the undecided medical student is likely to have an opportunity to train as a GP in future. However if the undecided medical student tailors their CV towards primary care at this stage they are potentially unintentionally ruling out opportunities to train in other specialities.

It is of interest when I ran a popular search engine at the time of writing with the term “medical student uk” on page 1 a link encouraging medical students to gain student membership with the Royal College of Physicians of London was prominent whereas no such RCGP link encouraging student membership was present.

The career as a GP has the potential to be extremely rewarding diverse career with many job opportunities in the community, doctoring at sporting events, the options to work as a GP with a specialist interest and the advantage of not being tied down to having to live close to a tertiary hospital. Rather than continuously stressing the ever increasing workload in general practice I strive to lead by example, inspiring students to follow a rewarding career as a GP.

1 Your GP cares campaign. BMA http://bma.org.uk/working-for-change/your-gp-cares last accessed 25/11/14
2 Put Patients First: Back General Practice. RCGP http://www.rcgp.org.uk/campaign-home.aspx last accessed 25/11/14
3 BMA quarterly tracker survey. Current views from across the medical profession. Quarter 3: July/August 2014. http://offlinehbpl.hbpl.co.uk/NewsAttachments/PGH/BMA_quarterly_report.pdf last accessed 25/11/14
4 Wakeford, R., 2014. Fire the Medical Schools Council if you want more GPs. BMJ, p. 349:g6245. http://www.bmj.com/content/349/bmj.g6245 last accessed 25/11/14
5 Millet D. Third round of GP trainee recruitment cost £113,000 to fill 72 posts. GP Online. November 2014 http://www.gponline.com/third-round-gp-trainee-recruitment-cost-113000-f... last accessed 25/11/14

Competing interests: No competing interests

25 November 2014
Christopher J Weatherburn
Academic Fellow in General Practice
University of Dundee
Tayside Centre for General Practice