The BMJ Guide: How To Get Into GP Training

The recruitment process for a GP ST1 post differs from other medical specialties and is overseen by the General Practice National Recruitment Office (GPNRO) across England, Scotland, Wales, and Northern Ireland. In 2020, 5,770 applications were submitted for 3,836 posts in the UK, giving rise to a competition ratio of 1.50 applications per place.

The first stage of the process to get into GP training involves completing an electronic application via the Oriel recruitment portal by the specified deadline for the specific recruitment year; dates and deadlines can be found on the GPNRO website. In order to be longlisted, you must meet the eligibility criteria as outlined in the person specifications on the GPNRO website; the main criteria include:

• Full registration with the GMC + license to practice by the time you start ST1

• Two years clinical experience by the time you start ST1 – e.g. FY1 and FY2, or internship + 1 year at SHO/F2 level

• Evidence of FY2 competencies

Make sure your application is complete with all sections filled in before submitting as you cannot make any changes afterwards, and incomplete applications will not be considered.

You will be notified of the outcome of your Oriel application directly on your Oriel account, so do check it regularly for any direct messages rather than relying on communications via email.

Once longlisted, you will move on to Stage 2, which requires you to sit a computerised entrance exam – the Multi-Specialty Recruitment Assessment (MSRA) – consisting of multiple-choice questions (MCQ) covering both clinical and professional dilemmas.

The professional dilemma paper consists of 50 situational judgement test (SJT) questions to be completed in 95 minutes, whilst the clinical problem-solving paper comprises 97 questions to be completed in 75 minutes. 

Under normal circumstances, you would be shortlisted to Stage 3 at a Selection Centre solely based on your score and ranking in the MSRA; this would involve three simulated consultations, each lasting ten minutes, and an essay-style question serving as a prioritisation exercise (30 minutes).

The top 10% of the cohort who sat the MSRA skip Stage 3 and are directly offered a training post. For the 2021-22 recruitment cycle, however, the Selection Centre assessment has been scrapped altogether and your MSRA score alone will determine whether you get an offer.

Job allocation will be based on your national ranking as well as preferences. Competitive places, such as London, Oxford, or Cambridge would need you to get the best score possible; a pass will not suffice.

GP Training Application Timeline

Normally, there are three rounds of recruitment annually – Round 1 (November/December; jobs starting the following August), Round 1 Re-Advert (February/March; jobs starting August the same year), and Round 2 (July/August; jobs starting the following February).

For the 2021-22 cycle, however, there will be no Round 1 Re-Advert. Round 2 jobs are those left unfilled from Round 1; although, posts tend to be limited, and some places will have no posts left at all. Specific dates for the 2021-22 recruitment cycle are summarised in the table below.

Table 1 GP ST1 Recruitment 2021-22 dates.

GP Training Curriculum

Training to be a GP usually takes at least three years and includes 18-24 months of working as a specialty registrar in a variety of hospital specialties – such as obstetrics and gynaecology, psychiatry, paediatrics – followed by 12-18 months as a GP specialty registrar in a general practice.

As part of the GPST programme, you will also be required to complete workplace-based assessment (WPBA), a professional capability framework that constitutes one of the three components of the Membership of the Royal College of General Practitioners (MRCGP) examination; the other components are the Applied Knowledge Test (AKT) and the Clinical Skills Assessment (CSA).

Once you have obtained full Membership of the RCGP (MRCGP), you will be awarded the certificate of completion of training (CCT) to go on to work as a consultant GP.

GP Training Salary

NHS junior doctor basic pay is the same for all specialties, including GPST, but varies between Scotland, England, Northern Ireland, and Wales owing to different junior doctor contracts. The pay scales for GP ST1-ST3 across the four home nations are summarised below.

Additionally, GP trainees are eligible for an annual flexible pay premia of £8,789 during ST1-ST3 placements – and ST4 if training takes longer than three years – since GPST is a hard-to-fill training programme.

Table 2 GP Training Salary in England (2016 contract; rates apply from April 1st 2020), Scotland (2002 contract; rates for 2019-20), Wales (2002 contract; rates for 2019-20), and Northern Ireland (2002 contract; rates for 2018-2019).

Resources

1. Applicant Guidance: General Practice ST1: Recruitment 2021-22. General Practice National Recruitment Office. Available from: https://gprecruitment.hee.nhs.uk/Portals/8/Documents/National/GP%20ST1%20Applicant%20Guidance%202021-22%20-%20FINAL.pdf?ver=gHHgW03K80KRDZDs-Fe3CA%3d%3d

2. General Practice ST1: Person Specifications. General Practice National Recruitment Office. Available from: https://specialtytraining.hee.nhs.uk/portals/1/Content/Person%20Specifications/General%20Practice/GENERAL%20PRACTICE%20-%20ST1%202021.pdf

3. General Practice National Recruitment Office. Available from: https://gprecruitment.hee.nhs.uk 

4. GP Training and Development. Healthcareer | NHS. Available from: https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/general-practice-gp/training-and-development 

5. Specialty Recruitment Competition Ratios [Internet]. Specialty Training | NHS. 2019. Available from: https://specialtytraining.hee.nhs.uk/Portals/1/Competition Ratios 2019_1.pdf 

6. Pay [Internet]. British Medical Association. Available from: https://www.bma.org.uk/pay-and-contracts/pay