Training for house officersBMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6921.136d (Published 08 January 1994) Cite this as: BMJ 1994;308:136
EDITOR, - In a survey of preregistration house officers in eight English regions Jonathan H Gillard and colleagues found that 61% of respondents disagreed or strongly diagreed with the prospect of four months in general practice in the preregistration year.1 Lisson Grove Health Centre has been taking preregistration house officers from St Mary's Hospital, London, for four month rotations in general practice since 1981. The 30 doctors who did the rotation in the first 10 years of the scheme were recently sent a questionnaire to evaluate it; 26 questionnaires were returned (response rate 87%). When asked if they would recommend the general practice rotation to a friend 24 respondents (92%) said yes, compared with 57% in Gillard and colleagues' study. Another question asked if the doctors had ever regretted missing four months of hospital medicine and surgery; 25 respondents had not. The general practice house officers work a 40 hour week (excluding on call), receive up to three hours of individual tuition a week, and spend nearly 60% of their working day with patients.
I conclude that house officers who have no direct experience of preregistration house jobs in general practice are, understandably, nervous about the prospect. Doctors who have experienced such a rotation have a different view. I find it particularly sad that the doctors questioned in Gillard and colleagues' study had negative views about a house job in general practice when they were critical of their hospital rotations. A house job in general practice would at least provide them with an opportunity to explore an alternative to house jobs in hospital. Gillard and colleagues discussed the educational implications of their findings: there were serious deficiencies in the education the house officers received in post; and the house officers performed inappropriate tasks and worked excessive hours.
If changes are required to improve the quality of the preregistration year (more contact with patients, more teaching specifically for house officers, a shorter working day, fewer inappropriate duties) I suggest that introducing a general practice rotation would be an effective way of doing this.