Education And Debate

Integrating undergraduate and postgraduate education in general practice: experience in Tayside

BMJ 1995; 310 doi: (Published 17 June 1995) Cite this as: BMJ 1995;310:1577
  1. John Bain, professora,
  2. Robin Scott, regional advisera,
  3. David Snadden, senior lecturera
  1. a Tayside Centre for General Practice, Westgate Health Centre, Dundee DD2 1AU
  1. Correspondence to: Professor Bain.
  • Accepted 24 March 1995

Several forces have resulted in the creation in Tayside of the first formally integrated unit of undergraduate and postgraduate education in general practice in the United Kingdom. Forces that helped this integration included the desire for change, national developments in education, financial support through funds set aside to cover the additional cost of teaching, and a management structure which concentrates on shared leadership. Forces that hindered the integration included uneasiness about ideas for reforming traditional structures, institutional inertia, the complexity of financial arrangements, and tensions over priorities. The experience of managing institutional changes in Tayside has been invaluable and will lead to a more cohesive approach to undergraduate teaching, postgraduate training, and the provision of services relevant to the development of general practice.


General practice, despite its short academic pedigree, has increasingly featured in British medical schools over the past 25 years.1 2 3 4 5 6 Vocational training for general practice has a similarly short history: training was regulated by statute only in 1980, and this led to the formal creation of support networks of regional and associate advisers. Responsibility for undergraduate and postgraduate education has remained within two separate organisations, and some people believe that this separation has impeded development of the discipline of general practice.7 8 With recommendations for changes in medical education,9 10 11 12 opportunities existed to test the feasibility of creating an integrated unit which would embrace both undergraduate education and postgraduate training in general practice.


The original university department of general practice in Dundee was based in a practice with two core staff, who, in addition to academic duties, had responsibility for 2500 patients. The postgraduate department of general practice operated in parallel with the university department and was responsible for the vocational training scheme and continuing medical education. It …

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