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At the heart of general practice since 1960

GPs face massive culture shift under training revamp

By Gareth Iacobucci

GP registrars would make up as much as a fifth of the general practice workforce under plans for a radical shake up of training.

The huge cultural shift is set out in an RCGP report for the Government, setting out the business case for extending GP speciality training from three to five years.

Current three year programmes did not sufficiently equip trainees for the complexities of general practice, and might lead to a lack of confidence, ‘over-referring and over-prescribing' the college said.

It claimed to have almost unanimous support for the plans, which would change the ratio of GPs to registrars in the average practice from more than 15:1 to as low as 4:1.

But the college admitted its plans would require new funding for practices to house registrars, who would spend three years in the practice setting.

The new report, on how to take forward the Sir John Tooke's recommendations for GP training, was requested by the Department of Health. It recommends the new system should come into force in England [check] in 2011, with the first cohort of newly trained GPs ready by 2016.

In Scotland, a significant number of trainees have already been offered four year training programmes, starting last August.

But GPs north of the border said while they supported the move, practices did need resources to ensure it was a success.

Dr Richard Williams, a GP in Edinburgh and chair of Lothian LMC, said: ‘GPs and training is a hot topic. It does need to be a five year, and properly funded and supported.'

Dr Gregor Purdie, a GP in Castle Douglas, said his LMC was also calling on the Government to invest in the proposals.

‘Practices need to be financially underpinned to be able to undertake this extra training,' he said.

The RCGP report predicts that, if the UK introduced a five year training programme, there would be in total 9,900 registrars in general practice at any one time, as well as Foundation doctors and medical students.

But it warns the current shift away from the traditional partner model could lead to an erosion of GPs skills, making a revamp essential to avoid a downgrading of quality. ‘If this employment situation continues there is a risk that GP skills will be eroded.'

RCGP: proposing major extension of GP training RCGP: proposing major extension of GP training

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