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At the heart of general practice since 1960

Help yourself by taking on a student

Apart from financial incentives, taking a medical student under

your wing can be rewarding for all concerned – Dr Peter Saul explains

Despite Government propaganda, the number of GP whole-time equivalents is rising only sluggishly. The same can't be said about the number of medical students – there has been a 50 per cent increase in the past five years, and several new medical schools have opened.

All this is designed to produce more doctors and more GPs.

To get doctors interested in general practice we need to catch them young and 'crack' the hospital mould that is being built around them. This strategy fits well with the changing curricula of many medical schools where students are now frequently taught from an early stage in primary care settings.

Increasingly it is recognised that this type of experience is as valid educationally, and also more relevant, than traditional work on hospital wards. For a start, patients are seen as real people rather than disease conditions.

Central to these changes is the need by medical schools to find appropriate practices in which to place students. Enthusiasm on the part of the GPs is more important than being an 'academic' or having particular qualifications or experience in teaching or training. Usually, medical schools will offer appropriate training to involved GPs.

Students in practices may fall into two groups, those in their early years who are likely to need a more planned and structured involvement with the practice, and those who are well into clinical training who are perhaps the easiest to fit into the practice routine.

It is hard to be specific about what is expected from the practice because each medical school has a different programme. At the very least the practice will need to show students how the practice and associated primary care team members work and deliver care, and the rationale and philosophy behind this care.

Perhaps students are not so likely to see rare conditions, but the general practice setting will offer plenty of opportunities to see clinical problem solving and practise history-taking and examination skills.

The financial incentives can be good. Our practice takes students from the University of Wales College of Medicine based in Cardiff. We have one student three times a year for a six-week period. Payment is £6,000 and there was a set-up grant of £1,000 to get books and extra medical equipment as well as a laptop computer.

Because we are based near a district general hospital, accommodation is handled there. Other administrative matters and paperwork are negligible.

In practical terms what is needed is for all the practice team to agree to student placements and for most to be prepared to get involved. Students need to see how primary care works so they will need to 'shadow' team members and sit in on consultations.

Where appropriate they should have the opportunity to see some patients themselves, presenting the case to the GP and suggesting and discussing management. With our set-up formal tutorials are not required, although informal sessions based on the student's clinical experience occur quite often.

Space can be an issue because a room is often needed for the student to see a patient on their own. We've not found any problems with patients agreeing to see the student alone or when they are sitting in with the doctor, and all our students so far have been excellent and a pleasure to work with.

Apart from the financial inducements, my practice has found involvement in teaching students fun, interesting and challenging.

Medical schools are desperate to find motivated and interested practices. Useful contact points would be your local department of general practice or the undergraduate tutor at your local hospital. Geography is not critical so contacts with more distant medical schools can work too.

Don't be afraid to approach more than one school if you think what is being asked of the practice does not fit what you can deliver.

Who knows, increased exposure of students to primary care may go a long way to resolving our future recruitment crisis as well as being financially and intellectually rewarding to the GPs involved.

Peter Saul is a GP in Rhos, near Wrexham

Useful contact points for finding students

lLocal departments of general practice

lUndergraduate tutor at the local hospital

lMore distant medical schools

What a practice needs to take on a student

lEnthusiasm

lPreparedness to let student get involved, sit in on consultations, 'shadow' primary care team members, etc

lAdequate space in the surgery

lEnough books, surgical equipment, and possibly a laptop (remember, grants are available)

lSomewhere for student to live

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