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At the heart of general practice since 1960

'I spent my whole time recording what I needed to know but I never actually had the time to learn any of it'

Pulse's surreal blog 'Through the K hole' takes a caustic look at the sorry state of GP training

Pulse's surreal blog 'Through the K hole' takes a caustic look at the sorry state of GP training



Deaneries all over the UK have started to feel the squeeze. As society tightens its belt, SHAs have begun the unenviable task of downsizing their education budgets.

A group of current trainers and registrars were asked for their thoughts and opinions on general practice training and the changes that they felt would improve the programme for future doctors.

A skittish registrar who enjoys an excessive amount of hand-washing said: 'I shall never forget the first patient I ever saw in general practice - the whole experience completely freaked me out. He had a wisp of fine hair, answered all of my carefully selected questions with a gurgling noise and seemed to be oddly fascinated with his own feet. I assumed that the patient had a rare growth disorder and I was in the middle of ordering a complicated endocrine screen when my trainer helpfully pointed out that the patient was actually something which lay people term "a baby".'

'It probably won't come as much of a surprise when I say that I haven't had any paediatrics training since medical school, and even then I had a totally banging headache for the whole eight-week block and can't remember a f***ing thing.'

'Aside from paediatrics we need to be trained how to do the really important things in general practice, like cutting corners and fudging QOF points and ticking boxes and having the balls to take a blood pressure for the contract when your patient tells you that they're worried to death about skin cancer. I would also like to know how to tell patients to f**k off and die but in a really nice way. The sheer inadequacy of my training is beginning to weigh heavily on me.'

Sophie, a faintly annoying registrar whose hobbies include playing grade eight piano and being generally diligent, said: 'I worked really really hard during my three years of GPVTS. I managed to pass my AKT and CSA with the highest marks in my year and I meticulously ticked off all of the college's competencies. After showing such commitment to my profession, I can't wait to become a locum with no financial security - or if I'm really lucky I might be appointed to a salaried post which is really the career equivalent of a "partner's b*itch". I will have to do all of the bums-on-seat consulting whilst they cream off the profits and fatten up their pensions.'

'Please don't ask me any more questions because I might cry.'

A trainer speaking from behind a one-way mirror in Hartlepool said: 'I can't believe how utterly, utterly sh*t my current registrar is, and believe me I've trained up some sh*t over the years. I've been spying on him for the past six months and his main problem stems from the fact that English is something like his tenth language.'

'The truth of the matter is there simply aren't enough home-grown doctors. The medical men of yesteryear prefer to sit on their arses watching Jeremy Kyle drinking tinnies all day long. Why be unemployed when they could still have the option of doing that at medical school?'

Nigel, a GP registrar with a rather dubious collection of military memorabilia, said: 'I'm smart and white and homogeneous and even I can't pass the CSA. I failed it last time because I looked at a patient in the wrong way. I heard the assessor whispering something about a shortage of Chateau Petrus in the college wine cellar before he stuck a fat cross in my box.'

A sore knee from Croydon complained: 'It took the registrar at my practice three consultations and enough pain relief to kill a fox before I got referred to someone who knew what they were talking about. It's not easy being a knee you know, especially when the trainee can't tell the difference between a meniscal tear and a posterior ligament strain, which for a knee is like not being able to tell your arse from your elbow.'

Sophie concluded: 'The e-portfolio is a subliminal waste of time. It's a soft substitute for actual learning. I spent my whole time on the internet recording what I needed to know but I never actually had the time to learn any of it. I mean it's the sort of thing that would give even Kafka a headache. In fact the very last entry in my e-portfolio after having ticked off all of my core competencies was: "Learning need: The whole of f***ing medicine, full stop". I feel completely ill-equipped to deal with anyone's problems. Medical training has never felt so good.'

As GP training is blended into an increasingly homogenised soup, the toothless doctors of tomorrow will suck it up through their collective drinking straws and for the sake of future references they will just have to learn to keep quiet.

Written in response to: Millions stripped from funding for GP training Dr Kevin Hinkley is a GP in Aberdeen.

Click here for more from Through the K hole Through the K hole

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