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GPs go forth

GP settings in medical school imagery 'significantly underrepresented'

Medical schools significantly underrepresent community settings in their imagery which could 'undermine' recruitment efforts, new research has found.

Despite the ongoing national drive to recruit more GPs, there is much greater promotion of hospital-based settings within medical school prospectuses. 

The journal Perspectives on Medical Education looked at 650 images, depicting 1,817 people, from websites and prospectuses of 33 medical schools in the UK.

Researchers found that only 2% of these were centred on community placements, compared to the 24% that were hospital-themed.

The report said: 'Medical schools are signalling to students a strong preference for hospital-based settings, despite a strong national drive to recruit more general practitioners.

'Community specialists were significantly underrepresented in the images portrayed, compared with hospital specialists. Of the 108 people who were assumed to be a doctor, only 10 of them were assumed to ahve a community-based specialty.'

The report added: 'Statistics from NHS Digital regarding full-time equivalents for GPs and hospital consultants, show GPs made up 41.95%, and hospital consultants make up 58.05% of senior doctors, meaning the percentages shown in this research of 9.26% for community-based doctors and 90.74% for hospital doctors fall significantly short of the comparator data.'

It follows a similar study in 2009, which also showed that community placements were underrepresented. The authors suggested this showed the 'phenomenon' had not changed in the last nine years. 

The research said: 'This builds on the signals medical schools are sending with the overall theme of the image, and image theory suggests that this longstanding preference for hospital-based images may be putting off potential students from choosing general practice as their specialty.'

The study also showed that medical schools also fail to represent ethnicity, 'leading to incorrect signalling about the ethnic makeup of their students'. 

It found that 'no group of medical schools was accurately representing the proportions expected for ethnicity'. 

The research said: 'The photos have a significant potential to be negatively influencing peoples' decision making by violating fundamental values around diversity and equality.'

The authors deemed the underrepresentation of community settings in the images ‘surprising’, due to the challenges currently faced by recruitment in UK general practice, adding that it may ‘undermine the recent initiatives by regulatory bodies and universities’.

Professor Simon Gregory, deputy medical director of primary and integrated care at Health Education England, said: ‘Health Education England and Medical Schools Council identified this in the work of the Commission led by Prof Val Wass which reported as 'by Choice, not by chance'.

‘The second recommendation was, develop, promote and disseminate positive, realistic awareness and understanding of general practice to pupils in primary and secondary education.

‘The use of realistic imagery is vital to this. HEE also prioritised general practice in the allocation of the recent expansion of medical student numbers and the opening of five new medical schools.

‘These two pieces of work are bringing about significant change in the presentation of GP in medical schools which will be realised in coming years.’

It follows measures last year by the University of Worcester to boost general practice exposure in its degree course with the hope of producing more GPs. Third year students in Wales were also offered the chance to spend the whole year in general practice as part of a scheme to address the shortfall of GPs in rural areas. 

Readers' comments (4)

  • At the rate we're going at there wont be many GPs left so perhaps 'not seeing them' in a prospectus is more accurate and merely reflects the future....

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  • Ultimately its what you want to do in life and not what the government/HEE/DHS/NHSI/NHSE wants you to do just because there is a workforce shortage in a certain speciality. Gauging from previous responses from these bodies in the past they are just knee jerk reactions. They keep proving that history repeats itssel, in ten years time these same bodies would be encouraging people to come into hospital medicine, in fact its already happening- acute medicine/ a&e. The reason for all the misery and unhappiness in medicine is because of these misguided policies. LET NOW START THINKING FROM THE TRAINEES PERSPECTIVE, WHAT DO THEY WANT? FOR ONCE

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  • But it is not just about the pictures. It reflects institutional bias against primary care to the detriment of patient care. Too much training in medical schools has not changed in the last 40 years. This make it not fit for purpose now let alone for the next decade, when major changes will come through innovation, technology and artificial intelligence.

    PS only 5.6% of professors in medicine are primary care.

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  • perhaps its time to have medical schools for hospital consultants and medicals schools for primary care specialists only - now there's a thought. don't like the one you have to retrain in the other.

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