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Independents' Day

Four year training a ‘gift to the next generation’ says Gerada

Extending GP training to four years will be the RCGP’s ‘gift to the next generation’, college chair Professor Clare Gerada has told GPs.

In her keynote speech to delegates at the RCGP’s annual conference in Glasgow, Professor Gerada said the proposals, which will now be considered by ministers after being accepted by Medical Education England last month, would enable the profession to ‘rise to the challenge of 21st century general practice’.

In a wide ranging and warmly received speech, Professor Gerada - who took to the stage in a Team GB jacket draped in a union flag - also urged general practice to channel the wisdom of ‘giants’ of the profession in order to safeguard an NHS ‘in distress’. 

She paid homage to forebearers Dr John Horder, Dr David Morrell and Dr Iona Heath, who she said could inspire future generations in this time of ‘triumph and turmoil’.

Professor Gerada said she was proud that the RCGP was the first medical institution to publicly oppose the white paper over health reforms, and said she cried when the NHS - a national treasure that should be treasured - was given centre stage at the Olympic opening ceremony.

Reflecting on the passage of the Health Act, Professor Gerada said the NHS was experiencing ‘the mother of all top down reorganisations’, after the reforms were ‘rushed through at breakneck speed and qualified by a thousand amendments, longer than a Tolstoy novel.’

‘As a result, our NHS is in distress. And so, too, are many of us,’ she warned.

She lamented the fact that despite making progress in scientific research meaning GPs were as likely to give methadone and insulin as their fore gave penicillin, the length of GP training has remained the same.

But she said four year training would be the College’s ‘gift to the next generation’ so they could ‘rise to the challenge of 21st century general practice.’

Professor Gerada described former RCGP president Dr John Horder, who died this year, as the father of modern general practice, who worked tirelessly to give general practice the same prestige as other medical specialisms. ‘His contribution to our profession is immeasurable’ she said.

Dr Morell, whom Professor Gerada trained under in the 1990s, was praised for being the first academic GP to become president of the BMA. Awarded a papal knighthood for his care of the sick and disabled, he also campaigned to take the profession ‘out of the mire of the marketplace to the high ground of professional medical care’, a challenge Professor Gerada said she still agreed with. 

Lastly, Professor Gerada quipped that current college president Dr Iona Heath was ‘not allowed to retire’.

‘She inspired me, as she has done many in this room. Generations of us have been moved by her writings, her speeches, her honesty an her values,’ she said.

Readers' comments (14)

  • If RCGP truly want to give the next generation a gift, I suggest they start looking else where. I had fantastic 12 months of training by a motivated and experienced trainer who prepared me well for when I qualified. I didn't think "gosh, I really could do with another 12 months of being a registrar".

    If RCGP wants to improve a newly qualified GP's then I suggest they reverse the current trend of more work and less pay in primary care. I would love to go on a diabetes post grad diploma course or dermatoscopy programme but I have neither time nor the income to afford such luxuries. Why not pay for a newly qualified GPs to be able to attend group meeting, courses, or even catching up with the old trainer - all of things I would have liked to have done and would have been helpful.

    Instead we are going to cocoon them for further 12 months. What they (and we, as the old wilting long qualified GPs) need is independence supported by appropriate opportunity for further training in the real world.

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  • Vinci Ho

    I 'cautiously' welcome this rather than with extreme euphoria . The whole GP training programme needs better structure.. Yes , giving people chances to do certain diplomas is good idea.

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  • I agree with all the above, we need better quality trained graduates and longer training does not in any way guarantee that in any way.

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  • There is already a serious lack of trainers and training practices in some parts of the country. Until this is addressed Dr Gerada's plans for extended training are pie in the sky.

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  • this will be great for partners as they can have an extra year of cheap labour!

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  • Peter Swinyard

    There is a risk of confusing length of training with quallity - as in length of appointments versus quality of the interaction. My concern is that newly qualified trainees are not seeking out partnership opportunities even when they exist - and the difficulty in many parts of the country in recruiting doctors with the commitment to become partners is threatening the future of the profession - we must emphasise the importance of continuity of care throughout training and the virtues of the partnership model of continuity of responsibility

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  • We recently advertised for a new partner. Worryingly for long-term General Practice recruitment 80% of the applicants were overseas graduates. Naturally all had MRCGP but few had any other postgraduate qualifications and NONE had acquired any other skills - coil fits/minor surgery etc. I just hope that GP training isn't about acquiring MRCGP and nothing else.

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  • Surely longer training is precisely to allow Registrars more time to study more advanced medicine? It can't just be taking an extra year to get to the same point. I imagine it is exactly because it's so hard to do advanced training once you get into the real world that this is being proposed.

    General practice is now about so much more than essential services and a newly qualified GP with no other skills will find it increasingly difficult to find work.

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  • No offence but anonymous above is a comment highlights the lack of understanding in general practice.

    We need people& work environment who are able to continually able to advance themselves whilst working. Its of little benefit to patients if GPs are only upto date at the point of CCT - they will be out dated in less than 5 years without the means to continually engage with moving medical care.

    Hence the problem here is not the length of training needed at the Regitrar level - its lack of resources to continue that education. Yes, adding an extra year to help the registrar is "helpful" to those that are there at the time but surely resources would be better spent looking at the bigger picture?

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  • Total Bluff. No matter what the RCGP says or dreams. It is upto the local programme and the trainer, How they encourage and educate the trainees. They treat GP Registrars, not as a registrar but as a cheap labourer. Denying exam leave, travel claim, causing lot of psychological distress, demotivation and adding extra pressure because of the exit exam. Some of the trainers are behaving as 100% blood sucking employers misusing registrars to do the clinical work like home visits like a bonded labour. There are so many hippocracies among the GP Trainers.
    I do not understand why these people become a trainer if do not want to help and support Trainees! May be for extra pair of cheap labour and few extra pounds.
    The change should be from the heart to make a real change in General Practice which is going to be very hard and almost impossible for some trainers.

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