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A faulty production line

Dr Maureen Baker: Medical schools have a responsibility to 'big up' general practice

RCGP chair Dr Maureen Baker says medical schools need to promote general practice as it’s one of the most rewarding and diverse jobs in the world.

Being a GP is one of the most rewarding, interesting and diverse jobs in the world – and medical schools have a responsibility to ‘big up’ general practice to ensure that we are attracting sufficient numbers and that we do not lose out to other medical specialties.

We need vibrant marketing campaigns to show medical students what a fulfilling and intellectually stimulating career choice general practice really is.

Our 2015 election manifesto also calls for financial incentives, effectively a ‘teach first’ scheme for the NHS, to encourage medical graduates to train as GPs and then practise in areas that currently do not have enough family doctors but where patients need us most.

General practice is currently grappling with unprecedented workload and workforce pressures. We are making 340 million patient consultations a year – 40 million more than five years ago – and there is no doubt that some medical students are being put off from entering the profession because they hear about GPs working longer hours and seeing more and more patients to try and meet demand.

We urgently need increased funding and at least 10,000 more GPs by 2020. But the tide does seem to be turning, as demonstrated by the positive proposals for the future of general practice announced by NHS England last week.

There is an expectation that support for general practice will be materially better within a few years and medical schools should be working with students to ensure they are aware of the opportunities and challenges of a career as a GP.

Being a GP is certainly the most varied job in medicine. We are carrying out treatments in general practice that 10 years ago would have been immediately referred to a hospital physician and as more care is shifted from hospitals to primary care, we believe it is the best job in medicine for the 21st century.

General practice is the cornerstone of the NHS and it is imperative that all those working in medical education do their duty to promote being a GP as the first choice for medical students, for the sake of our patients and for the future sustainability of the NHS.

Dr Maureen Baker is chair of the RCGP

Readers' comments (5)

  • Quite right. My daughter is a medical student contemplating what she should do at the end of her course. She tells me that the prevailing view of General Practice is overwhelmingly negative, something you would only do if you can't get a better job.

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  • medical schools have a responsibility to ‘big up’ general practice

    What a laugh. I didn't meet many deluded stupid or liars at medical school!
    There's nothing to 'big up' about the career and job.
    Medicine is a wonderful profession, my daughter is embarking on getting entrance to it but there should be no medical school daft enough to promote the 'job' as it is.

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  • Azeem Majeed

    The current recruitment and workforce problems in NHS general practice in the UK are not because of the actions of medical schools.

    Newly-qualified doctors are not applying for general practice training schemes and established general practitioners are retiring early because the working conditions of general practitioners have deteriorated substantially in recent years. The volume and complexity of the work that general practitioners are asked to do has increased; and many general practices have seen large reductions in their practice budgets. [1]

    It is the Department of Health and NHS England (and their equivalents in the devolved nations) who are responsible for this, not medical schools. Medical schools do have a role in promoting primary care but ultimately, it is only through a fairer funding mechanism for general practice in which workload as well as population health needs are taken into account that we can address the current problems in UK primary care.[2]

    1. Majeed A, Rawaf S, De Maeseneer J. Primary care in England: coping with financial austerity. Br J Gen Pract. 2012 Dec;62(605):625-6.
    2. Majeed A. General practice in the United Kingdom: meeting the challenges of the early 21st century. J R Soc Med October 2013 vol. 106 no. 10 384-385.

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  • Azeem may be right, but addressing things at medical school is one of many ways in which the problem should be being addressed.

    There still seems to be a prevailing view that GP is a 'second best' medical school and beyond.

    I remember when I was asking for references for my GP application- and all the consultants and supervisors said how 'disappointing' it was, and one even said I 'ought to be far to ambitious for that'... an interesting view given that GP has enabled me to pursue a unique academic opportunity that would not have been available otherwise.

    ...I don't think there are any simple solutions. Encouraging better representation of GP in stakeholder organisations (e.g. MSC as advocated by Richard Wakeford in his recent BMJ piece), increasing the exposure that medical students and foundation doctors have to GP, improving the nature of the job (cf. the RCGP and BMA campaigns) and helping to change public perception of the profession could all help...but social change is not easily achieved, and certainly not quickly.

    Since starting my GP rotation- I can see how different my experience is now as a GP registrar than as it was as an FY2, and as a medical student. The job does have pressures, and does have challenges- as all areas of medicine do. However, I find aspects of GP uniquely rewarding and enjoyable, and didn't find myself deriving the same enjoyment from any of my hospital jobs. When it boils down to me, my patients, and good holistic medicine- the day to day job is actually fun, enjoyable and rewarding.

    There are systems, means, and indeed professionals who take on roles to deal with the bureaucracy that can detract from this...but it need not be something to drag us all down, and it is certainly not something unique to GP (although I am in full support of the campaigns to increase support for GP!). Seeing how things are from a referral point of view, or talking with colleagues from other disciplines, it is only too clear that the NHS as a whole has been undermined, undervalued and underreported by the structures (government, and society at large to a certain extent) that it exists to serve.

    Perhaps I am still too 'fresh faced' and naive. I look forward to Mondays, and enjoy the rich interaction I have with my patients, and see challenges as an opportunity to develop and explore solutions. Something that we are uniquely positioned and empowered to do. This should be a real selling point.

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  • "Big up" General Practice - hmmmmmm..... you are caught between Ofsted - style inspections, an accusatory Government, a venal, dishonest and GP - hating press, hotel-style anonymous feedback on the internet about your consulting style (or anything else, for that matter), the possibility of being referred to NCAS which can interrogate you and inspect you to the nth degree.... and of course you can be closed down if the CQC see something they don't like. You are told what to do by NICE and treated like a criminal if you think their advice is daft.....FUN!!!!! And of course quite soon your income will be on the front page of the local paper. Yes - diverse and interesting - a wide variety of ways to be bashed over the head in public! I think the Government and Press needs total transformation of its attitude towards GPs. Without massive attitudinal change there, can anyone really honestly recommend this as a job?

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