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Education bosses launch landmark review into GP attitude in medical schools

Education bosses will launch a review on attitudes and exposure to general practice in medical schools as a first step to developing a strategy for improving undergraduates’ experience of the profession.

In a presentation of its business plan for 2016/17, Health Education England has said it was launching a review after GP leaders condemned the ‘toxic’ anti-GP culture that persists in some UK medical schools, and has seen undergraduates told if they ‘fail they risk becoming GPs.’

HEE’s action plan said it aims to ‘review the profile of the GP career in medical schools, publish a report and recommendations and develop a strategy for implementation’ as a key deliverable. 

The GPC told Pulse that they were represented on the review group and had recently run a symposium with stakeholders in GP undergraduate training to identify what problems persist.

The ‘task and finish group’ has been commissioned by HEE and the Medical Schools Council, which last year said it was working with the RCGP to promote general practice, and that its members had made a ‘commitment’ to articulate the importance of general practice to students.

That committment followed comments by RCGP chair Dr Maureen Baker, who said there was a ‘toxic anti-GP culture’ in universities, which has to be addressed before the gaps in GP postgraduate training can be fixed. 

But this was undermined when Sir John Oldham, chair of the Independent Commission on Whole-Person Care and a GP in Glossop, reported that a medical school dean had told an intake of students that ‘We work you hard because we don’t want you to fail and become GPs’.

And last November NHS England director of primary care commissioning Dr David Geddes said that general practice ‘prejudice’ needed to be ‘stamped out’ at all levels of training, ‘because we need far more GPs than we need more consultants’.

A HEE spokesperson said: ’Health Education England invited Professor Val Wass to chair a working group which is co-sponsored between HEE and Medical Schools Council. This group will report in the summer. It has extensive involvement of medical students, trainees, GP bodies and medical schools.’

Dr Krishna Kasaraneni, chair of the GPC’s education, workforce and training subcommittee, told Pulse: ‘This is about trying to look at the culture in medical schools themselves, and how can we improve the quality of general practice training and education at undergraduate level. So hopefully, with positive experiences in general practice, medical students will choose general practice again.

‘This isn’t a shotgun solution because culture change is much more difficult to achieve. At least if we get the ball rolling, then 10-20 years down the road there will be many more students in general practice.’

Dr Baker said: ’We have been calling for any anti-GP rhetoric that might exist in UK medical school to be tackled for some time, so we welcome this review by Health Education England, and look forward to working with them to shape its outcome.’

Pulse revealed last week that the Department of Health was looking to reform funding for training placements in general practice at all stages of medical education.

But the negative publciity from the Government’s ongoing dispute with junior doctors has taken a toll with applications to medical schools dropping 13.5% in two years, even before Jeremy Hunt announced he would impose a new contract requiring routine weekend working. 

How to solve a problem like GP recruitment?

Professor Bill Irish - online

Professor Bill Irish - online

Research shows that undergraduates are now spending 14% less learning time in general practice than in 2004.

 Then-chair of the GP National Recruitment Office, Professor Bill Irish, pointed the finger at long-established medical schools in Oxford, Cambridge and London failing to train the best candidates for GP specialist training.

A GP Taskforce report, which HEE had been accused of burying, suggested medical schools should be incentivised for boosting recruitment.

But despite this recognition, applications for GP specialty training have fallen 5% in this year’s first recruitment round, following 11% of training places were again left vacant last year.

Readers' comments (30)

  • Yes it is all about spin and presentation. Nothing to do with the facts about the job.
    Medical students are stupid gullible fools with no independent thought who can't work out which specialties they should enter and mistake banter for real life. They actually think orthopaedic doctors are carpenters and that GPs are weak willed morons that somehow hoodwinked the entry process into medical school.

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  • Medical students can judge for themselves whether to join a profession trying to survive in a sewer. And sixth formers are choosing not to even train as a doctor!

    Until NHSE makes all NHS jobs less stressful and, believe it or not, create some enjoyment in the job recruitment will only get worse.

    Perhaps NHSE and trusts will throw open the door to doctors and nurses from Russia and Cuba......

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  • Azeem Majeed

    Medical schools could do more to promote general practice as a career for their graduates, but the current recruitment and workforce problems in NHS general practice in the UK are not caused by the actions of medical schools. These problems are relatively recent: 5-10 years ago, there was little difficulty in recruiting GPs. Newly qualified doctors are not applying for general practice training schemes and established GPs are retiring early because GPs’ working conditions have deteriorated substantially in recent years. The volume and complexity of their work has increased, and many general practices have seen large reductions in their practice budgets. The Department of Health and NHS England (and their equivalents in the devolved nations) are responsible for this, not medical schools. Medical schools do have a role in promoting careers in general practice, but the current problems in UK primary care can be rectified only when workload and funding issues in primary care have been addressed and the job of a GP is seen as more attractive to medical graduates.

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  • Medical students can figure out for themselves what they want to do. There has been a "toxic anti-GP culture "for years in many med schools but GP recruitment varies depending on the terms and conditions of the job. Often a pompous consultant who is anti-GP actually helps our recruitment. Focus on sorting out the job and trainees will come.

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  • Pay them and they will come.

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  • it's not even about the money anymore.

    this job is about as enjoyable as pulling my own toenails out with pliers.

    this job is depressing.

    it's harmful to the physical and mental health of those that do it.

    if they want to ban rugby in schools - they should definitely ban medical students coming anywhere near general practice for their own safety.

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  • I wouldnt advise anyone to do medicince as a degree at the moment.The way we are all being treated,tuition fees,juniors/ senior contract etc etc.the only reason at the moment to do medicine is to use it as a gate way to an alternative or to leave the country to emigrate.There is no bearable alternative in the UK at the moment.Its not able the medical schools its about the t&cs of the jobs you will now be lumbered with till you drop down dead because the pensions and not worth the cost.

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  • It is like ordering a review on junior doctor morale the day that juniors were shafted by the new contract being imposed!

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  • It is not a toxic anti GP culture. Not at all. Just the truth.
    A 50% reduction in pay per item in 10 years. Penance and neglect and imposed Contracts not my words, but Mr Hunt].
    The daily papers. Even the ex head of GP land, Prof Fields is ashamed of GPs, never mind Thomas or Grant etc.
    That is why almost every GP who can leave, is leaving.
    Not toxic at all. It is true, if you fail everything else you will land up in this Ss.. Hole.
    And you cannot wait to get out, seeing 45 patients a day, working 12-14 hours, going bankrupt and needing bailed out.
    Not toxic at all.
    In this age of candour, you cannot describe how bad it is in some places.
    No rest or sleep..
    Oh no, not toxic enough, because there are still plenty joining. Dear God!!!

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  • Not toxic enough. In fact, there should be a skull and crossbones over GP training, a clear warning.
    If you dont believe me, they have cut funding in GP land from almost 12 to almost 7% in 10 years.
    What does that tell you.
    In any case, just read Copperfield's article in this issue. It will tell you how toxic it actually is.
    Besides, young students, why oh why are all the GPs leaving this wonderful ship?
    Could it be holed beyond repair? Or do you want to find out?

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