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Independents' Day

Expert review knocks plans to extend GP training to four years

Calls for GP training to be extended to four years have been knocked back by the group responsible for advising the four UK health departments on making medical education suitable for the next 30 years.

A report today from the UK Shape of Training Steering Group said that a ‘three plus one’ model would be preferable and would offer more flexibility for varying local needs.

This will prioritise one year fellowship schemes either in the middle of the existing three year training, or after achieveing their Certificate of Completion of Training – whether immediately or later in the GP’s career.

The report says: ‘Panel members considered that the 3+1 model better aligns with the principles of the Shape of Training Review (STR)

'The content of such an additional year would add skills beyond those that are required for CCT and would be responsive to local provider and patient needs. It also closely follows the Shape of Training vision for credentialing and would support Government strategies for delivering more complex care in the community.

'Most importantly the Panel believes that this model would help meet the demands of current trainees for portfolio and flexible careers.'

Four-year training has been an RCGP priority for years and was even backed by health secretary Jeremy Hunt until 2014 when realisation of the scale of the workforce crisis saw ministers kick plans into the long grass.

The steering group, convened to take forward the recommendations of 2013’s Shape of Training report, calls for more to be done to place general practice on an equal footing with hospital-based specialties.

It says that medical schools must do more to build the teaching of generalist skills into the curriculum as well stamping out a culture of denigrating GPs that the RCGP has called ‘toxic’.

The report states: 'Based on the changes that we are proposing to curricula it will be important that medical students understand the values and attitudes that will be expected of a doctor.'

This will include an understanding that a generalist and a specialist will have equal status and that most doctors will require to have and to maintain the skills to treat acutely ill patients in the emergency setting. There is also an expectation that general practitioners and hospital doctors will have equal status.

And Pulse has shown how BMA calls for the merging of the GP and specialist register are backed by the GMC.

Chair of the BMA’s Junior Doctors Committee, GP trainee Dr Jeeves Wijesuriya, said: 'We welcome a pragmatic approach from today’s report from the UK Shape of Training Steering Group, which has listened to, rather than undermined, professional bodies for doctors in the UK.

'We want to reassure patients and doctors that we continue to oppose any changes which devalue the high standard of medical training in the UK or compromise patient care.'


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Readers' comments (8)

  • Tom Caldwell

    So another college aim comes to the level of fruition to which we have become accustomed?

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  • Rogue1

    Who are these so called 'experts'?

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  • 1. ive been very impressed with the quality and dedication of the GP registrars we have had over the last few years. despite the "old" me saying they dont work as hard as i did as a junior doc in their hospital jobs... perhaps teaching is better than on the job training! so im not convinced we need to extend GP training.
    2.newly qualified GPs and consultants arent the same. a consultant is way more experienced. the problem is a year 1 GP despite being good isnt as experienced as a good senior GP.
    not that im a member of the college or support much of what it does but the myth that MRCGP is the same as a consultant isnt true. in most hospital specialties Membership of College is a qualification you get along the way - there are exist exams and CCST assessments.
    my opinion is MRCGP should be something people do in training to partly proove to themselves they are generalists and to proove they have the basic skills to operate as a "basic" GP. there then should be a fellowship exam to be taken 3-5 years later that is considered the same as a consultant post.
    the current lets give an F to our mates on production of 3 letters from friends so they can have a nice meal and access to the college wine cellar is rubbish.
    the question is what to do with existing GPs who dont want to sit exit/exams. well a combination of appraisal and assessment on the job - that isnt hundreds of pages of documentation is probably the way to go.

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  • The whole point of shape of training is not to produce specialists but to provide service fodder 3+1 does nothing but mean GPs are paid less and service needs of trusts probably despite being fully qualified

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  • I have just been through the list of member of this "expert" group (p51/52 of the report) - THERE ARE NO GPs on this group. The closest is the second year GP trainee mentioned in the article, the only other is Dr Paddy Woods who is deputy Chief Medical Officer for Northern Ireland and doesn't appear to have worked in General Practice for decades (not on GP register)

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  • Apologies, the group also contains Prof Gallen, who is another former GP who hasn't worked in primary care for 15 years and isn't on the GP register.

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  • My last trainee and my new trainee are both LTFT at 80% full time. My last trainee had Fridays off (20%) and Thursday afternoon as private study (which we all know means off).

    My new trainee has Fridays off, Thursday afternoon off for private study and Wednesday afternoon off so that we can make sure they do not exceed the contract hours limit. They also will get an extra session and a half off each month because we have to give them time off in lieu when they do out of hours.

    That is essentially 7 sessions/ week (inc their training session) V 5.5 sessions per week. Or less than 80% of the opportunities (i perhaps incorrectly don't count out of hours as part of the learning opportunities).

    That MUST come with an understanding that the best half of trainees will still get through training, but the worst half of trainees will have less opportunities to learn and are less likely to make it through training. It should be understood and expected that many trainees will automatically extend through just not being good enough to get through the exams and training.

    I suspect a lot of people will be doing 4 year training schemes anyway.

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  • The 3+1 should include ' Fellowship' - making membership of the RCGP almost compulsory?????
    Am I getting this right, or does 'fellowship' her mean something else.
    If I am right, then RCGP must be desperate to be able to continue preying greedy for member contributions although causing more damage than good.

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