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Figures show widening shortfall in GP training with 20% of places unfilled

A fifth of GP training places in the UK remain unfilled after two rounds of recruitment according to official figures obtained by Pulse, raising serious questions about Government’s promises to increase the GP workforce.

Data supplied by NHS Education Scotland show that just 80% of the 3,641 available training places across the UK have been filled ahead of the August training intake.

Education bosses in England have refused to confirm that the figures are correct, but they come shortly after the health secretary rolled back on his pre-election commitment to introduce an 5,000 additional GPs by 2020, saying this was only a ‘maximum’.

The figures are disastrous for education bosses and mark a widening shortfall in filled GP training places.

Last year, at the same stage, around 13% of places remained unfilled in England and 11% in Scotland after the unprecedented third round of recruitment - a situation that the GPC described as the ‘worst ever’.

The shortfall comes despite the health secretary boasting there had been 300 more applications to GP training this year in his ‘new deal’ speech, although Pulse later revealed this was because failed applicants had been allowed to retake entry exams.

According to the figures, around 2,918 places have been filled across the UK so far, with a third round of recruitment in England to follow.

No figures were available for England or Wales, but Scotland have filled just 240 of the 305 GP training places on offer, 79% of the total and increase of just 9% on the first round.

Health Education England has yet to publish the vacancies for GPST1 recruitment in England despite the final deadline for training place uptake having passed on 11 June, but these UK-wide figures suggest it will struggle to meet its current target of 3,250 graduates entering general practice by 2016 and there will also be shortfalls a

The Government has been under pressure to provide evidence of how it will achieve it’s pledges to drastically increase GP numbers in England, including a pre-election pledge of 5,000 new GPs by 2020, and it’s already delayed target of 3,250 medical students going into GP training by a year.

Pulse revealed last week that Jeremy Hunt has begun to distance himself from the election promise of 5,000 new GPs when, at the announcement of the ‘new deal for general practice’ two weeks ago, he said: ‘We are leaving some flexibility [in the target] because in some parts of the country it is very hard to recruit GPs.’

And last week he added that 5,000 looked like the ‘maximum’ achievable by 2020.

The DH declined to comment on today’s figures, adding the breakdown of figures for England would be available ‘shortly’.

NHS Education Scotland said that the remaining training places will still be made available for ongoing recruitment with local training boards, and a third round of recruitment will be launched in August for a February 2016 start date.

Dr Krishna Kasaraneni, chair of the GPC workforce and training subcommittee, told Pulse the figures were of ‘significant concern’ to the GPC and said the downward trend in recruitment would not reverse until young doctors could see GPs workload improving and GPs enjoying their work.

He added: ‘Is it surprising that they’re worse than last year? No, because realistically there hasn’t been a great deal of investment – in terms of making things better for general practice- in the last four months, or prior to that.’

‘If last year was the worst ever, this is even worse.’

‘Even when the concept of the new deal was announced with routine seven day working and so on, it goes to show we don’t even have the workforce at present to deal with the normal demands of general practice.’

Deputy chair of GPC Scotland Dr Andrew Buist told Pulse he hoped this would be a wake-up call for politicians.

He said: ‘I hope the Government now are waking up that they’ve got a very, very significant problem on their hands. The figures today don’t really come as a great shock, we knew this was happening.’

‘They really need to start talking up general practice, that’s one of the reasons things are so bad, they’ve been talking us down for the best part of eight years and morale is low. The young doctors, and medical students pick up on that.’

Readers' comments (55)

  • Trainers should be made to take the AKT examination each year to see if they are CLINICALLY competent to teach their useless consultation skills which in real life hardly any doctor would use.

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  • Some of trainer have very poor knowledge no idea of exams and nice guidelines and can easily destroy career of Doctor , there is no check on competencies of trainer

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  • Una Coales. Retired NHS GP.

    Back in 2001/3 there was a severe shortage of NHS GPs. GP land was in turmoil. GPs were burning out on call for their patients 24/7 and no one wanted to be a NHS GP. The BMA balloted its members and voted for mass undated resignation. Meanwhile deaneries did their best to entice hospital trainees with carrots to join GP training schemes. I was one such hospital doctor who was lured with bundles of carrots! Entry was one easy interview and no exams or jumping through assessment hurdles.

    There was no time to feel depressed as a British BME/IMG at never getting a NHS training number in general surgery or ENT even with double FRCS in general surgery and ENT, when GP VTS welcomed me with open arms, gave me a free weekend at forest mere health spa with free beauty treatment, free weekend at Verona, free trip on the London eye with free chinese dinner nearby, no eportfolio (my trainer had a paper logbook of competencies and just ticked off all the boxes in my last week. I mean asking me to demonstrate doing a rectal exam with FRCS in general surgery seemed a bit daf; she knew it and I knew it), 99% pass rate free MCQ+video summative assessment (although I chose the optional tougher 4-module MRCGP for £190 a module) and then £2000 study leave money and free residentials in fancy resorts with fine food and fine wines for my first 2 years as a newly qualified GP, and in S London they were handing out £5k golden handshakes to those who signed up to be salaried fodder. They lured us with so many carrots I knew there would be a stampede of hospital doctors defecting to GP land.

    Shame to see GP trainees now being beaten with sticks, referred to the GMC, burdened with expensive exams and onerous eportfolios at a time when now more than ever we need doctors' bums on seats to save the NHS but more importantly the profession of general practice.

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  • Given the crisis, why did the BMA refuse the concept of a staff grade of GP? I agree with Una that the RCGP needs sorting out, but the quick solution would be to authorise a staff grade, so all those who have fallen out of the system at this point can be welcomed back in with open arms. they would be far more useful than any Physicians associate, and probably far safer. And they'd be far more useful than any pharmacist.

    That would then buy you the time to sort the rest of the mess out.

    As for the future:
    - Expect far fewer GPs anyway you cut it. But if the choice is between PAs & AHPs or a staff grade sat below a much smaller tier of MRCGPs then that sounds more palatable to me.
    - Expect a salaried service. Look at the HMRC definition of employee vs contractor - in charge of their own work and how it is done. We already fail that test to be ICS. Bevan's aim has finally been achieved - ICS was always a fudge. He aimed for a more socialist staffing, not just a socialist output for patients.
    - Expect a capitated payment model, which will align nicely with either a fixed tax funding model from HMG, with/out a co-pay model, and/or a total switch to private insured model - probably done gradually via co-pay until it goes from 'top up and extra service' to 'only the poor get it free'.

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  • Una Coales. Retired NHS GP.

    @10:47 am what you say makes sense except IMGs/BMEs who were failed by CSA because the RCGP did not recognise negative unconscious bias or test for it, does not mean we make these GP trainees subgrade staff grades when had the exam been recorded and monitored by CCTV, 100s of IMGs/BME GP trainees may have had grounds to win appeals and be awarded MRCGP instead of face the utter humiliation of release/expulsion with nothing to show for 3-4 years of so called GP training.

    Those who have been released are now working in A&E, community hospitals or private medicine. There is no need for them to accept a subgrade staff grade post in general practice.

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  • what's the pay like in Canada? I seem to get variable answers on the google search

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  • If our country is suffering and stinking because of our useless political policies, we should attempt to clear the garbage.
    Am afraid importing non- EU doctors would not work as they are far better in their abilities than local graduates and are going to places where they are treated like professionals, not like doormats like in the UK.
    If we have a problem, we should have the guts to accept and try to solve it, though not sure would happen.
    I might sound selfish, but I wouldn't be out of work whatever happens; the poor general public would keep being manipulated by useless people in charge.

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  • Una @11.43
    Well said Una. You are a legend.
    I believe more than 90% of the IMGs released from training would have passed this Russian Roulette assessment if they had a fair chance in this closely guarded exam which continually and blatantly denied any form of evidence of the conduct of the exam to the date!! Trainees word against ONE examiners word is the only evidence you are allowed in this disgusting and immoral appeal process which they charge £800 !! HOW CAN YOU APPEAL IF YOU HAVE NO EVIDENCE TO APPEAL? AM I MISSING HERE SOMETHING?
    Engineered to fail, IMG trainees are not suitable to do substandard GP work while a lot of these guys managed to pass decent highly competitive exams such as MRCP,MRCS, MRCPch, and MRCOG. Majority of such released trainees are slowly finding their way back from the betrayals and humiliations they suffered from the very people who trusted to support and protect them. They should never turn back. These doctors are too good to be doing a second class job for GPs while they have a potential to be hospital consultants and lead happy and fulfilled lives.

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  • Dear Una,

    I was one of those IMG that luckily only failed my first attempt at the CSA. My trainer, excellent as he was, had no training on how to bridge cultural and communication gaps. I passed my second attemp only because I paid for extra courses and because I was lucky enough to have an English wife who taught me a lot about the British ways.

    Thank you for all your hard work supporting IMGs and fighting against ingustice.

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  • I will have to reflect on the learning points in this..

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