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Gold, incentives and meh

Our new medical school offers hope for both present and future GPs

The new Anglia Ruskin medical school’s focus on general practice will not only help inspire the future workforce but also create hope for GPs working in the area, writes Dr Roger Tisi

roger tisi sq crop

It might seem odd for the GP lead of the new Anglia Ruskin School of Medicine to admit he has a problem with the idea of channelling medical students into general practice, but I do.

Trust an Essex boy to spoil the mood music but I’m simply not sold on the idea that we can or should attempt to engineer the careers of our students in ways that they will quickly see through and possibly resent.

So, what to do instead? Well, for one, give them chances to see that some of their brightest and best future colleagues choose to work in primary care because they believe in it and because it allows them to make a difference.

Putting students into general practices from year one and involving working GPs in delivering campus-based teaching will help to achieve this, as there is nothing like a bit of role-modelling to stir the imagination.

Our intention is not to drag our students to the watering hole of general practice but persuade them it is somewhere to consider going for themselves

I have been impressed, in every sense of the word, by the capability and enthusiasm of GP colleagues who want to contribute to our teaching, most particularly those who are early in their career and looking for opportunities to spread the love. So much for talk of a profession that is often reported as being demoralised to the point of despair.

In addition, it helps for our School to generate a positive culture around general practice from the outset. Health Education England’s 2016 report ‘By choice not by chance’ points to endemic, casual denigration of GPs in medical schools, so an important part of my role is to call this out where I see it; whilst it is yet to be seen whether our new school will do any better, I think it might.

We encourage a view of general practice as an intellectually robust discipline, signposting our students to the evidence base that demonstrates its effectiveness in relieving human suffering, both on an individual and population level. To counter negativity and prejudice, our curriculum encourages students to engage in conversations with their supervisors and peers that will challenge notions of what it is to be a professional; as a spoiler alert, this will include considering the pervasive effect of ‘banter’ on building respect between colleagues. Heaven knows, they will be busy enough fielding off the ‘hilarious’ jokes about Essex.

We do not plan to shy away from the terms ‘general practice’ or ‘primary care’ when describing to students the contributions GPs make to patient care, in the process reminding them of where the patient journey usually begins and ends. Our integrated course will enable students to compare and contrast the delivery of care in Trusts and in the real world, allowing students to understand the processes of decision-making and the consequences of intervention.

Presenting general practice as the seat of problem-solving and thoughtfulness should make it an attractive place for those who value these aptitudes. To misuse an old analogy, our intention is not so much to drag our students to the watering hole of general practice as to persuade them that it is somewhere they should consider going for themselves.

As I walk around our rather wonderful new building, I am struck by the juxtaposition of our state-of- the art simulation facilities with the more down-to-earth GP Suite (which, frankly, needs a few faded health promotional posters on the wall to make it look entirely authentic). We have the opportunity to do great things in both.

Will the Anglia Ruskin School of Medicine solve the GP recruitment crisis in Essex at a stroke? Of course not, but it will make a difference, potentially a life-saving one. Not just by training doctors who may be inspired to join our workforce in the future but also, crucially, by creating some hope and opportunity for those already working in general practice in our area at a time when both seem in short supply. Enthusiasm is catching and magnetising. If this sounds like an advertisement for the Essex Tourist Board then you are not far wrong.

Dr Roger Tisi is GP lead in general practice at Anglia Ruskin University School of Medicine

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Readers' comments (14)

  • Moniker @ 5.02pm.

    The article mentions GPs who are early in their careers providing campus-based teaching, and from this I inferred young and of limited experience. Perhaps this was in accurate and if so, I apologise.

    I would be keen to see a follow-up article from Dr Tisi perhaps addressing some of what has been seen in the replies here, especially some more concrete details of how this institution will differ from the traditional medical school and the GPs enhanced role .

    I think General Practice is a seriously difficult job to do well and my endless carping is not primarily to wind up my fellow GPs (but admittedly it does make for some good discussions!);I know that I would feel hopelessly prepared to do this job with the training that most GPs get and my points reflect this, rather than any lack of ability amongst my peers, who simply work with what they have.

    Any institution which purports to train a generation of new GPs to do a quality job in 10 minute appointments with the current training in terms of depth and tragically it seems scope too (ie GPs who have not done any secondary care psychiatry or only 3 months COTE and 3 months rehab as their general medical experience) is bound to fail.

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  • @IDGAF

    If I have understood you correctly, your entire first paragraph amounts to "young GPs should not be teaching first prinicipals, and basic A&P" and the second and third amount to "first priniciples and A&P across general practice is poor.

    With regard to your first point, I am glad that you agree that the "stuffy old GP" stereotype would be even worse. Therefore in the absecne of an alternative, I think we can agree that young GPs are the best suited working clinicians.

    I would absolutely agree that a lot of these principles should be taught by academics whose primary focus is this. To be fair to Dr Tisi I don't think he ever said that students would be taught exclusively by doctors. They should be taught first principles in their first two years by people trained to do so, I agree, and I think they will be.

    However in the current climate the flavour is for integrated courses whereby people get clinical exposure early, and as said above, young keen GPs seem an excellent way to do this. Whether you agree with that priniciple is a different matter, but certainly I think (and I know a lot of academics agree) that having a practical framework to hang your first principles off of engages students more and improves their happiness and one would hope ultimately improve them as clinicians.

    You say about young GPs that they have their teaching qualifications at the expense of experience, well which do you want? You either get an anatomy expert with zero experience but incredibly knowledge, or a working GP with a mixture of the two. The older the GP, the more the experience, sadly the less fresh the knowledge. (and to be absolutely clear I say this not to denigrate my more experienced colleagues in any way at all). Can't have it both ways I am afraid.

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  • @Cobblers

    Frankly that's just rude.

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  • Cobblers

    @TheRudeWorrier 5:08pm

    Which bit?

    Mucky, Manipulative or Mitts?

    I am assuming the previous paragraphs being a statement of fact would not be rude.

    Dr Tisi wishes to train the students in such a way as to get them to see the Damascene light and become GPs. So I think 'manipulate' and 'mitts' fair game.

    Mucky is a moot point. I do think slanting the training programme to favour GP when there is the gamut of medicine out there for them to choose is wrong and, based on the Southampton training, doomed to fail.

    And frankly I hope it does too as GP should be gone into with eyes wide open as the current sh!tfest is more political than anything.

    GP can be a wonderful job.

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