This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

A faulty production line

Stop med school GP 'banter' to boost recruitment, says RCGP

The RCGP and Royal College of Psychiatrists have teamed up to call for an end to stigmatising ‘banter’ in medical schools, which they claim is contributing to the shortfall of GPs and psychiatrists and stifling efforts to put mental and physical health on a par.

College chiefs Professor Maureen Baker and Professor Sir Simon Wessely warned the ‘systematic denigration’ of general practice and psychiatry is putting medical students off these specialties - and said all doctors should take a stand against it.

It comes as latest figures revealed only 100 extra GPs have joined the workforce over the past six months, despite Government aims to boost recruitment and retention of GPs, and the RCGP’s own efforts to raise the profile of general practice amongst students.

In an editorial published today in the British Journal of General Practice, Professor Baker and Sir Simon noted that recent research has shown general practice and psychiatry are the most derided specialties during medical school training, and that medical students are rejecting careers in each ‘because of the stigma attached to them’.

They said a 'hierarchy' that has developed across all medical schools ‘puts physical health over mental health, hospital care over community care, specialism over generalism, and "medical" specialties over "non-medical” ones’.

This also ‘perpetuates the view that hospital-based specialties offer more excitement, clinical challenge, and prestige’ than general practice, which is seen as a ‘back-up’ option, the College leaders argued.

And they warned the stigma around psychiatry – including throwaway comments referring to psychiatrists as ’pest controllers' – is hampering the drive to achieve parity of esteem between physical and mental health.

The editorial concluded: ‘The systematic denigration we are seeing in medical schools is founded on misperceptions that maintain a negative impression of both general practice and psychiatry, and a lack of respect for the importance of these specialties.

‘It is exacerbating a shortage of GPs and psychiatrists in the NHS, and directly contravenes efforts to achieve parity of esteem between physical and mental health, causing a negative impact on patient care.’

The RCPsych is already pushing a #banthebash campaign, to ‘address Badmouthing, Attitudes, and Stigmatising in Healthcare’, and Pulse understands the RCGP is in the process of developing a GP version of the campaign, with the help of members and medical students.

But Professor Baker and Sir Simon insisted their campaigns are not about ‘prohibition of banter’ but about ‘fostering respect between specialties and an understanding that the NHS is predicated on having sufficient numbers of all medical specialties, so that we can keep patients safe and well'.

Professor Baker, who has consistently complained about medical schools’ ‘toxic anti-GP culture’ during her time as chair, said it was ‘depressing’ how little attitudes had changed.

In a separate comment, she said it was ‘very concerning’ that ‘this “banter” is yet another barrier we are up against when trying to recruit enough GPs to ensure a safe and robust service for the future of patient care’.

She added: ‘It has to stop. The College is doing what we can to challenge misplaced and archaic stereotypes, and our Think GP campaign aims to show what a fantastic career choice general practice can be – but it’s clear that more needs to be done from within medical schools, and medicine as a whole.'

Br J Gen Pr 2016; available online 29 September

How medical school ‘banter’ is putting medical students off general practice

Professor Baker has previously raised the College’s concerns about the ‘toxic anti-GP’ culture with medical school leaders, and called on them to each individually tackle what she called ‘blatant bigotry’ against general practice.

But evidence of prejudice against general practice has continued to surface, with one medical school dean telling students they 'must work hard to avoid failing and becoming GPs'.

More recently the head of the RCGP in Wales claimed junior doctors were too scared to tell trainers they intended to go into general practice in case they were barred from experience on secondary care procedures or clinics, with NHS England primary care commissioning chief Dr David Geddes acknowledging the stigma around general practice.

NHS England chief Simon Stevens has also waded into the argument, accusing Oxford and Cambridge Universities of failing to promote general practice to medical students. GMC research from last year found that 'elite' universities are shunning general practice.   


Readers' comments (51)

  • Once GPs stop being wet walk-over cardigans then maybe med schools will stop taking the pi$$.

    Unsuitable or offensive? Report this comment

  • It is only a shit job because the politicians made it so.

    Emigrate and practise in a country that values you and tries to make your life easier.

    Unsuitable or offensive? Report this comment

  • On the other hand, RCGP, maybe you should also stop trying to persuade people that it's better than it is, with your "never been a better time to be a GP" nonsense and your colouring book bollocks.

    Spin works both ways you know.

    Unsuitable or offensive? Report this comment

  • does that mean we can't make jokes about the literacy of orthopods or the communication skills of surgeons any more either?

    Unsuitable or offensive? Report this comment

  • A few years ago when QOF was introduced the juniors were tripping over themselves to get GP job. If GPs are paid well with a manageable workload then there will be no problem.

    Unsuitable or offensive? Report this comment

  • I remember the same banter when I was at med school in London not too long ago. I had no intention of doing GP then. I recall a lecturer stating that 50% of us would be GPs. When the realities of life hit you after med school and being treated like shit in hospitals on-call rotas, weeks of nights, moving around so much geographically percieved 'prestige' suddenly became completely insignificant and GP became very appealing high income (have been on 6 figure salary since reg year), can settle in one area, can choose where you want to be (for me near London). Despite recent pressure still much happier than I was in hospital medicine, earning much more money and settled in nice area wife kid and big house. My advice to med students and junior doctors would be to look around at the lifestyles of your senior colleague in hospital medicine and GP. You will find consultants can do very well in high earning specialties (mainly surgical) but need to work very hard in PP to make good income (only a minority are making mega bucks and that is after a lot of very hard work). You will also find a lot of very well off GP partners on a very good income 120K+ which is achievable soon after VTS.

    Unsuitable or offensive? Report this comment

  • I started GP training in August and I've already noticed a marked difference in the attitude of my Medical Consultants and Registrars towards me. They aren't bothered about teaching me anything because they say you "well, you don't really need to know this". They give the impression that we are not worth their investment. I did acute medicine for three years before going into General Practice and I never had this experience then.

    Unsuitable or offensive? Report this comment

  • Hogwash! Lack of insight by these colleges, blame "others" eg medical school.
    Stop subscribing comrades!

    Unsuitable or offensive? Report this comment

  • I have said for many years that general practice is the hardest job in medicine to do well and the easiest to do badly.

    Unsuitable or offensive? Report this comment

  • So, it's the "banter" that pushes general practice down the chute.
    Nothing to do with underfunding, doing hospitals' dirty work, CQC inspections, bureaucracy and litigation.
    I wonder if Lady Wessely has any comments to make.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say