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'Elite' university students shun general practice

Medical graduates from the top-ranked ‘elite’ universities are avoiding general practice, with fewer than one in six University of Oxford medical graduates applying to become GPs, official data has shown.

Data released by the GMC reveal that only 16% of Oxford graduates choose to enter general practice, followed by St George’s Hospital Medical School with 19%, the University of Edinburgh at 22% and the universities of Bristol and Cambridge with 25%.

The GMC analysed graduates over three years, from 2012 to 2014, and their figures are a blow for the Government’s target of 50% of medical graduates entering general practice by this year, and follow disappointing results from the first round of GP training recruitment, which showed that one-third of places remained unfilled.

They also follow a series of rows between GP leaders and medical school deans, who have been accused of telling undergraduates that general practice is a ‘second-class’ career option, while the RCGP has met with medical school leaders to discuss a ‘toxic anti-GP’ culture.

GP leaders have said that the figures are ‘distressing’, and it is up to universities like Oxford to put more of a focus on promoting general practice.

The figures revealed that not a single university saw 50% of its medical graduates apply to become GPs.

University of Leicester medical students were most likely to want to become GPs, with close to half (45%) of its medical students applying to train as GPs, followed by Keele University (44%), then the University of East Anglia (43%).

The number who went onto be offered a place and accepting it was lower, including 28% for students from Leicester and East Anglia, 24% for Keele, 11% for Oxford and 14% for Cambridge.

But Professor Azeem Majeed, professor of primary care at Imperial College London, which saw just over a quarter (27%) of its medical students apply to GP training in the first intake, said medical schools were not to blame for poor GP recruitment generally.

He said: ‘I think [variations between medical schools] has always been the case and I think people who blame medical schools for problems with GP recruitment are probably attacking the wrong target.’

He added that it was more likely that it is ‘the job itself that is the problem’, with increased workloads at a time when income was falling.

However, he said that his own institution had stepped up its game in a bid to promote the profession recently, including hiring more GP lecturers.

GPC education and training subcommittee chair Dr Krishna Kasaraneni said that the newer medical schools, such as Keele and East Anglia, tended to put more emphasis on general practice, and more focus was needed on ‘medical schools like Oxford where less than 20% of their graduates end up being GPs’.

He added: ‘It is not about educating doctors who are more suited to general practice than other specialities but it is about ensuring that they have balanced exposure to general practice as well as other hospital specialities so that they can make an informed decision about their future careers.’

But he added that Government targets for 50% of medical students to choose general practice was completely unrealistic.

Dr Kasaraneni said: ‘None of these universities have hit that target, not a single one. So when politicians are making these pre-election pledges they need to realise they are promising what no medical school has ever delivered.’

A spokesperson for the The Medical Schools Council said that it ‘recognises the need for a workforce which reflects society’s current requirements - and the difficulty of responding quickly to urgent needs in particular specialties’.

They added: ‘MSC fully supports the recommendations in both the Tooke Report and the Shape of Training Review that there should be broad based core training before later specialisation as required.’

Dr Maureen Baker, chair of the RCGP, said: ‘It is disappointing and distressing to see the huge differences in medical students taking up general practice depending on which university they attend. All medical schools have a duty to promote the opportunities and challenges of a career as a GP.’

Dr Tim Lancaster, director of clinical studies at the University of Oxford, who is also a GP, said: ‘We do not agree that it is undesirable that there is variation between schools in the proportion of graduates entering different career paths. Oxford unashamedly selects students who have the potential to benefit from a course which places strong emphasis on the understanding of biomedical research.’


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Readers' comments (40)

  • this makes total sense and i'm pleased that medical graduates are doing their homework and properly evaluating their career choices.

    General Practice has become incredibly difficult and is set to get a lot worse - so it's no surprise that sensible graduates are avoiding it.

    I'm assuming that the group that wants to do General Practice must really want to do it and are willing to take on board the risks - it's a shame if they are doing it as they feel they have no choice as they are really going to hate it :(

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  • The RCGP needs to keep it's coffers full.Just ignore all it's propaganda and stay away from General Practice.You'll be allright.

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  • Oxbridge is 'elite' in what way?


    Amused Scottish Graduate of the University of Aberdeen

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  • The T test, the one which gives P values in research results panned: ' false discovery rate problem'
    The whole 'Scientific Evidence' issue could be decimated if this theory is anywhere near accurate.

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  • 3 possibilities:
    a) Oxbridge graduates really are brighter, and therefore less gullible and can see how bad the prospects are (doubt it);
    b) those universities are preferentially admitting students who are poorly suited to the specialised type of work GPs do, managing risks, businesses, people, etc;
    c) University staff are guiding them away from GP-land. Possibly with good insight!

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  • Nhsfatcat

    It's a game show- Who Wants to be a GP?
    a) Yes
    b) No
    c) Maybe
    d) As a last resort.

    50/50 gets rid of Yes and Maybe
    Phone a friend gets rid of No
    Ask the audience, they would have asked for an appointment, the coughing major would have been sent an ambulance by 111 , so it leaves 'As a last Resort' which of course is the incorrect answer and wouldn't lead to a million quid either.

    I do not need to make the analogy with the game show 'Pointless' -to obvious
    And Family (doctor) Fortunes: Our survery said XXXX

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  • I strongly resent the implication that GP is a career for those who don't understand biomedical research. while at med school the last thing I wanted to be was a GP. I was very academic and wanted to be a surgeon. I changed my mind after house jobs.
    I would love to be an academic GP, and I still love research and the geeky side of Medicine, as well as people.
    Negative stereotyping and the idea that GPS are second best is almost everywhere :the media, A&E, the medical reg on the phone when you make a referral....and so on. An enormous amount of work is needed to change this.

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  • "I strongly resent the implication that GP is a career for those who don't understand biomedical research"

    No-one is claiming that GPs don't understand biomedical research, but surely you must acknowledge that it is harder to undertake (and less frequently undertaken) in the Primary Care setting?

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  • St George's elite? Hahahaha!
    Hardly - they let me in with the lowest A level grades. Things must have changed in a couple of decades.
    And there lies the problem - the obsession with four A stars at A level - you don't need to be super intelligent to be a good doctor. You need people skills and oodles of common sense.

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  • I think that we may be making heavy weather of this. The brighter the student - the less likely they are to be conned into going into general practice. I would not make the same mistake again!

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