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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)

  • The obsession with A stars at A'Level is part of it. Large numbers of potentially good doctors are not getting places, and it would seem from where I stand that entrance criteria are set to accept highly academic candidates only, without taking into consideration that the types of job (and the skills required) vary considerably across the profession. As long as undergraduate clinical education is predominantly hospital based the myth of GPs as failed hospital doctors will be perpetuated. As it is we are actually the cleverest doctors who now do the most detective work. We need specialists to advance medical care and more than ever we need excellent generalists. The generalists have to be as well supported as in hospitals though otherwise the job will not appeal to bright young doctors, and there has to be a career progression that is meaningful. If you have achieved your goal at 30-35, the only thing left is burnout

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  • General practice is a hard job to do well but it is easier than other specialties to get into. Those at the highest performing universities are amongst the most competitive and competitive doctors. Is it really surprisingly this self-selecting group of high achievers are preferentially entering the most competitive medical specialties? Someone tell the thought police that they cannot control what clever university students think. If they want more GPs they need to make the job better.

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  • Even before MTAS junior doctors were changing careers to become GPs after the 2004 contract. Since then conditions have gradually got worse and the low level of GPs is the result. Junior doctors really aren't stupid.

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  • It's more to do with Job Satisfaction than Medical School.

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  • Clever bunch I say!

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  • Una Coales. Retired NHS GP.

    Of the 16% who want to do general practice, how many are using general practice as a ticket to Australia or Canada?

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  • Why does anyone want to be a GP partner - fixing broken roofs, negative equity, responsible for staff redundancy, if the practice collapses [ see Peverly]. If Pev regrets being a GP and he can see clearly, why would you ask anyone to be one? I think it has become a completely hateful job. Pev gets palpitations at night and panic attacks.
    I find it distressing and disturbing that there is no duty of care by any Body to GPs.

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  • General Practice is going down- fast. No Medical School should encourage their graduates to join the cesspit that GP has become. This job is s...!

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  • It applies to those GPs who are generic Gps. Those who changed speciality have MSc, PhD and various research degrees.
    As for taking GP training, I would strongly discourage students which ever the university from.

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  • Back in the 1970's my late father, also a GP, said being a GP was deemed second rate and the profession was at an all time low. Things changed slowly. Feels like the profession has gone back to those dark days again.

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