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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 use of the phrase " ending up as Gp's " says it all.

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  • Ending up alcoholic . Ending up destitute . Ending up dead . Does " ending up " have a negative connotation ?

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  • Hi - thanks for the comment. We have taken it on board and changed it.

  • Dr Lancaster hits the nail on the head. DOI GP, not from the Universities above but not afraid to admit to variation in students at different institutions (although I am surpised at the George's stats....)

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  • As above, Dr Lancaster's assertion is sensible. The amount of GPs conducting clinical research is comparatively small (as a proportion) to the amount of hospital Consultants that do - many specialities strongly encourage a PHD before CCST whereas in General Practice this is obviously quite rare.

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  • Well done Edinburgh.I remember the figure there used to be as high as 50%.Clearly some sense has been knocked into the young brood.

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  • those universities attract highly academic high achieving perfectionist control freak types so its not surprising they dont want to do something as vague touchy feeley and generalised as GP. After all you have to be able to realate to people where they may get on better with books and computers.
    Enough sterotyping?
    May also be all the irritating tick boxing, government scehemes, admin and stuff that detracts from just dealing with the patients presenting complaint as were trained to.

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  • If I were a medical student today, I would not consider general practice.
    If i was a very high flying oxford graduate who wanted a high flying career I would discount GP out of hand. What possible incentive would there be?

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  • totally agree with Nick Marotta, the type of character churned out from the 'elite' universities are devoid of character and interpersonal skills. Being able to relate to and empathise with patients is imperative in general practice. Let those highly intellectual folks with delusions of grandeur remain behind closed doors in an academic context or in the operating theatre!

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  • Would be interesting to see some context and a bit more of an in depth look at this i.e is this unusual for elite universities like Oxford? How has the position changed across all Universities over time?

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  • Students now realise that by the end of their training there will be no general practice to enter. I could be wrong but I think the next 5 years will prove my point.

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