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At the heart of general practice since 1960

The new generation

An important aim of the contract is to persuade more young doctors to choose general practice ­

Lisa Thomlinson visited Warwick Medical School to seek students' views

Given the pressure of work and burden of debt that is part and parcel of being a medical student it seemed unlikely that many of the 550 students at Warwick would have much awareness of the new GP contract.

But the second-year postgraduate students we spoke to earlier this month turned out to be extremely knowledgeable. They claimed their peers were too. Although only two years into a four-year course ­ and then five years away from becoming GPs if that was what they wanted ­ they were already viewing their future career options very seriously.

How had they heard about the new contract?

The answer was that news had infiltrated the walls of Warwick Medical School via the internet, the newspapers, trade press and lectures. But for one student, Zarqa Khawaja, the introduction to the new contract was at first-hand during the first day of an eight-week clinical placement at a three-GP practice in Solihull. She told Pulse at the end of her first week at the practice all she had heard was moans about the new contract. She said one of the GPs at her practice was angry because of all the performance criteria they felt they had to achieve to get the money in. Zarqa said this GP felt 'bullied' into voting Yes because he didn't feel there was an alternative. Zarqa said she sensed there was real anger at the practice.

Another student, Kathryn Lawes, said: 'GPs at the practice where I'm on placement feel cheated because they were all promised they would earn more money but they are saying they are going to lose out compared with bigger practices.'

One of the aspects of general practice Kathryn values is the opportunity to build long-lasting doctor/patient relationships. She said her placement practice had 'a really nice atmosphere' but the GPs there were 'worried they were going to lose this family atmosphere under the new contract' because of the heavy administrative demands of things like the quality and outcomes framework.

So how likely are you to go into general practice?

Despite experiencing first-hand GPs' doubts and fears about the contract, students on general practice placements during this historic transition period said that far from being put off, they found themselves converts to the career.

Zarqa explained: 'My first exposure to this contract has been negative but I think the contract will work for our era even though it doesn't work now. It suits our agenda.'

High on this agenda for the students is a healthy work/life balance with time for family and friends, career flexibility and progression, job security, a generous pension and high earnings. 'Money is even more important here because we're graduates and have huge student debts,' said one.

Others described how GPs on their placements felt it an affront to lose responsibility for out-of-hours, something our students said they would be only too pleased to do. This highlights the generation gap the contract will have to straddle.

Kathryn said GPs on her placement were of an era that 'wanted to take care of patients from start to finish whereas our generation wants to move around, see the world and do other things'.

Students whose aspirations lay outside general practice also had interesting views on the contract. Gareth Thomas, an aspiring oncologist, said he was attracted to the challenge, higher salary and faster pace of hospital medicine but thought GMS2 had made general practice 'more appealing'. He also thought it had raised the status of GPs. Andrew Wrench had his heart set on paediatrics but was impressed by the way the contract had increased regulation of the medical profession. 'It will keep doctors on their toes,' he said.

The students we talked to made it clear they were open to change ­ but that they refused to be short-changed.

What the students want

from general practice

nOpportunity to build long-lasting doctor/patient relationship

nHealthy work/life balance

nTime for family and friends

nCareer flexibility

nOpportunity to progress in career

nJob security

nGood pension

nHigh earnings

What the students feared

nThe Government reneging on the new contract deal

nIncreasing regulation and monitoring

nDecreasing amounts of time to spend with patient

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