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Independents' Day

Yes, I am a trainer – but not for much longer


I realise that telling you I’m a GP trainer might cause something of a shock. It certainly does to my trainees. But it’s true. And what’s also true is that my next trainee will be my last, because I’ve had enough. True, explaining why I’m jacking in training goes against the grain of the RCGP’s ‘not in front of the children’ approach. But sod that, I’m going to tell you anyway:

1. It’s hard work.

If you don’t think so then a) you’re not a trainer and b) you’re wrong. As we all know, we’re running as fast as we can on the Great Hamster Wheel of general practice yet, each year, the speed is cranked up further. So something has to give, and, in my case, that’s training.

2. There are too many abbreviations.

And I’m allergic to them. COTs, CBDs and mini-CEXs make me itch. CSA, AKT and WPBA trigger angio-oedema. And NTN, ARCP and COGPeD have me reaching for the adrenaline. Though it’s not just the abbreviations that are the problem. Combine them with the jargon, the arcane processes and the whole educational schtick, and you end up on Planet Fluff, far, far from home.

3. The e-portfolio.

It is literally impossible to say ‘ePortfolio’ without putting an expletive between the ‘e’ and the ‘portfolio’. It’s like an episode of James May’s The Reassembler, but in reverse. Instead of experiencing the joy of constructing something from its component parts, we dismantle the educational process until we despair at the hideous, non-functioning mess we’ve created. Then we have to tick boxes to confirm that’s what we’ve done, proving, as if the appraisal process hasn’t already, that having to be seen to do something completely destroys the value of actually doing it.

4. The new junior doctor contract.

I’m not going to bang on about the massive logistical and philosophical problems this creates for trainers, because Pete Deveson has done that better than I could ( Nor am I going to pretend that it was the final nail in my training coffin, but it certainly added another layer of lacquer.

5. The pay-off.

Training has always been a trade-off in terms of effort and benefit. One of those benefits was the feeling that, by nurturing young talent, you were helping future-proof the profession. No longer. The vibes these days are that many trainees are just passing through en route to careers that may be very distant vocationally and geographically from general practice. I realise trainees can, of course, decide to do what they damn well please, and that my saying this might piss them off. But I don’t care, because it’s a genuine and gnawing feeling, and one that causes increasing discomfort as each day gets busier and lonelier.

Put simply, if you want to ruin training, then deconstruct it, over-regulate it, mystify it, strangle it with bureaucracy, render it less rewarding and then suck any residual joy out of it. Which in fact is a fair description of what is happening to general practice, so you could argue current training is the perfect preparation. But don’t tell trainees that.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield

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Readers' comments (10)

  • SPOT ON. i'll not be far behind you. had enough

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  • I have trained my last trainee and have not renewed my trainers accreditation. The whole process with peer review of videoed tutorials, pages and pages of evidence that the practice is suitable was akin to the CQC inspection. I had a fantastic trainee who failed his CSA first time almost destroying his confidence. It appears that you have to preform to the narrowest criteria set down by the RCGP to pass. So churning out clones of what the college determine makes a good GP. The eportfolio took up so much time and getting all the evidence prevented him developing his skills in the time available. The pressure to attend courses and meetings with little ability to back fill means the work waits to be completed at the expense of family time. Much as I enjoy teaching the whole training process has ground into a tick-box bureaucratic quagmire. Sad days ahead.
    DOI MRCGP(1995)

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  • I am just surprised it has taken you all so long to get to this point! Completing the Trainers course was good, but at the Practice inspection visit the beaurocratice work load became apparent, so I was relieved when we appointed a new partner who took on the role. I was then able to support them but able to pursue less beurocratic but perhaps more patient-centric persuits! Sorry to see you guys go and wonder if the time with you was the last good one for them in Primary Care?

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  • In our practice we all recognise that most of our partners were ex-trainees, so we see the value of training, and encourage everyone to take turn, and without doubt some are better than others. I did my fair share of both registrar and student training, but was not sad to stop. Each year it seems to get more process obsessed, and I question whether it actually makes for better GPs - the good ones are that way despite rather than because of the training, I fear.

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  • It has occurred to me that as a practice CQC lead, appraiser and trainer I spend as much time doing soul-destroying bureaucratic nonsense as I do with patient care. Something has got to give....

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  • I totally agree with this article. Education of doctors has been ruined by the 'measurement' movement. Handing responsibility of educating doctors over to the regulator ( GMC) run by an non doctor is the final nail in the coffin. It is no longer a profession akin to an apprenticeship. So much has been lost. Too late to regain have to wait for reinvention

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  • Spot on. It is a reflection of managers job creation and doctors giving up their freedoms and professionalism. Some doctors who cannot do the work join these groups of managers. We should all boycott this and see how they get trainers.

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  • War is peace.
    Freedom is slavery.
    Ignorance is strength

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  • Very similar reasons to mine for giving up appraising. A worrying parallelism between the strictures being placed on appraising and the over-regulation of general practice. We are producing an army of ex-GPs who seem to have found a new career in slowly strangling those who are left in the ***t. I escaped some years ago and foolishly thought I could do some good helping GPs navigate A&R. Not so easy, I'm afraid. Too many boxes to tick. We all know what a good appraisal looks like. But we have to dissect the process and in the process kill it.
    Great shame.

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  • I passed the CSA but was deemed not satisfactory. I got assigned more months but they still aren't happy. To do with badly structured consults in the videos I show and running late (not much later than them) How common is this?

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