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At the heart of general practice since 1960

We need to do more to inspire the next generation of GPs

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‘What advice would you give to your former student self?’ And so concluded my interview from Lara, Zeyar and Faseeha - three second year medical students from Glasgow University, visiting for the day to produce a video about the job of an island GP.

The enthusiasm from undergraduates, untainted by scepticism and experience, is a major reason why our whole practice team values having medical students join us for their placements. We aim to provide a number of open electives, as well as several formal placements for Glasgow, Dundee and London universities. Our motivation to continue these is easy to derive from the feedback we generate.

There is an absolute obligation on us all to provide these opportunities where possible, if we are to inspire the next generation.

However, like many rural practices, there is no shortage of applications to experience the delights of generalism. One of the most frustrating observations from the last year is the fact that we have had to turn down over eighty applications for electives - most of which have been from the UK.  We simply can’t take them all, and yet unfortunately there is no alternative route for students to follow, other than individually applying to another practice.

I used to forward these enquiries to confreres in other parts of rural Scotland. However, they are all experiencing similar saturation levels, or indeed have reached the point that ‘nice but unresourced’ work such as elective placements are simply too difficult to justify amongst other rising pressures.

And yet we know that undergraduate experience works. It’s evidence based, by the World Health Organisation no less, that providing general practice experience to students - particularly rural practice - sparks the tinder of realisation that generalism offers some of the most challenging, rewarding and stimulating medicine. So much so that the experience is heavily influential on choosing a generalist career later on.

So it pickles me to wonder why we haven’t already made it easier - at a national level - to ensure that we inspire the next generation of GPs with the experiences they’re asking for. It will need leadership, money and co-ordination, but in return we could crack one nut that the sustainability of general practice will depend on. We can build on all the fantastic work going on already in university GP departments to help students see a bright side of medicine.

Thinking back to my own student days, I found myself repeating advice that I had received whilst a student in Stornoway: ‘Seize every opportunity. And never lose sight of the diagnostic power contained within your patient’s story combined with sound clinical examination.’

With the interview concluded, I can only hope that their interest in generalism has been sparked like mine was - wherever that may lead them.

Dr David Hogg is a GP on the Isle of Arran, Scotland. You can follow him on Twitter @davidrhogg

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Readers' comments (10)

  • Aye, but if that were true. Why are establishment GPs leaving? Why do we have to bail out established practices ?
    Perhaps re students who want to come in their hordes as students soon see CQC and GMC and Defence and complaints and penance etc. Maybe your GP land is different from mine. But a lot of GPs do not wish to stay.
    You Have to give them the whole picture.

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  • - Because workload is unrelenting.
    - Because we can't do "free" anymore
    - Because many of us can't bring ourselves to lie to juniors and tell them its a good choice anymore.

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  • There is a dichotomy between the enthusiasm of the young medical students and the stark reality of the doctors. In the UK the gap is even more dramatic and aggravated by the weight of two factors now become unbearable: the habit of the people to complain against physicians, with an accomplice stupidity of the managers who are called to settle the cases.
    The second weight, terrifying, is the GMC and the MPTS two bodies acting against the law, in an uncontrolled terror; using prevarication and intimidation as usual weapons.
    To be doctor in UK is comparable of being the Partisans of Resistance to oppressive regimes.

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  • Pay them good money . That usually works if there is a shortage of skill. But if HMG think they're not worth it , then this might explain their lack of enthusiasm.

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  • Can't polish a turd my friend!

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  • Medical Students are full of the expectation of a wonderful job as a GP. Well it used to be 30 years ago. Not anymore.

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  • I would tell students to graduate and then

    DITCH THE COUNTRY COMRADES AND MOVE TO A LAND WHERE THEIR FUTURE IS SECURE AND PROFESSION IS VALUED

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  • David, it's unethical to lie to your junior colleagues. I know Arran is lovely, but for most, the job will break you, and as evidenced today, our political masters don't give a toss. The public and the rabid media apparently think we should all be grateful to have a gold plated NHS job dealing with their every whim and sniffle. We all retire at 50 anyway, apparently.

    They should start paying F1s in Aussie Dollars.

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  • We should not be a recruitment agency for the DOH. We should not deceive the youngsters. I would certainly not think of a GP career if I was starting out again!

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  • David Hogg

    Thanks for the comments there, some of which I was expecting! I realise that I am fortunate to work in an environment which can still offer a decent learning environment.

    I think there is a difference between enthusing students to be NHS GPs, versus helping them to realise the overall opportunities in medicine. Events today, and in the run-up to today, have angered me more than probably any other event of my career, and yet 1) I'm in Scotland and 2) not a junior doctor, so it doesn't directly affect me. We are witnessing, in England, the sell-off of so many values that have been our raison d'etre for so long.

    The problems in general practice do seem far more pronounced in England, not least because of Hunt's complete dissociation from the medical profession. There are plenty of challenges up here in Scotland, and plenty of frustrations about what our government should be doing to support quality general practice. However the situation in England seems absolutely desperate (from many reports), and I'm not for a minute suggesting that we paint a rosy picture for students who want to go into NHS GP there... or indeed anyone who plans to be a junior doctor under an enforced contract.

    That said, general practice has and continues to provide a stimulating career for some of us. A career in medicine can, and should, extend beyond the realms of the UK NHS and I think most students are switched on to that prospect. Increasing numbers seem intent on living in Australia immediately after qualifying - our loss, their gain. The NHS landscape for them will likely be different in the next 5 years. Whilst realising the many problems of seeking work abroad, if it doesn't offer current students/FYs/STs the career they want, there is a rich international market who will be keen to value them more appropriately. This will be the legacy left by current decision makers.

    Writing an article like this is bound to attract some criticism, particularly those who are even more fed up than me with the politics of late, and I gave that some thought before submitting this blog. Despite all the frustrations in GP, there is still a bit of room for occasional positive thoughts. Personally, the enthusiasm and initiative of medical students helps to propel me through my career, and I don't like to see potential wasted.

    I am absolutely against any idea of misleading students into a dead-end career. However, one of the best ways for them to see the positive aspects of generalism - wherever they may end up working - is to facilitate placements like the ones mentioned. Who knows, once some areas of the NHS realise how they stand to lose out bigtime (NHS England?) on the commitment and skill of doctors-to-be, there might just be the turning point that current medical students need to see a career in the NHS open up again.

    Meantime, things aren't all rosy in Scotland either, but I continue to get satisfaction from seeing medical students develop here, and still wonder how we can support our future confreres more effectively. Perhaps some of the comments above are simply highlighting the profession-decomposing effects of such poor leadership from political 'masters'.

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