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Independents' Day

Remember you were the future – once

Dr Zoe Norris

‘Trainees nowadays don’t know anything. They just learn how to pass exams, how to request lots of fancy tests.

‘They follow all the guidelines, no common sense; just not ready for the real world of general practice.’

Yeah you know the type who says this.

Whatever challenge you face, they had it harder. That patient with the weird presentation – they’ve seen it. The diagnosis you were so pleased to pick up – it was obvious.

They have a litany of what’s wrong with the profession, but can’t offer solutions. While lamenting the fact that hospital juniors don’t work 120-hour weeks any more, or that someone keeps letting all these damn women into medical school, they forget the first rule of being a GP: don’t criticise other groups of GPs.

The second rule of being a GP is DON’T CRITICISE OTHER GPS.

If this was a generational thing, maybe it would be easier to get my head around. But it isn’t. Some of the most vocal criticisms of trainees and newly qualified GPs come from their close peers.

If you think new GPs don’t have the skillset they should, then stop whinging and do something about it. Telling them they are rubbish before they have even started is probably higher on the list of sins than telling them things are all roses and kittens in general practice at the moment.

Write to the college – it sets the curriculum. Give specific examples, not general complaints. Offer to teach at your local VTS, and cover the ‘real-world’ topics you think are lacking. A few sessions on practice management from an experienced partner or practice manager can be invaluable.

If you are a trainer, look at the content that’s being delivered. A few VTS sessions at the end of ST3 covering all those bits that aren’t in the curriculum (but everyone needs to know) would be perfectly viable. Make sure there is long-term support; encourage trainees to stay in touch with you, their trainers and each other. Make sure that trainees are aware of their LMC and who represents them.

Or here’s a novel idea, why don’t we ask the trainees what they would like to know? Ask them and the First5 cohort, what was missing and how we – their colleagues – can help. Often it’s the simple things that seem the hardest.

Where do they get the right locum A & B forms from? What do they do if they’re having problems? How do they join the out-of-hours service?

Whatever support they need, the rest of the profession can provide it. We just have to listen, and maybe set aside our own preconceptions for a while. What is right for me isn’t necessarily right for you. What general practice looked like 20 years ago is not what it looks like now.

It may not be a popular view, but the profession is changing. Let’s support our trainees in creating the general practice they want to work in and stay in. Remember, we may need someone to prescribe our donepezil sooner than we think.

Dr Zoe Norris is a GP in Hull


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Readers' comments (10)

  • Vinci Ho

    ''The world is yours, as well as ours, but in the last analysis, it is yours. You young people, full of vigor and vitality, are in the bloom of life, like the sun at eight or nine in the morning. Our hope is placed on you.'' That was what evil Mao propagated to his youngsters in 1967. And of course , history had proven his dangerously flawed hypocrisy.
    I use this as a reciprocal motto warning myself everyday to put aside any pride and prejudice in facing young people , especially the bit 'the world is yours , as well as OURS......'
    It was then , this is now . But the cycles of history never stop. The wave in the front is pushed by the ones from behind and them from those further behind with no pausing.
    Real learning is through making mistakes. One may not agree but I would say for those who have established with time(may be I am qualified to be one) , it is a responsibility to create and maintain a 'safe' environment and atmosphere within which our young learners can make their 'mistakes'.........
    '......I don't know how to answer you, except to say that I teach you truths. My truths. Yeah, and it is kinda scary, dealing with the truth. Scary, and dangerous...'
    To Sir , with Love(1967).
    PS declare of interest : I am never a trainer.

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  • Cobblers

    Yes things change but in essence it stays the same. My senior partner some 35-40 years older than I had similar comments about me.

    Old news this blog and I suspect even older than we think. (millenia)

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  • Really well said Zoe, thank you.

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  • Tom Caldwell

    Largely agree, though I see one potential weakness.

    The career that many are choosing to work in is missing something crucial. For very good reasons they are looking to less than full time working; they are looking warily at partnership (biding their time); they are looking at what else a CCT in general practice offers. None of these are bad things.

    However the workload outstrips what is on offer in terms of workforce. This means those already firefighting to keep stuff standing whilst changes can occur are taking a double hit of less choice and more demands.

    So "someone" has to have it worse than "someone else" for an understaffed underdoctered primary care to accommodate the career these newer ex trainees wish to pursue.

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  • Vinci - every day I look forward to reading your comments and this is one of the best.

    I do hope I can meet you one day at Pulse Live.

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  • Criticising people simply for lack of experience is never helpful. Thinking people should "know their place" as a trainee is never helpful.
    I love the idea of reverse mentoring for example. New ideas and ways of doing things should be welcomed .

    Insight on all sides is required however. Someone who has never done a job needs to think carefully about telling people who have done it how to do it. And someone who has been doing it for years shouldn't think they know it all.

    I have loved taking trainees through the scheme as a PD and a trainer. I have learned loads. I have also been told to "shut up and only speak when spoken to" in a meeting as a trainee GP. Open mindedness is the key.

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  • I know when GPs have started to learn - when they used to say 'the guidelines say.....' they now say, 'the guidelines say....., but', in other words they are thinking about the individual, and what is best for the individual.

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  • Vinci Ho ... your lateral take on things .. but I must be getting old .. well said!

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  • AlanAlmond

    So who is actually saying this kind of stuff about trainees? Seriously who? Yet how many readers are nodding smugly to themselves thinking 'oh that's so right ..go Zoe!'
    Mocking nonexistent/minority stereotypes, magnifying false divisions. and grinding ancient axes.
    Isnt this actually a little sexist, ageist and a wee bit divisive? Does this kind of article bring us together or feed feelings of resentment and division?

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  • I hold my hands up-I was probably lying in a gutter somewhere when I should have been attending the tutorial in which "The Rules of Being a GP" were being taught.If there are further rules, beyond the 2 mentioned above, then I humbly ask someone to enlighten me.....

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