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The waiting game

Giving the next generation of GPs a voice

Editor’s blog

Editors love control. So it was a massive surprise to my team when two months ago I invited a group of GP trainees into Pulse HQ to guest-edit the magazine.

They were delightfully insightful and forthright bunch, with many ideas on what we should cover and how we should start a debate on GP training and the future of the profession (you can see some behind-the-scenes pictures of our meeting on our GP Facebook group here).

In fact they had so many ideas we decided to have a month-long special on Pulse in August, with a series of investigations, opinion pieces and advice articles published throughout the month on subjects that are important to the next generation of GPs, as many step out clutching their brand new CCTs.

As GPST2 Dr Alex Gates says in his column today, there is often speculation about what the next generation wants or needs, but it is rare that trainees are given a voice themselves. That is precisely what we intend to do this month.

Today Pulse published its first ever survey of GP trainees showing their career intentions after qualification. Contrary to popular belief, nearly 40% see themselves becoming a partner one day. Rumours that the partnership model is dead, are perhaps premature.

The national newspapers all went on the line that one in five GPs are thinking about leaving the profession altogether, but the overall picture is a lot more complex. GP trainees are – on the whole - enthusiastic about their choice of career, but perhaps not for the reasons most think they are. On average GP trainees wanted to work a 5.5 session week and many cite ‘work-life balance’ or having a ‘portfolio career’ as the top reasons for them choosing general practice as a medical specialty rather than the straitjacket of working in a hospital trust.

GP trainee roundtable

GP trainee roundtable

This idea of general practice becoming a ‘part-time profession’ may be uncomfortable for some, but Dr Gates argues powerfully that that ‘sugarcoating’ full-time general practice will not help attract medical students to join the profession. Perhaps wisely, GP trainees value the flexibility of being able to work less hours in the consulting room, thereby protecting themselves from burnout.

But all this raises profound questions for general practice as a whole. How many more GPs will be needed to plug workforce gaps if all new recruits decide to work part-time (c.f. Professor Ian Cumming’s recent comments on ‘Millennials’)? How can continuity and the partnership model be preserved if a tribe of portfolio doctors are clocking out in the middle of the working week? How can younger GPs learn the day job if they are spending half their time starting tech companies and dabbling in medical politics?

What is clear is that a full debate is needed about what the future workforce in general practice should look like and whether the current model is fit for the next generation. But it is crucial that this discussion includes GP trainees themselves and their expectations about their future careers.

A major shift is coming, whether we like it or not, and the profession needs to prepare for it and listen carefully to those who will be taking general practice on in the years to come.

Nigel Praities is editor of Pulse

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Readers' comments (3)

  • Vinci Ho

    I think there is a potential argument of how many sessions a week as a minimum to just maintain continuity. It is always about a happy medium.
    Certainly an open debate is much welcome

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  • AlanAlmond

    The ability to work part time, have outside interests and have a flexible career are part of the reason I became a GP, and I've been one for 12 years. Many of my fellow trainees felt the same back when I was training. This isn't 'new'. These have been reasons to be a GP for many years and isn't something peculiar to the current crop of GP newbies. Neither are these aspirations incompatible with the partnership model. Plenty of partners work part time.
    If the partnership model is struggling it isn't because it is inherently unattractive. It's because it been strangled almost to death by government micromanagement (QOF, QCC etc etc) and underfunding. That's what needs to be fixed. I would suggest the future of general practice is very bleak indeed if the ONLY option for those qualifying into general practice was working as a salaried GP for an entire career. Why would anyone spend thousands of pounds and years of study qualifying as a Dr only to work as a salaried GP until they are 68? For all the talk of a future with 100% salaried service I'm quite sure it won't happen - at least not the way the powers that be would like. No one would bother to train as a GP if that's all there was. I suspect the bulk ofl GPs will end up offering their services as locums...effectively opting out of the straight jacket of an NHS contract. If we don't fix the funding and micromanagement problem with partnerships...that's what we're going to get. Not salaried GPs...Locum GPs (truly independent contractors who will require payment at a genuine market rate)

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  • Azeem Majeed

    Thank you Nigel and the Pulse Team. This was a great opportunity for GP Registrars.

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