If we want to attract more GPs, the profession needs to flaunt its best bits
Offering work placements in general practice for GCSE students, attracting business-minded medical students, and running a pro-GP marketing campaign would all help the profession get its reputation back on track, argues Dr Ben Brown
In its GP2022 strategy, the RCGP is calling for 10,000 more GPs to join the profession - it argues an increase in numbers is essential to meet the future demands placed on our health system.
Arguably, labelling the current recruitment situation a ‘crisis’ is not necessarily helpful. However, it is essential to acknowledge and understand the problem in order to remedy it. To enable us to bring more GPs into the profession we need to know why they are leaving - or not joining general practice in the first place.
The causes are multiple and complex. We are losing GPs through early retirement, and this is coupled with declining numbers applying to join the profession. Contributory factors to the latter may be ‘over supply’ of doctors into other specialties such as surgery, and negative perceptions of primary care. GP ‘bashing’ in the media and the barrage of headlines claiming that we work fewer hours and less hard for more money, diminishes the confidence of the wider public in general practice and perpetuates a lack of understanding about what the life of a modern GP is really like. We also know from research that young doctors and medical students are simply not considering GP as an option at the outset.
But we shouldn’t ruminate on the reasons why doctors are not choosing to enter general practice. There are many positive steps I believe that can be taken across the system.
Focus on your best bits
Prior to medical school, work experience placements for sixth-formers and GCSE students would stimulate interest and influence their career options early, showing them how interesting a life in general practice can be.
At medical school, there could be early input from GP tutors in the curriculum. Basic clinical sciences such as physiology, anatomy and pharmacology could be taught by GPs at the start of training rather than just being confined to communication skills in later years. This would not only bring to life the clinical relevance of these subjects but also develop inspirational GP role models. We should look to the universities who produce large numbers of GPs, and emulate how they achieve this throughout the UK.
Better insight into what the job is actually like would also be useful at undergraduate level. General practice offers flexibility and many opportunities not available in other specialities. Gaining the insider view of how to run your own business whilst balancing this with clinical commitments would, I’m sure, appeal to many entrepreneurial medical students.
Championing general practice as a scholarly specialty may also help. During selection for GP training there is currently no impetus to aspire to excellence - you are not asked about your previous achievements at interview or to talk about your CV. This can perpetuate the perception of general practice as a non-academic specialty, and changing this may improve our image. In addition, better integration of primary care academic and teaching departments at medical schools would showcase the opportunities for academic endeavour in primary care to high flying undergraduates. Summer schools and academic prizes awarded on a competitive basis may also attract the best students and foundation doctors.
Another idea might be to offer an academic qualification earlier on. Aspiring medics and surgeons can reinforce their commitment to their specialty by doing the first part of their Royal College exams in foundation years – perhaps something similar could be extended to GPs?
For foundation doctors, early placements for all in general practice would allow enough time to make an informed choice when applying for specialist training. Well supported placements help to prevent isolation and mitigate dealing with clinical uncertainty, which may put off newly qualified doctors who favour the security of hospital medicine.
For those beyond foundation training, it should be made easier to switch specialties. Previous clinical experience should also be taken into account so you do not have to repeat aspects of training you have already covered.
Finally, to counteract negative stereotypes, a co-ordinated mass PR or marketing campaign to present general practice as an exciting and fulfilling career would be welcomed. For example, you only have to look at the scheduling of the television shows ‘Doctors’ (daytime) versus ‘Holby City’ (primetime) to see what we’re up against. Failing that, all GPs should be encouraged to act as ambassadors for our profession and promote general practice as the varied, stimulating and rewarding profession it is.
In my role as RCGP AiT Committee Chair, I meet GPs at varying stages of their careers and all are extremely proud of what they achieve and the difference they make to the lives of their patients. The AiT committee is working on a project to showcase the expansive career opportunities available for GPs in the hope we will encourage more doctors to apply to this worthwhile specialty. Hopefully this will go some way to stem the current recruitment problem and make general practice an appealing career for the next generation.
Dr Ben Brown is chair of the RCGP AiT Committee and an academic GPST3 in Manchester.