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Where are all the decent GPs of the future?

After a depressing round of VTS interviews, the Jobbing Doctor fears for the future of general practice.

After a depressing round of VTS interviews, the Jobbing Doctor fears for the future of general practice.

The Jobbing Doctor has been helping to select people for General Practice Training for more than 20 years. Now, the whole process has become centralised in each region, and as a result some of the individuality of the selection process has been lost.

When Jobbing Doctor became a General Practice Vocational Training Scheme (VTS) course organiser, the interview process consisted of each department in the VTS sending at least one consultant to the interview, plus all the trainers being represented. This resulted in an interview panel that sometimes consisted of twenty people! A very long table with all these people congregated around, and one poor interviewee at the end: it was ghastly. It reminded me of the famous picture in the Walker art Gallery in Liverpool about a captured royalist boy being quizzed by the roundheads: ‘And when did you last see your father?' painted by William Yeames.

Slowly I changed it so that the interview panel consisted of me, a consultant and a trainer. That worked pretty well, until the authorities decided to take it over.

41223913We have been through all sorts of panels and interview ideas, until we've reached the current one, and I'm not sure any of them are any better than the way we developed it in our patch with the small group of interviewers.

The quality and the range of candidates has also fluctuated, and we have hit some purple patches, with excellent young locally trained doctors opting to stay in the region and selecting a career in primary care. We had a particularly good period from around 2003 to 2006 - a period that coincided with an opportunity to not have to do evenings and weekends and a hike in our income.

That period is over and it really ended around the time that there appeared an co-ordinated campaign to denigrate general practice, which most of us believed was orchestrated from within the Government and through their favourite media outlets, including the Daily Mail.

The quality and numbers have declined fairly steeply. Evidence of this was clear when Jobbing Doctor attended a Regional selection day for recruitment. There was a dearth of talent and of the interviewees at least 75% were foreign graduates, many with quite poor language skills and limited knowledge of UK general practice.

It was, I'm afraid, a fairly baleful experience, that actually made Jobbing Doctor quite depressed. There were no more than a handful of local graduates, and you must bear in mind that this was a second round of interviews and worse candidates than these had already been selected out.

So I ask myself ‘where have all the good ones gone?' The ones that come to my practice as medical students and have been really good. The ones I have tried to be a role model to and have spent hours teaching and encouraging in their career choice. To see where I need to look at the chatter that occurs on doctors' fora on the internet (I visit these sites from time to time).

I have been made aware of the catastrophe that is junior doctor training with ‘Modernising Medical Careers' and the ‘Medical Training Application Service'. I have seen and understood the absolute lottery that is planning for your own career and the icy unforgiving hand of bureaucracy and the despair wreaked on general practice as a result of Government policy. The only career options in these difficult times seem to be some salaried posts and an opportunity to work in a ‘Darzi-style' polyclinic.

What is the talk of on these doctors' websites?

Emigration to Australia.

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