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Top universities failing to produce enough future GPs, says head of recruitment

Exclusive The top universities in the country are not doing enough to produce future GPs and are adding to a recruitment crisis in the profession, the chair of the GP National Recruitment Office has warned.

Professor Bill Irish, a GP in Bristol, said that older medical schools - such as those at Oxford, Cambridge and in London - were not doing enough to train the best candidates for a GP specialist place, despite a national shortage of GPs.

Speaking exclusively to Pulse in this week’s Big Interview, Professor Irish - who chairs a group on workforce as part of a Government taskforce on boosting GP numbers - said there had been a steady increase in GP training places, but admitted they were ‘a way off the target’ set by the Department of Health to boost the number of GP trainees by 20% by 2015.

He said the taskforce was looking at figures showing that general practice was not often a ‘first choice of career’ and there were ‘big differences’ between medical schools in the number that choose to take up the profession.

His warning comes as Pulse revealed vacancy rates in general practice have quadrupled in two years, leading to claims of a looming workforce crisis in the profession.

Professor Irish told Pulse: ‘Certain medical schools have a very low output of GPs, and others - particularly the new ones - have a very high output.’

‘There is something around the way those medical schools choose students, or something about the curriculum, or the hidden curriculum  - the things they are told in their training – that pushes people one way or another.’

‘The Ivy League equivalent - the Russell Group universities - tend to put a lot of emphasis on academic achievement and the production of biomedical sciences, which, while important, doesn’t fit closely with most people’s ideas of general practice. We need to be looking at people who are slightly more rounded, more mature with a more holistic view of medicine.’

He added: ‘It takes many years to make these changes. But I would make the point that medical schools are largely funded by Government… it is incumbent on medical schools to produce the kind of trainee we want.’

Professor Irish cited a 2011 study in the British Journal of General Practice that showed only 11.9% graduates from Oxford and Cambridge cited general practice as their first choice career path. In London, the figure was 19.4% and the figure for other long-established medical schools was 23.3%.

However, in new medical schools - such as East Anglia and Brighton & Sussex - 27.6% of students cited general practice as their first choice.

Professor Michael Goldacre, who is a professor of public health at the University of Oxford and one of the authors of the BJGP study, said: ‘One explanation is the characteristics of the students who successfully get into the Russell Group. Oxford and Cambridge would say they recruit students who have a strong biological science orientation.’

‘The other explanation is the way careers in general practice are marketed by medical schools and some will be stronger in promoting general practice than others.’

Dr Krishna Kasaraneni, chair of the GPC GP registrars subcommittee, said: ‘We need to publicise that general practice is a rewarding career. That message doesn’t seem to be getting across to medical students at the moment.’

The Russell Group which represents a number of leading universities was unable to provide comment in time for publication.

 

Pulse Live: 30 April - 1 May, Birmingham

Pulse Live

Stephen Dorrell, chair of the House of Commons health select committee, will be talking about where general practice will fit into the NHS of the future at Pulse Live, Pulse’s new two-day annual conference for GPs, practice managers and primary care managers.

Pulse Live offers practical advice on key clinical and practice business topics, as well as an opportunity to debate the future of the profession, and a top range of speakers includes NICE chair designate Professor David Haslam, GPC deputy chair Dr Richard Vautrey and the Rt Hon Stephen Dorrell MP, chair of the House of Commons health committee.

To find out more and book your place, please click here.

Readers' comments (8)

  • Its not that the medical schools are "failing" to produce GPs but that most medical students choose not to go into general practice.Its a sad fact that GPs are still regarded by most (including hospital colleagues and the media) as "failed hospital doctors".On top of that when you consider the worsening situation of declining pay,increasing workload and tick-box culture,not to mention the stress of meeting the expectations of an increasinginly litiginous population with shrinking resources,its not surprising that they are quite sensibly staying away from General Practice.

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  • My son has just started at Oxford, I have told him not to waste such an excellent education on becoming a box ticker.

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  • One other explanation is that the newer medical schools are likely taking in a higher proportion of mature students (my local school has students in their forties), and the decision to do GP is often a "mature" one, taken when doctors have families, etc, to consider.
    MMC, in forcing many doctors to choose their future career little more than a year out of medical school inevitably reduced the proportion going into GP. Prof Irish could work someway to reduce this by going back to offering more shortened schemes to doctors part way through specialty training, as in the halcyon days pre MMC (when half took this route). This would also bring more GPwSI into the profession and lead to a more diverse and skilled workforce.

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  • I am a GP. I previously worked as a Specialist Registrar in Diabetes and passed MRCP (on the first attempt) in addition to winning a Scholarship at medical school. There are many other GPs with a hospital background who voluntarily chose GP land. Does that make me a "failed hospital Dr???". The only thing I am guilty of is naively assuming that one would be treated as a professional in General Practice rather than as a dogsbody by all and sundry. The reason for the lack of interest is rather that "the word is out about the major structural problems in GP land". Making the speciality more attractive is the only solution-students are voting with their feet.

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  • Vinci Ho

    (1) First of all , one has to understand that General Practice is a Speciality by its own right . We are all Specialist in Family Medicine
    (2) The government needs to stop OPPRESSING GPs
    (3) I am not sure about the concept 'good' GPs can only come from the 'top' medical school . Be careful we are not falling into some kind of right wing ideology
    (4) The recruitment crisis is not built up in one day. People inside and outside the profession needs to clear their mind and identify who or what is the real devil causing the crisis.......

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  • Harry Longman

    I'm just reading Julian Tudor Hart on the pivotal role of the GP in Britain's NHS. Recommended to the heads of the medical schools. We should celebrate one of our greatest strengths in healthcare is general practice. "Inspire a generation" is the phrase that comes to mind.

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  • Remember David Haslam's article in the Sunday Times in 1992 "Just a GP" I do . It was so apposite.
    Last month in front of a an orthopaedic surgeon friend married to a GP I got the "just a GP" bit from a senior banker so I retorted by saying and here is a just a revision hip surgeon!
    I pointed out that i was a jack of all clinical trades, a master of a few, and additionally that asa GP I am also a financier, manager, entrepreneur, employer, landlord, educator, mentor, Chief Executive Officer, organiser and deliverer of clinical services all as part of being "just a GP".

    Nothing further heard!

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  • Good for you Peter :) glad to see someone standing up to such pig headed ignorance!

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