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Analysis: Much more to do, but Gerada has laid the foundations

RCGP chair Dr Clare Gerada could barely contain her excitement as she announced via Twitter that the College has received approval from Medical Education England for plans to extend GP training to four years

‘Can't keep it quiet any more,' she said, before adding wryly: ‘Only taken 50 years.'  

The clearing of this major hurdle undoubtedly marks a significant step in the college's quest to extend general practice training, following its initial success in convincing the Medical Programme Board of the educational merits of the proposals, back in April of this year. 

But there is still a huge amount of work to do before the plans become reality, with Dr Gerada neatly describing the latest step as like gaining ‘planning permission' to build a house.

The college hopes four year training can begin from 2014, but must first convince the Treasury to back the plans, which will need to make financial as well as educational sense before being approved.

Dr Gerada has insisted that the plans will be cost neutral, but there remain question marks over the implementation.

The suggestion by education leaders that a national tariff could be developed for service provision by fourth-year trainees, in a bid to offset the cost of a further year's training, has proved controversial,  while the GPC are anxious to ensure that the plans financially viable, and that any changes enhance rather than just extend GP training.

The house might not have been built yet, but the foundations can now be laid. As the chief architect, Dr Gerada will strive to ensure momentum is maintained - but she may need a hard hat for the attritional work ahead.