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Experts call for overhaul of general practice education funding as time spent in GP placements falls

Funding for general practice education needs overhauling, researchers have concluded, after the publication of a study that found medical students are spending two weeks less in GP placements than they were 10 years ago.

The research, published in the British Journal of General Practice and first revealed in Pulse, shows that general practice teaching for medical students has plateaued at 13% of medical schools’ curriculums.  

It also shows the total amount of exposure to general practice over a course has, on average, fallen by almost two weeks between 2002 and 2012.

GP leaders said that the failure of medical schools to promote general practice as a career could have a ‘devastating effect’ on the profession.

Researchers, including Dr Alex Harding, secretary of the Society for Academic Primary Care and a GP in Exeter, along with colleagues from UCL, are now urging a ‘national re-examination of undergraduate curricular priorities’.

This is in a bid to redress the low amount of time medical students spend on general practice training and help make it a more attractive career choice in the face of the ongoing GP recruitment crisis.

The researchers surveyed 29 UK university medical departments and found that the number of 3.5-hour teaching sessions per student delivered in general practice during years 3 to 5 of medical undergraduate courses declined by 14%, from 119 sessions in 2003 to 102 currently, equating to 1.7 fewer weeks.

The study found that undergraduate exposure to general practice positively influences future career choice.

This is particularly important in the current environment where the Government wants 50% of all medical students to join general practice, but currently only 19% of medical students express general practice as their first career choice.

The cross-sectional questionnaire study also revealed that general practice teaching received only 7.1% of clinical teaching funding.

The researchers stress that current payment mechanisms for undergraduate GP teaching are highly variable and can be complicated, and suggest a ‘simpler and more direct payment mechanism’ that might include earmarking funds for general practice teaching and the direct transfer of these funds to general practice.

They conclude: ‘This would bring the payment mechanism in line with payments made to hospitals and may help ensure that general practice teaching receives more appropriate resources.’

Responding to the research, RCGP chair Dr Maureen Baker, said: ‘It is astonishing – and outrageous – that the proportion of time spent in general practice placements is actually falling, given the importance of the profession and medical generalism in the NHS.’

She stressed that all medical schools have a responsibility to promote the opportunities and challenges of a career as a GP

Dr Baker warned: ‘Failure to promote general practice as a career by universities could have a devastating impact on the profession and the NHS as a whole.’

Earlier this month, data released by the GMC revealed that only 16% of Oxford graduates choose to enter general practice, followed by St George’s Hospital Medical School with 19%, the University of Edinburgh at 22% and the universities of Bristol and Cambridge with 25%.

Richard Wakeford, a fellow at the University of Cambridge, has pointed out that only two of the 33 representatives on the Medical Schools Council are GPs, which he says leaves general practice education at a disadvantage.