Excusive A record number of doctors applied for initial allocation GP specialty training places this year but the vast majority face rejection, Pulse can reveal.
Across the UK, 15,036 applicants applied for over 4,000 GP ST1 training posts in the first round of this year’s application cycle.
This is the highest number of applications since 2013 and represents a vast increase from last year, when there were of 4,522 applicants to the GP Specialty Training Scheme (also known as the Vocational Training Scheme).
GPs and junior doctors expressed concerns that the Government’s target to increase GP training places in England to 6,000 by 2031 is not at the pace needed and prospective GPs are being turned away.
Dr Hannah Hafezi, a Foundation Year 3 doctor, said: ‘Junior doctors are passionate about becoming GPs and serving their local community, but it is frustrating to take years out and be stuck working in hospital medicine until you get into GP training.’
Dr Hafezi previously applied for GP training and felt this year’s application cycle was more difficult.
‘Locum jobs are becoming harder to get, there is no job security jumping from hospital to hospital and a lack of continuity of care leads to poor patient care.’
‘More needs to be done by the government – 6,000 is just the tip of the iceberg of what we need.’
Dr Tafsir Ahmed, Foundation Year 3 doctor going into GP training next year, added: ‘This year is unprecedented compared to previous years.’
Some of the aspiring GPs Pulse has spoken to felt that high competition ratios in other specialties has exacerbated a GP training ‘bottleneck’, resulting in more doctors choosing GP.
Dr Faisal Rehman, a Foundation Year 3 doctor, applied to both GP and anaesthetics training, and said: ‘There are lots of people I know who want to go into GP and are having to travel one or two hours away because of the lack of spaces; one friend has put his offer on hold to opt in for upgrades.
‘The system is saturated as more doctors take years out and struggle to get into other specialties. Nothing is being done to mitigate the whole process – it is only going to get worse next year.’
An HEE spokesperson told Pulse that final numbers of posts for GP specialty training were not yet available, but there would be a minimum of 4,000 posts advertised in England across two rounds of recruitment with August and February start dates.
They said: ‘Further posts may become available during this round of the application cycle, but the final numbers of trainees will not be finalised until the February 2025 start date.’
Dr Selvaseelan Selverajah, GP partner and training programme director in East London, said: ‘It is really great to see GP remains an attractive post but [the figures] show we need to desperately increase GP training places, fund more GP trainers and GP premises, and ensure support programmes are present to retain newly qualified GPs in the area they are qualified.’
Junior doctors were particularly critical of the ‘Professional Dilemmas’ aspect of the Multi-Specialty Recruitment Assessment (MSRA), which was solely used to rank candidates, and point to the prioritisation of trainees who apply to GP as their first choice as a potential solution.
Dr Ryan Carey, Foundation Year 4 doctor, said: ‘The test is a random number generator – you can only study so hard for it.’
Junior doctors also expressed concerns abut allied healthcare professionals impacting on the number of GP training posts.
A GPST1 trainee, who wished to remain anonymous, said: ‘The cynic in me says not creating enough places is because you can probably get away with staffing practices with cheaper labour.’
The RCGP changed its stance earlier this month and explicitly stated that GP training and retention should be prioritised over physician associates.
Figures show there are over 1,500 full-time Physician Associates (PAs) working in GP practices and primary care networks and a third of PAs are hired through PCNs via the additional roles reimbursement scheme (ARRS).
GPs are concerned that putting applicants through such a competitive process will exacerbate already high levels of burnout prevalent amongst GP trainees.
Dr Thanigasalam Nissanthan, GP trainer and training programme director in Central Hertfordshire, said: ‘The incredibly high competition ratio this year is going to have an impact – morale in GP is already not very high.’
Dr Malinga Ratwatte, chair of the BMA’s GP Registrars Committee, said: ‘The falling number of specialty training posts available in general practice is concerning. General practice isn’t being given the resource it needs to train the next generation of doctors to provide this care.
‘To train a GP, a practice needs a trainer – a senior, experienced GP who can mentor that doctor. With pressures on general practice so intense, many experienced GPs are burning out and leaving. Elsewhere, practice running costs are so high that even if a surgery wanted to hire a GP trainer, they cannot.
‘The Government must urgently put more investment into general practice so that we can expand the number of GP trainers and registrar posts.’
Pulse has contacted the Department for Health and Social Care for comment.
The deadline for holding and upgrading offers for this application round is 9 April, with round two expected to begin in July.
Full figures for the 2013 to 2023 application cycle:
Year Applications Posts Competition Ratio 2023 10,514 3,935 2.67:1 2022 8,549 4,137* 2.07:1 2021 7,640 4,269 1.79:1 2020 5,770 3,836 1.50:1 2019 5,166 3,861 1.34:1 2018 4,987 3,763 1.33:1 2017 5,097 3,857 1.32:1 2016 4,863 3,802 1.28:1 2015 5,112 3,612 1.42:1 2014 5,477 3,391 1.6:1 2013 6,447 2,787 2.3:1
*Round three data from 2023 has not yet been published, and thus this is not a final figure of acceptances.
READERS' COMMENTS [4]
Please note, only GPs are permitted to add comments to articles
Well when the application only involves the same exam as the majority of other specialties, a large number of applicants will tick the GP box to give them an extra option. I did the same with psychiatry when applying for GP.
This is called ”black humour”———many years back I was exempted from Vocational Training because I had returned to Practice within nine years of leaving it——–so I’d got an allowance for having done no ‘hands on’ training———just as well, because it’s not necessary anyway
In early 80’s only one year trading was required to get jcptgp certificate and prior to this nothing except full gmc registration was needed to be a gp.
They need to find shorter route for doctors who have done a lot of hospital work and also recognise overseas experience.
According to the available places for GP training since 2013 it should have been 24000 GPs added to the workforce already. So, 24000 GPs plus all those qualified before 2013 minus those who have retired or left equals THE NUMBERS DO NOT ADD UP! Huston we have a retention problem.