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GPC to push for ‘radical overhaul’ of ‘outdated’ GP training

The GPC has demanded that the NHS fund leadership, business and management  courses for GP trainees as part of a ’radical overhaul’ of GP training.

The motion by the BMA’s GP Committee at the LMCs Conference in Belfast, called for GP trainees to spend more time in general practice and less in secondary care.

It also called for all FY2 doctors to spend time in general practice, and an overhaul of the e-portfolio requirements.

All parts of the motion were passed in a tight vote.

Dr Justin Copitch, a GP trainee who proposed the motion, said: ’Most of you here are GPs so tell me, are you seeing the same type of patients, doing the same work, with the same computers? Is the business essentially the same? No, it is not. So why are we training the same we did?

’It is said that all foundation doctors should do a block in the community to ensure that everybody, even if you’re not going to be a GP, knows what is involved in primary care. Exposing people to GP will also increase recruitment, retention and promote GP by choice, not chance.’

’My colleague had to do six months as an SHO in that specialty as part of her GP training as that was the job she got. What a waste of time.

’We propose GP training to stay in general practice for the entirety. Just like now, 18 months will be in general practice, but the other 18 months is split. Trainees visit clinics or visit specialties related to their special learning needs.’

Dr Francesca Silman who opposed part i of the motion said: ‘Sometimes its only with hindsight you realise what you lose out on. It’s only two years since I qualified as a GP and like the trainees I spent 18 months suffering on the wards of a hospital. but I do think I learnt things on those wards that you just can’t learn anywhere else. In one of my jobs we were doing palliative care, end of life care plan on a weekly basis. In GP it just doesn’t come up enough, and when it does, you are responsible.’

In favour of the motion was Dr Rami Eliad from Hertfordshire, who said: ‘Having been a trainer since 1998, this has been one of the most rewarding and sustaining part of my work as a GP. I’m very proud to see, what we called trainees, now registrars. However, with the new contract, the increased perplexity of general practice of both clinical and managerial, I question whether we are training our GP registrars for their future jobs.’

Dr Fiona Sanders, however, said: ‘Lets not throw the baby out with the bath water. Yes trainees do need more time in general practice but surely that should not be at the expense of getting valuable hospital experience.’

BMA GP trainees subcommittee co-chair Dr Zoe Greaves said: ’It’s not enough to leave training with clinical competence alone.’

She added: ’We need to be clear in what the words of this motion are saying. They are not saying they do not need any experience in hospital, and I don’t think anyone on the committee, or trainees would say that but we need the right experience in hospital that will help us when we return to the community. If we were asking a surgeon to spend half their training in general practice, they would be appalled.’

Motion in full

That conference recognises GP training is outdated and needs radical overhaul. We call upon GPC to work with relevant stakeholders to:

(i) push for GP trainees to be predominantly based in general practice with set time to attend secondary care for learning opportunities

(ii) overhaul the e-portfolio requirements to ensure it is equitable across the UK

(iii) learn skills vital to modern GPs such as leadership, business, and management through funded courses

(iv) ensure all FY2s have a community placement amended to: ensure all FY2 have a fully funded community placement