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Stress of training forces four in ten trainees to consider quitting

Exclusive GP trainees are becoming disillusioned with ePortfolios, long working hours and excessive time spent filling secondary care service gaps, to the extent that many have considered quitting training over the past 12 months, a Pulse survey has revealed.

The survey of 282 GP trainees found 38% have considered abandoning their courses in the past year. However, it also found that – on the whole – trainees are satisfied with the GP training they receive, while there is a split over whether a fourth year of training, based in general practice, would be beneficial.

But GP trainees’ reasons for considering leaving training were linked to ‘stressful’ bureaucracy and problems with secondary care placements, rather than the general practice elements of training.

Dr Aisha Mukhtar, a GPST2 currently in a hospital post, said she had contemplated quitting ‘due to the ePortfolio learning log requirements’, which she said were ‘exhausting’.

She added: ‘It takes away from our time to focus on learning/clinical needs. Any time I have left when I get home is used to do a learning log showing “reflection”, and I am left with no time to look up or read stuff that I think is clinically important.’

One GPST1 from Hertfordshire said: ‘The training is very ePortfolio-heavy and the pressure that causes is very offputting and stressful’, while a GPST2 from Somerset said ‘the GP ePortfolio is still archaic’.

gp trainees figures box

gp trainees figures box 580x, August issue

A GPST2 from the west of England said: ‘I don’t feel like I’m training to be a GP – just an SHO filling gaps in the hospital rotas, working under consultants who specialise in a different field and aren’t interested in general practice.’

After a landmark review last year found medical students were being deterred from general practice by tutors who see it as a ‘low status’ option, the Pulse survey found 80% of trainees who answered the question had experienced denigration of the profession at medical school.

And this continues in specialist training, with 29% experiencing denigration by consultants every week, and a further 37% saying they had experienced consultants badmouthing general practice once or twice a month.

Dr Mukhtar said: ‘I was complemented on how good I was and asked why I wanted to be a GP and told that “it is a waste”. Another time, one of the consultants said to me “I am sorry for you, you are going to join a truly horrible group of people”. I was hurt and it made me doubt the path I chose.’

However, trainees expressed satisfaction with the training they received in general practice. A total of 62% of respondents said it sufficiently prepares them for their career, while almost 90% said the clinical work they are required to perform is appropriate for their stage of training.

At the same time, 39% expressed support for an extra year of training, with an equivalent proportion disagreeing.

The RCGP has been pushing for a fourth year of training, with former chair Professor Clare Gerada recently going as far as to suggest a five-year programme.

Pulse also revealed last month that the RCGP has commissioned the Health Professional Assessment Consultancy to undertake a review of the MRCGP.

Read more from Pulse’s special on trainees here

 ‘We do the shifts hospitals can’t fill’

‘I have considered quitting – although GP training is great. The GP sessions are good fun, the teaching focused and appropriate.

‘However, for most, 50% of the GP programme involves working as an SHO in a hospital post. These have become heavily service provision-oriented.

‘For example, in an emergency medicine post you do three times as many night shifts as you might have only seven or eight years ago as emergency department rota managers cannot employ staff at other grades for these.

‘The bosses claim that is essential for training. You can try to raise the issue with training programme directors but as a trainee your voice falls on deaf ears.

‘I’m looking forward to ending my time as an SHO.

I just felt like I had to suck up these jobs and get on with it.’

GPST2, west of England