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‘Competition is fierce’: four young GPs give their views on training numbers

Four young GPs give their thoughts on the low number of applicants to GP training schemes and discuss why a career in general practice is still highly competitive.

Dr Nikita Kanani, a GP in Kent

'As a speciality, general practice allows one to develop a broad knowledge base and unique patient relationship. It also offers the most flexible way of working compared to any branch of hospital medicine, combined with a substantially shorter training period and no out-of-hours commitments and so is an attractive option for many.'

'That said, it is a difficult job with high numbers of patients, the potential for professional isolation, and numerous targets and requirements that have to be met.  A greater level of exposure to the nature of general practice may be responsible [for the fall in applicants] as many FY2 training programmes include four months in GP nowadays.'

'Furthermore, there may be an artefact causing this - since MMC, many individuals who were a few years post qualification have been unable to continue pursuing their preferred career option, and many of these will have applied for general practice.  Since MMC, specialty training is run-through and most applicants for ST1 are now coming from their FY2 jobs.  Basically, the surplus of doctors unable to pursue their first choice careers may have dried up, resulting in a reduction in the number of applicants for general practice.'

'If anything, anecdotally, medical students and FY doctors that I have come across seem more keen to consider general practice as a career, with the changing scope and potential of the job.'

Dr Deshani Shan a GP in London

'I wonder if the recent hordes of reality TV shows glamourising hospital medicine have had an impact on numbers. General practice may lack dramatic appeal compared to the televised hospital specialties.'
'Another factor may be that hospital career paths are much more structured and efficient than in the past. Part of the appeal of GP training previously was its set number of years. Now that all specialites are involved in run-through training, juniors in hospital are potentially seeing fewer disillusioned senior colleagues stuck in career ruts. Improved hours, more structured training, and the opportunity to work in a range of hospitals from DGHs to tertiary care centres can all be appealing for them. I think many people also still think of GP as an option to take up later in life, after gaining a few years experience in a specialty that interests them.'

Dr Ishani Patel (pictured), a GP in northwest London

'I'm really surprised that the applications and hence the number of vacancies have reduced... I guess from my perspective I see so many FY2 doctors keen to enter and trying to get on courses to improve their chances at the GP selection process.'

'I would have thought that there is a general shift away from medicine post graduation. I know lots of hospital doctors and GPs that are pursuing consulting, banking, journalism, as they see medicine and the NHS a harder perhaps less fulfilling nut to crack.'

Dr Surina Chibber, a GP in London

'I'm surprised that applicants have gone down as many feel that there are too many applicants and not enough places. Many people I know who applied to get a place on a GP training scheme were unsuccessful. It seemed competition was fierce for the places that were available and many were forced to spend time doing locum work or accept hospital SHO jobs whilst they waited to apply again next year.'

'London particularly has many applicants for each GP training place and many GP trainees have had to relocate to schemes outside of London in order to train as GPs. In addition applicants to general practice often include doctors who have been on a hospital speciality training scheme who decide to change career paths and become GPs - but it's very rare for GPs to do the reverse. Therefore competition for training is not just for doctors completing their FY2 year but also doctors applying from specialities of medicine and surgery.'

'In terms of hospital medicine - again from talking to colleagues and from my own experience hospital medicine training places and registrar and consultant posts have been decreased year after year leaving many SHOs little option of career progression. This together with decreasing NHS budgets, staff cutbacks, decreasing resources and increased pressure on hospital services makes hospital medicine more and more unattractive for many doctors and it seems to be becoming less about your patients and more about politics. For most doctors it was the medicine and the patients that forms our first priority and interest.'


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