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Why college has been riled by no to five-year training

The RCGP may not say so openly, but it is irritated by a second knock-back to its cherished training plans

The RCGP is a pretty serene, level-headed organisation. It takes quite a lot to get under its skin.

You won't hear its chair, Professor Steve Field, mouthing off, even after his proposals for five-year training of GPs were firmly knocked back once again.

Secretly though, the people at the college are pretty annoyed by this one, as much by the way it was done as the fact of it.

It doesn't help that a member of the board at Medical Education England, which was reviewing the RCGP's second report on five-year training for the Department of Health, suggested trainee GPs should simply work harder instead.

When the college asked for longer training, 48 hours a week rather than 40 was probably not what it had in mind.

The goalposts appear to have shifted, too.

The college had already submitted a detailed account last year of why five-year GP training was needed, to cope with the growing complexity of the profession's work.

This second report was supposed to be filling in the gaps, by providing a detailed cost-benefit analysis to demonstrate beyond doubt that the investment was worth it.

At least, that's what the RCGP thought, only to be told, on the eve of Medical Education England's decision, that it hadn't wanted a cost-benefit analysis after all.

What it wanted – and this is what has really riled the college – was a comprehensive case for why current levels of training are just not good enough.

To put it simply, the RCGP didn't do a good enough job at trashing current training standards – which is maybe not surprising, given it is responsible for them. It's a bit like having to call your child retarded to secure them extra maths tuition.

And after a week when NHS London proposed shifting 55% of outpatient appointments from hospitals into general practice, there is considerable puzzlement about why the board couldn't see why GPs of the future might need a spot of extra help in coping.

The college believes the case was ‘blindingly obvious'.

But the some reason, the NHS's educational experts just didn't see it.

Richard Hoey, Pulse editor