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Education bosses launch landmark review into GP attitude in medical schools

Education bosses will launch a review on attitudes and exposure to general practice in medical schools as a first step to developing a strategy for improving undergraduates’ experience of the profession.

In a presentation of its business plan for 2016/17, Health Education England has said it was launching a review after GP leaders condemned the ‘toxic’ anti-GP culture that persists in some UK medical schools, and has seen undergraduates told if they ‘fail they risk becoming GPs.’

HEE’s action plan said it aims to ‘review the profile of the GP career in medical schools, publish a report and recommendations and develop a strategy for implementation’ as a key deliverable. 

The GPC told Pulse that they were represented on the review group and had recently run a symposium with stakeholders in GP undergraduate training to identify what problems persist.

The ‘task and finish group’ has been commissioned by HEE and the Medical Schools Council, which last year said it was working with the RCGP to promote general practice, and that its members had made a ‘commitment’ to articulate the importance of general practice to students.

That committment followed comments by RCGP chair Dr Maureen Baker, who said there was a ‘toxic anti-GP culture’ in universities, which has to be addressed before the gaps in GP postgraduate training can be fixed. 

But this was undermined when Sir John Oldham, chair of the Independent Commission on Whole-Person Care and a GP in Glossop, reported that a medical school dean had told an intake of students that ‘We work you hard because we don’t want you to fail and become GPs’.

And last November NHS England director of primary care commissioning Dr David Geddes said that general practice ‘prejudice’ needed to be ‘stamped out’ at all levels of training, ‘because we need far more GPs than we need more consultants’.

A HEE spokesperson said: ’Health Education England invited Professor Val Wass to chair a working group which is co-sponsored between HEE and Medical Schools Council. This group will report in the summer. It has extensive involvement of medical students, trainees, GP bodies and medical schools.’

Dr Krishna Kasaraneni, chair of the GPC’s education, workforce and training subcommittee, told Pulse: ‘This is about trying to look at the culture in medical schools themselves, and how can we improve the quality of general practice training and education at undergraduate level. So hopefully, with positive experiences in general practice, medical students will choose general practice again.

‘This isn’t a shotgun solution because culture change is much more difficult to achieve. At least if we get the ball rolling, then 10-20 years down the road there will be many more students in general practice.’

Dr Baker said: ’We have been calling for any anti-GP rhetoric that might exist in UK medical school to be tackled for some time, so we welcome this review by Health Education England, and look forward to working with them to shape its outcome.’

Pulse revealed last week that the Department of Health was looking to reform funding for training placements in general practice at all stages of medical education.

But the negative publciity from the Government’s ongoing dispute with junior doctors has taken a toll with applications to medical schools dropping 13.5% in two years, even before Jeremy Hunt announced he would impose a new contract requiring routine weekend working. 

How to solve a problem like GP recruitment?

Professor Bill Irish - online

Professor Bill Irish – online

Research shows that undergraduates are now spending 14% less learning time in general practice than in 2004.

 Then-chair of the GP National Recruitment Office, Professor Bill Irish, pointed the finger at long-established medical schools in Oxford, Cambridge and London failing to train the best candidates for GP specialist training.

A GP Taskforce report, which HEE had been accused of burying, suggested medical schools should be incentivised for boosting recruitment.

But despite this recognition, applications for GP specialty training have fallen 5% in this year’s first recruitment round, following 11% of training places were again left vacant last year.