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Fewer trainee doctors intending to become GPs, show official figures

The proportion of foundation-year doctors intending to become GPs has dropped in the last year, according to the latest career destinations report.

The 2018 report on the intended and final career destinations of F2 doctors also found the proportion actually going into specialty training, including GP training, has plummetted from 71% in 2011, to just 38% last year.

More doctors are also taking breaks after foundation training, in part due to ‘increased stress and burn-out’, the report said.

While the BMA said the drop in GP numbers is ‘worrying’ and will only worsen the current workforce problems, Health Education England said the latest trends highlight a ‘change in attitude’ which need ‘further exploration’.

This comes despite the GP trainee recruitment target being surpassed for first time last year.

The annual UK Foundation Programme Office report surveyed all F2 trainees on their career aspirations and planned pathways, with 6,407 responses included.

It said: ‘GP self-reported intention fell from 21.4% to 18.7% and core medical training (CMT) increased from 18.3% to 20.7% compared to 2017.’

When looking at where the trainees actually ended up, the survey found the number going into specialty training (including general practice) had decreased every year since 2011, from 71.3% to 42.6% in 2017 and then 37.7% in 2018.

However, an increasing number of doctors are also taking breaks after foundation training.

‘Since 2011 there has been a downward trend in the number of F2 doctors moving directly from the Foundation Programme into specialty training in the UK, with 37.7% of F2 respondents reporting immediate entry into specialty training in 2018,’ the report said.

Although the report said it could not provide definitive reasons behind the decreasing GP numbers and increasing breaks, it is thought stress and continuous examinations could be important factors.

It said: ‘Investigation by the GMC and other organisations has demonstrated increased stress and burn-out along with dissatisfaction with certain elements of the training structure among junior doctors generally.

‘The unremitting examination and assessment cycle throughout medical school and foundation training results in many doctors expressing a desire to “step-off” training and have more control over their working schedule or to take up the opportunity to travel with or without a work component.’

It added that GP recruitment is ‘more complex’ as last year saw a record number of GP trainees recruited, an increase which seems to go against these findings.

However, this is most likely due to many of these new GP trainees not coming directly from foundation training, the report said.

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BMA GP executive team member Dr Krishna Kasaraneni said: ‘Whilst it is positive that GP recruitment has improved this year, the fact that fewer and fewer foundation doctors are choosing GP as a career overall is worrying.

‘If that trend is not reversed, we do worry that GP workforce will continue to drop and the workload will become unmanageable for the ones left behind.’

Health Education England deputy medical director for education reform, Professor Sheona MacLeod, said:Opportunities for portfolio-based careers, the chance to develop additional skills and recognition of less than full-time training for doctors are just some of the factors which have led to a decrease in the number of doctors at the end of medical school who are intending to progress as soon as possible into specialty training (including GP).

‘It highlights a change in attitude which is evident prior to entry into the UK Foundation Programme and this needs further exploration.’

Earlier this month, Health secretary Matt Hancock told Pulse a new date for the Government 5,000 extra GPs target has not been set, although he admitted it would be ‘slower than was originally’ thought.

A five-year GP training scheme – recruiting trainees straight from medical degrees – is also in discussion and could start in 2021, following a pilot in East London, an NHS England advisor told Pulse.

Stated Career destinations of successful foundation level 2 (F2) doctors

Subtotal for specialty (including GP) training in UK:

2011 – 71.3%

2012 – 67.0%

2013 – 64.4%

2014 – 58.5%

2015 – 52.0%

2016 – 50.4%

2017 – 42.6%

2018 – 37.7%

Source: F2 Career Destination Report 2018