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HEE set to open up GP recruitment to failed trainees and hospital doctors



Exclusive Education bosses are planning a major shake-up of GP recruitment which would give ‘targeted’ support to trainees who previously failed to complete entry requirements, and specialists wishing to retrain in general practice.

Health Education England is looking at how a new scheme could work for groups including those who left GP training after failing the RCGP’s qualification exam (MRCGP), in a bid to boost GP numbers.

The ‘fixed term targeted GP training programme’ – which comes as the Government is fighting an uphill battle to fulfill a promise of 5,000 more GPs by the end of its term – would also be open to hospital specialists wishing to retrain in general practice and doctors from overseas who require further training.

HEE has invited the GPC to advise on the new programme in a letter seen by Pulse.

It said the new programme would offer additional personalised training to doctors who are currently blocked from GP training.

The GPs will not have to obtain a certificate of completion of training (CCT) through the RCGP exams but will instead be able to enter general practice through an equivalent qualification, the ‘Certificate of Eligibilty for GP Registration’ (CEGPR), which is usually reserved for overseas doctors.

The RCGP has previously said this route ‘is generally not intended for doctors who had not managed to attain MRCGP.’

In a letter to the GPC, HEE said: ‘We are looking for individuals to gain GP registration and we expect that this would be through one of the CEGPR routes, it is unlikely the individuals would fulfil the statutory requirements for CCT, but we would not wish to close this option should they do so.’

But it added that it was ‘important that we maintain the existing standards of appointment, training and assessment to ensure the continuance of the high standards and safe patient care provide by GPs’.

The letter further said a ‘bespoke training’ programme would give flexibility to take into account any ‘existing experience and expertise’ a doctor might have and any ‘transferable competencies’.

This could be particularly relevant for doctors looking to retrain as GPs from another specialty who are prohibited by time or loss of income constraints.

The GPC told Pulse that it welcomed the recognition that training should be ‘personalised’ to support doctors, who would otherwise be locked out of general practice, to demonstrate the competencies needed.

Dr Krishna Kasaraneni, GPC lead for education, training and workforce, told Pulse that it had accepted HEE’s invitation to join the talks on the new targeted training programme.

He added: ‘This is not about dropping standards, this is not about introducing new grades, it’s about providing personalised training that trainees need.

‘People who need extra time and extra support, will get that time and support to meet the competency, which is what the BMA has been calling for as part of our work on differential attainment in GP training.

An embattled exam

Pulse revealed earlier this year that the RCGP estimates said ‘around 400’ potential GPs were trapped in MRCGP limbo after being unable to pass clinical skills assessment component.

Candidates can typically only have four attempts at the exam and are then unable to complete the MRCGP – a pre-requisite for receiving a CCT.

Representatives had met with the College to argue these doctors could support the GP workforce if they were given further supported training time before taking an alternative assessment like the CEGPR.

But the College had pointed out that many of these doctors already struggle to meet ‘equivalence’ standards for clinical skills and knowledge, and said an overhaul would require regulatory change.

This followed the row over the differential pass rates between white and black and minority ethnic doctors taking the CSA, which led to the college undergoing a judicial review.

The court ruled the MRCGP was lawful but urged the RCGP to take action around the number of BME doctors and international medical graduates failing the exam.