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Dr Alex Harding: ‘Lack of space is a big issue’

At present we know that about 20% of medical students want to be GPs at the end of their training. We also know that to address workforce (and public) demands Health Education England has suggested that about 50% of medical students need to become GPs, so there is a job to do. 

We also know from work in America and Australia that placements have a powerful effect on students’ future career plans. Our survey of medical schools has found that at present the national average is for 14% of student placements at medical school to be in general practice. We also have found that these GP placements have been reducing over the past ten years or so.

The big question is why this is happening? What we can say from our survey is that lack of space to teach students in is a big issue for GPs. When students come to a GP practice they really want to see patients. This means that finding extra space for the students to talk to the patients becomes an issue. In our survey we couldn’t find much evidence of funding models to support this. 

We have also documented the large increase in teaching undertaken by GPs in the last 10 years. This includes the introduction of foundation training and the increases in postgraduate training. Quite apart from this there are the increases in GP workload. So there may be a squeeze effect that is relevant.

However, there may be other factors involved. We know that teaching methods have remained the same for a long period of time – maybe these need to adapt? We also know that some of the support mechanisms for GPs have changed. For example, the survey found that the number of university departments of general practice have reduced. 

These have traditionally been a source of support for some teaching GPs. As ever, the situation is complicated, but we hope that this survey has helped the debate a little.

Dr Alex Harding, is a GP and senior lecturer at the University of Exeter