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GP training rota has turned me into a dinosaur



I was alarmed this week to discover that I’ve turned into a dinosaur. Life comes at you fast; one minute you’re a regular down-with-the-kids GP-blogger-about-town, the next you’re a lumbering sauropod, swamp grass dangling from your slack jaw as you stare dumbfounded at the approaching meteorite. The figurative asteroid in question, and the cause of my sudden metamorphosis, is the new GP registrar timetable produced by NHS Employers.

I realise that I’m now an extinct reptile

I realise that I’m now an extinct reptile of the order Ornithischia, but just look at this damn thing. To fit the terms of the new junior contract, the concept of a GP registrar doing a normal working GP day has been chucked out the window. Instead, we now prepare our juniors for a professional career in general practice with a timetable that three days out of five sees them already home watching Fifteen to One before nursery assistants and milkmen have even clocked off yet.

We’re told that it’s just an example, but even utilising the secondary brain in my armour-plated sacral region I can’t figure out a way to provide a trainee enough hours of face-to-face patient interaction to pass the CSA without either a) breaking the contract (leaving the training practice liable to heavy fines) or b) departing totally from the traditional GP workday (meaning the trainer, who is obliged to provide ‘immediate’ clinical supervision during surgery, will be forced to do the same). Other iterations I’ve heard suggested include not coming in before 10 each morning or only turning up at work three days a week. ‘Has the world gone MAD?’ I bellow plaintively into the unheeding Jurassic twilight.

I hope any trainees reading this don’t misunderstand me here; I’m not arguing for exploitation. I just think it’s important that training gives you a genuine feeling of what the actual job is like, and these new rotas fail to do this, meaning your first experience of real GP working hours will be post-qualification, without the support of a training practice. Sorry if this sounds patronising. What can I say? I’m fossilised here.

But furthermore, this whole situation seems to have been imposed on training practices without any input at all from GP trainers, either in contract negotiation or rota design. With rumours of a 30% funding cut in the offing, I’d argue that’s not a sensible way to treat people. Unless you want GP training to end up, y’know, extinct. 

Dr Pete Deveson is a GP in Surrey. You can follow him on Twitter @PeteDeveson