I realise that telling you I’m a GP trainer might cause something of a shock. It certainly does to my trainees. But it’s true. And what’s also true is that my next trainee will be my last, because I’ve had enough. True, explaining why I’m jacking in training goes against the grain of the RCGP’s ‘not in front of the children’ approach. But sod that, I’m going to tell you anyway:
1. It’s hard work.
If you don’t think so then a) you’re not a trainer and b) you’re wrong. As we all know, we’re running as fast as we can on the Great Hamster Wheel of general practice yet, each year, the speed is cranked up further. So something has to give, and, in my case, that’s training.
2. There are too many abbreviations.
And I’m allergic to them. COTs, CBDs and mini-CEXs make me itch. CSA, AKT and WPBA trigger angio-oedema. And NTN, ARCP and COGPeD have me reaching for the adrenaline. Though it’s not just the abbreviations that are the problem. Combine them with the jargon, the arcane processes and the whole educational schtick, and you end up on Planet Fluff, far, far from home.
3. The e-portfolio.
It is literally impossible to say ‘ePortfolio’ without putting an expletive between the ‘e’ and the ‘portfolio’. It’s like an episode of James May’s The Reassembler, but in reverse. Instead of experiencing the joy of constructing something from its component parts, we dismantle the educational process until we despair at the hideous, non-functioning mess we’ve created. Then we have to tick boxes to confirm that’s what we’ve done, proving, as if the appraisal process hasn’t already, that having to be seen to do something completely destroys the value of actually doing it.
4. The new junior doctor contract.
I’m not going to bang on about the massive logistical and philosophical problems this creates for trainers, because Pete Deveson has done that better than I could (pulsetoday.co.uk/deveson). Nor am I going to pretend that it was the final nail in my training coffin, but it certainly added another layer of lacquer.
5. The pay-off.
Training has always been a trade-off in terms of effort and benefit. One of those benefits was the feeling that, by nurturing young talent, you were helping future-proof the profession. No longer. The vibes these days are that many trainees are just passing through en route to careers that may be very distant vocationally and geographically from general practice. I realise trainees can, of course, decide to do what they damn well please, and that my saying this might piss them off. But I don’t care, because it’s a genuine and gnawing feeling, and one that causes increasing discomfort as each day gets busier and lonelier.
Put simply, if you want to ruin training, then deconstruct it, over-regulate it, mystify it, strangle it with bureaucracy, render it less rewarding and then suck any residual joy out of it. Which in fact is a fair description of what is happening to general practice, so you could argue current training is the perfect preparation. But don’t tell trainees that.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield