I am an ST1 doctor just embarking on the GP Specialty Training Programme journey. In this role, I was recently asked to speak at a careers and job application workshop for newly qualified FY1 doctors. The session was jointly presented with a surgical colleague who began by asking how many people wanted to become a surgeon. He was pleased to note a significant number of positive responses and went on to discuss the best route to secure surgical training.
When I asked the assembled audience of 26 how many wanted to be GPs, to my surprise only two hands went up.
I decided to perform a small experiment. I asked the audience to close their eyes. When they had all complied, I repeated the question. This time, with eyes closed, at least a dozen hands were raised.
Reflecting on this effect, I was reminded of the 1992 UK general election. For those unfamiliar with this electoral battle let me set the scene; the Conservative party was aiming for its 4th term of office. Margaret Thatcher had been deposed and John Major was on his soapbox. (Old) Labour was lead by Neil Kinnock and was hoping to grasp power from the Tories after 13 years in opposition. The numbers looked good for Labour. Going into polling day the final opinion polls put Labour ahead by 1%. However the Labour victory party turned into a wake when the votes were counted to reveal a Conservative lead of 7.5%, taking 41.9% of the vote to Labour's 34.4%.
In the aftermath there was much soul searching, and not only by the Labour party. The pollsters were stung at having got it so wrong. The Market Research Society held an enquiry to determine the cause of their very public failure.
They found that many Tory voters had not declared themselves when asked in opinion polls or even exit polls. This became known as the ‘Shy Tory Factor’ and changed the way in which opinion polls were analysed throughout the 1990s.1 It seems that many Tory voters were, for whatever reason, unhappy to be known as such, even though they were the electoral majority.
It seems that I may have accidentally discovered the ‘Shy GP Factor’.
In retrospect, maybe I shouldn't be surprised. I first had an inkling of this effect in my first year of medical school. A fellow student asked me what medical career I was planning. I said that I had always been keen on general practice.
‘Oh’, she said, ‘You're the first person I've heard admit that’.
Naively, I hadn't considered it to be an ‘admission’. Further evidence arrived during a lecture. A senior hospital consultant asked our year how many of us were heading for general practice. I put my hand up, but very few others did.
‘Ridiculous!’ he declared, ‘At least 50% of you in this room will end up as GPs!’
It was phrased as a threat.
I was undaunted and persevered.
Even now, hospital colleagues often point to my two kids and smile knowingly. ‘You chose general practice because it's family friendly?’
It's easy to agree to this, general practice is relatively family friendly.
But that's not why I chose it. I chose it because I want to be a GP. I enjoyed my medical student GP placements. I enjoyed my FY2 GP rotation. I am enjoying working in general practice in my ST1 hybrid job. I just like general practice, OK?
I'm not alone. Last year 8768 people applied to GP specialty training, chasing 2802 places (G Evans, personal communication, 2008). General practice is certainly the ‘majority’ at present.
So, can we make it easier to ‘come out’?
I suggest that we should because if we draw from the political parallel I have presented, in the following (1997) election, many shy Tories abandoned the party altogether.
- © British Journal of General Practice, 2009.