As a newly-qualified GP, who has benefited from an extension in training from the standard 3 to 4 years I felt I should reply to the ‘Competent but not confident?’ article.1
Valid arguments were presented, including the need to review the quality of the current 3-year training programmes, and tailoring them to the individual trainee needs. However, the assertion that newly-qualified GPs are ‘not as well prepared as they used to be’ and an extension of training will ‘slow down the conveyor belt’ and ‘not make for better bangers’ is unfounded. Rather than being less prepared than trainees in previous years, it seems more obvious that the level of preparation required to fulfil the increasingly complex clinical and managerial role of a GP has increased, thus leading to calls for an extension in training.2,3,4
From my own personal experience the ST3 (registrar) year was very much focused on passing the components of the MRCGP such as the examinations and workplace-based assessments (WBPA). While these do offer an educational benchmark, I felt that they did not fully equip me for the diverse potential role of a GP including areas of research, service development, and commissioning. I, therefore, participated in a voluntary extension of training as an ‘Academic ST4’, splitting my time between primary care and a university primary care department.5 The ability to move beyond strategic learning targeted at exams, and developing new skills in research and practice development in a supported environment has been an excellent experience and was certainly not ‘always having one's hand held’.
The option to extend training by another 1 to 2 years offering varied programmes developing skills in clinical, teaching, academic, and management settings can only be encouraged. I feel this would lead to more confident GPs with an enhanced portfolio of skills to meet the challenges of the 21st century healthcare environment.
- © British Journal of General Practice, January 2011