As a trainers group that meet regularly to discuss issues with GP training in Shropshire we have spent much time recently discussing the suitability of the trainees entering vocational training (VTS). First, we have had some concerns over the standard of the undergraduate teaching from certain universities (sometimes even in the EU) where basic examination techniques and medical knowledge have not been thoroughly taught. Can we as GP trainers really be expected to cover the whole MRCGP curriculum, language, and communication issues as well as teaching all basic examination skills and medical knowledge in the 2–3 hours teaching we have each week? These problems may be avoided by a more detailed look at the candidate's undergraduate experience before allowing them onto the VTS. Perhaps for those deemed to have potential, a preparatory clinical period could be arranged before joining the usual 3-year scheme.
Second, we have found that some trainees do not possess the necessary communication and interpersonal skills to pass the CSA part of the nMRCGP. It has been shown that, statistically, certain groups of doctors are more likely than others to repeatedly fail the CSA, as we have witnessed locally. A trainee who has grown up in the UK must be at an advantage in understanding and using not only the words of language but also the colloquialisms and nuances of speech as well as broader cultural aspects. We understand that the UK does rely heavily on taking doctors from overseas to fill the gap in posts nationally, however, if the UK continues to award training places to doctors who may later struggle (despite their best efforts) we feel it would only be fair to offer increased support with language and communication skills when they are accepted by the NHS or at the latest when they start their specialist training. However, some of us doubt if this can easily be ‘taught’. We wonder if the situation is similar over the rest of the country.
The selection process already seems to have altered locally as the West Midlands Deanery did not fill all its vacancies on the GP training scheme in 2011 to avoid taking doctors who were unlikely to succeed. However, we would invite further discussion regarding these issues as we feel at present some of the trainees may have been treated unfairly. The consequences for them as individuals will be life long as they will be unable to work in general practice or retrain for any other speciality.
- © British Journal of General Practice 2012