The production process for fresh GPs from our specialty training is like the process for making sausages: a pleasing end product, but we distract ourselves from thinking about the content too much.1,2
The difficulties of the right mix of hospital training placements is that, for general practice, every hospital-based speciality is both relevant, and yet irrelevant. But why hospital-based training at all? No GP programme director has yet been troubled by the paediatricians demanding that their trainees receive placements in primary care — where the majority of paediatric practice occurs in the UK — and the ambition to integrate 4 months of general practice into every foundation placement remains unrealised. Why do we, as a college, and as a specialty, seem satisfied with filling our training programmes with the leftovers and castoffs from other specialties’ training? Why be satisfied with what we are given?
The very best place for general practice specialty training is within general practice, and for too long we have pretended that hospital-based placements are essential to develop good GPs, when the reality is that our trainees are required to keep the hospital service going. We need an end to the calls that paediatrics, psychiatry, and the rest are essential, and it is time to shout that GPs should be wholly trained within general practice for at least 3 years. Shout loudly for the proper resourcing of our skilled trainers to deliver the generalist, broad-based training that hospital practice will never give us.
Notes
Competing interests
Steven Taylor is Programme Director for Norfolk GPSTP, although he does not write in this capacity.
- © British Journal of General Practice 2017