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- Page navigation anchor for The discipline of general practice: recognition and teachingThe discipline of general practice: recognition and teachingAs final year medical students training in a graduate entry programme, “The discipline of general practice: recognition and teaching” by Sir Denis Pereira Gray in the British Journal of General Practice1 captured our attention. General practice training is emphasised throughout our course with a 6-week placement in our final year – equal to the other specialities that we focus on.In our experience, it is common that general practice is criticised by those working in hospital medicine.2 The discrimination against general practice certainly has a subliminal, if not obvious role in discouraging medical students from going into GP. It certainly would explain why only 59% of doctors agree that ‘general practice is more attractive than hospital practice for doctors at present’.3. We are lucky however, that unlike the medical schools mentioned in the article with no GP role model,1 we have block leads who are GPs as well as, teachers in various other areas such as ethics. There is no confusion in what should be taught at GP with clear learning outcomes provided by our medical school. We agree that as medical students, our most valuable teaching and that which is most relevant to our finals has been whilst at GP.With the UK healthcare system requiring that 50% of new UK-trained graduates in medicine should enter general practice,3 i...Show MoreCompeting Interests: None declared.
- Page navigation anchor for A students' perspectiveA students' perspectiveStudents find placements in general practice very useful. They provide a high turnover of new patients to clerk and examine, with a huge variety of presenting complaints and underlying diagnoses in every session.A GP tutor told me once, when I asked for a teaching session on paediatrics, “I can teach you about primary care paediatrics.” I hadn’t previously appreciated this distinction, and it is an important one. While it is true that one can learn much about looking after sick children in primary care, this perception of the substitution of specialist placement for general practice undermines what makes general practice special.If what is unique about general practice isn’t communicated clearly to students I would echo the author’s concerns that this can create a potential misunderstanding - that a general practice placement is “hospital medicine outside the hospital”.I suspect that promoting general practice placements in a way that even more clearly highlights that they are different and require rather different skill-sets from “hospital” medicine would be helpful.Competing Interests: None declared.
- Page navigation anchor for Improving the image of general practitioners at a costImproving the image of general practitioners at a cost
These BJGP editorials seem to be quite concerned of GPs being perceived as physicians falling off the hospital consultant ladder.1,2 Unfortunately, this misconception exists because some practicing GP principals were once specialist trainees, and later chose to become GPs due to various reasons. This is unfair to the GPs who are genuinely interested in their profession from the beginning of their training.
To rectify this misconception, the GPST Recruitment Office could consider limiting the openings for dropouts from specialist trainee programmes, and favouring applicants who directly apply to GP training straight from foundation years. However, without the dropout candidates from specialist training programs, many GPST positions would be unfilled. This proposed solution would only help GPs to maintain a prestigious image, but not resolve the work shortage problem.
Another possible solution would be for the GPST recruiters to spend more time evaluating candidates’ portfolios, primary care experience, and audit projects, rather than select candidates mainly based on examination marks and scores in the Selection Centre scenarios.3,4 This would help recruiters to find out who have keen, genuine interest in general practice, and do not see general practice as their last option. However, this would create more workload for the already overstretched GPs, because of the time needed to review applicants’ portfolios.
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Show MoreCompeting Interests: I have been paid for working as a physician, but not writing this letter. - Page navigation anchor for Medical schools and general practiceMedical schools and general practiceSir Denis Pereira Gray makes some salient points about the role of medical schools in GP recruitment, which I hope the new medical schools recently announced (one near me) will take note of. Even when a medical school has an active primary care faculty, they may not be engaged in promoting general practice as a career. Certainly when I was a medical student, our medical school had an academic department including a very well known professor; unlike almost every other specialty represented in the university, none of the senior academics seemed to have any involvement in teaching medical students - not even an introductory lecture to demonstrate why we should consider GP as a career. Our teaching at the university was exclusively done by what I now realise were academic GP registrars; not a bad thing in itself but perhaps not ideal without any senior input? Thankfully, I encountered a number of enthusiastic GP trainers on placements who took a clueless medical student into their busy schedules, introduced me to the writings of McWhinney and Starfield, and showed me what a diverse, exciting and rewarding career general practice offered. So, many thanks to Drs Nick Foreman, Tony Antoniou and especially Iain Crofton-Briggs; after two weeks in his company I knew that there was no other job I wanted to do. I hope that as a GP trainer I can do likewise for our local students in the future. However, I would implore the career GP academics in medical schools to step back from thei...Show MoreCompeting Interests: None declared.