I agree with Zou and colleagues1 that challenges concerning the quality of training remain, mainly because most GP trainers in China are practising in hospitals and lack expertise in managing patients in community settings. But, for the same reason, the development and implementation of community-based training programmes for GP trainers, as Zou et al suggest, may be difficult to realise on a large scale.
Under the hierarchical medical system initiated in 2015, China’s GPs and specialists in hospitals are encouraged to practise in community health centres, aiming to establish a stable cooperative relationship of technical assistance.2 It could be an opportunity for GP trainers to learn how to provide primary care in community settings. However, they seldom interact with primary care practitioners because of the limited duration of practice and the unawareness of improving their teaching competence regarding primary care in community settings.
Measures should be taken to promote interactions between GP trainers and primary care practitioners. Some recommendations may be worth considering. First, GP trainers should be treated as equals when they practise in the community. It is essential for managers and GP trainers to recognise the importance of learning from primary care practitioners. Second, the duration of GP trainers practising in community settings could be extended to increase continuity. For example, for a GP trainer who practises in the community for a half-day per week, it could be arranged for them to practise for 1 month per year. Third, opportunities for collaborative work could be created to help GP trainers be more familiar with managing community-dwelling patients in daily practice. They could become a member of the team led by GPs in the community to provide primary care, such as vaccinations and home visits. Finally, GP trainers could be encouraged to train GP residents in cooperation with GPs in the community. The effectiveness and limitations of their teaching method can appear more obviously in this approach, which may improve the quality of training in the long term.
- © British Journal of General Practice 2020
