‘The Fellowship is breaking, it has already begun’

James Bennett

doi:10.3399/bjgp24X739773

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Creating international community of practices to support newly qualified GPS
Koki Kato

Published on: 02 November 2024

Published on: (2 November 2024)
Page navigation anchor for Creating international community of practices to support newly qualified GPS
Creating international community of practices to support newly qualified GPS
Koki Kato, GP and the director of Madoka Family Clinic, Madoka Family Clinic
I resonate with Bennett's account that GP registrars focus on passing the qualification assessment, and the nuance of applying knowledge in practice as an expert generalist is at stake.¹ The situation is similar in Japan. To be eligible for the assessment, Japanese GP registrars must submit evidence of experience and its reflection in 20 fields, such as patient-centred care, designated by the Japan Primary Care Association (JPCA). GP registrars have struggled to complete them, and some couldn't take the assessment, so the JPCA recently decided to reduce the fields from 20 to 16.

However, GP trainers have also struggled to support GP registrars because they do not have enough time to help them and sometimes do not have enough experience to develop learners' reflections. Thus, the problem is not just the number of fields but, more broadly, the training structure, including the working environment, trainees, trainers and multidisciplinary teams. In this situation, the nuance Bennett described is also at stake here. Creating fellowship programmes for newly qualified GPs could be one of the practical measures to tackle the large iceberg.

I am also biased, like Papanikitas; I work with one such fellowship offered by the Hokkaido Centre for Family Medicine (HCFM), a GP training programme with a long and honourable history in Japan. HCFM provides a two-year fellowship for newly qualified GPs who work in the organisation. The fellowship helps...
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I resonate with Bennett's account that GP registrars focus on passing the qualification assessment, and the nuance of applying knowledge in practice as an expert generalist is at stake.¹ The situation is similar in Japan. To be eligible for the assessment, Japanese GP registrars must submit evidence of experience and its reflection in 20 fields, such as patient-centred care, designated by the Japan Primary Care Association (JPCA). GP registrars have struggled to complete them, and some couldn't take the assessment, so the JPCA recently decided to reduce the fields from 20 to 16.

However, GP trainers have also struggled to support GP registrars because they do not have enough time to help them and sometimes do not have enough experience to develop learners' reflections. Thus, the problem is not just the number of fields but, more broadly, the training structure, including the working environment, trainees, trainers and multidisciplinary teams. In this situation, the nuance Bennett described is also at stake here. Creating fellowship programmes for newly qualified GPs could be one of the practical measures to tackle the large iceberg.

I am also biased, like Papanikitas; I work with one such fellowship offered by the Hokkaido Centre for Family Medicine (HCFM), a GP training programme with a long and honourable history in Japan. HCFM provides a two-year fellowship for newly qualified GPs who work in the organisation. The fellowship helps participants have confidence in delivering advanced generalist care, practice management, and GP registrar education. HCFM started the fellowship in 2006 and now has 43 graduates. The fellowship has worked well so far, but it cannot cover a large number of GPs right now.

I recently went to Hull York Medical School to see a CATALYST fellowship programme and found many similarities to HCFM's. Professor Joanne Reeve, Dr James Bennett, and their colleagues kindly invited Japanese members to discussions to ensure that GPs can confidently provide advanced generalist care. I rediscovered the potential of fellowship programmes. The UK and Japan have wisdom in supporting young GPs. Although they are scattered, I hope connecting them creates a new landscape.

Reference
1. Bennett J. 'The Fellowship is breaking, it has already begun’. Br J Gen Pract 2024;74(748):505.
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Competing Interests: None declared.