General practice makes perfect
Around half of medical students will end up training to become GPs. Yet this career pathway is viewed by many students as a “soft option”—consigning you to a lifetime of colds and ingrown toenails. I recently heard a fellow medical student remark to another: “Don’t take this offensively, but I think you’d make a really good GP.” Where does this disregard for general practice as a career stem from, and why do some medical schools produce disproportionately fewer GPs?
In the latest UK Foundation Programme Office national F2 career destination survey, medical students from Bristol University were ranked third (after Cambridge and Oxford) in the list of universities whose medical students are least likely to train as GPs. At Bristol the course is separated into the lecture based preclinical period followed by the clinical years, which are predominantly spent in the hospital environment. Lectures are often given by hospital consultants, and teaching of clinical anatomy tends to be geared towards conditions that would present in emergency departments. Having spent so much time watching doctors racing around the wards and being surrounded by hundreds of patients and coworkers throughout the clinical years, students might feel more naturally channelled into hospital specialties and dislike the idea of slowing the pace and sitting behind a desk as a GP.
In contrast, at universities such as the University of East Anglia, one day a week is spent at a GP surgery throughout the duration of the course. Their problem based learning course structure predominantly focuses on clinical scenarios and is applied to situations presenting in a primary care setting in the GP teaching sessions. As such, it could be argued that problem based learning lends itself more naturally to a career in general practice as students from the universities with this course structure become more familiar with primary care than students from universities adopting a more traditional structure.
It is vital that universities with a low output of GPs take greater measures to promote the advantages of working in primary care. Life as a GP is challenging and rewarding, encompassing a huge range of presenting complaints and giving the opportunity to build more personal relationships with patients. General practice also lends itself more naturally to a more portfolio type career, with many GPs taking on additional responsibilities such as GP training, sitting on commissioning boards, and teaching.
For me the most effective teaching in a clinical setting has undoubtedly been the five afternoons spent in a GP surgery. To see a more equal distribution of graduates choosing to train as a GP, medical schools need to teach students much earlier that just as much job satisfaction can be found in a GP surgery as in any other specialty.
CAREERS, p x
1University of Bristol, Bristol
Correspondence to: firstname.lastname@example.org
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
- UKFPO. F2 career destination survey results. 2012. www.foundationprogramme.nhs.uk.
Cite this as: Student BMJ 2013;21:f4480