Could hosting medical students doing audits help to combat burnout in primary care?

Burnout is becoming a major problem in the NHS and elsewhere,¹ with many GPs ‘looking for a dignified exit from the profession they once loved.’² The nationwide shortage of GPs is likely to increase workload and stress for those still on the frontline, exacerbating problems of recruitment and retention. In our inner London general practice with 10 000 ethnically and socioeconomically diverse patients, doing audits with four bright, keen medical students helped renew our enthusiasm for primary care and may have reduced the risk of burnout. It may also have encouraged the students to consider a career in primary care.

For their audit, each student chose a clinical topic in which they, or one of the GPs, had a particular interest. Two audits were related to long-acting reversible contraception, one examined women of childbearing age taking teratogenic drugs, and one looked at gout and assessment of cardiovascular risk. With the help of our deputy practice manager and/or other non-clinical staff they then collected anonymised practice data and compared patient management with NICE guidelines.^3,4

FW and LA found that, of 50 women fitted with a contraceptive implant and 70 with an IUCD, 82% and 94%, respectively, were still using it after 12 months. HH found that all women (n = 4/4) aged 15–50 years on valproate and 87% (n = 13/15) on topiramate had discussion of pregnancy risks documented in their records. DP found that, of 128 patients with gout, only 39% (n = 50) had a record of cardiovascular risk assessment.

During the audit process the students were able to gain insight into the work of doctors, nurses, and non-clinical staff in a busy general practice. Feedback of the findings of the audits to the practice team may have improved the morale and motivation of staff and students to deliver better patient care.

Helping appreciative students to conduct audits in primary care may reduce levels of burnout in practice staff. Conducting audits helps to fulfil the requirements of the Care Quality Commission, and teaching students enables us to give something back. Most importantly, all four students are now considering becoming GPs.