The recipe for general practice

I agree with Steven Taylor when he writes of the problem of the hospital placements that currently form part of the training programme.¹ I am a GPST1 and currently work on a Care of the Elderly ward as well as doing my share of the medical on-call rota. Before entering the GP training scheme, I previously held training places in two other specialties. The GP training does not compare favourably with these; Steven Taylor is right when he says that our training programme is made up of the ‘leftovers and castoffs from other specialties’ training’. The training offered in other specialties is specific and targeted.

Currently, I feel that I am treading water waiting for my training to begin. I am unsure how much more knowledge of hospital medicine, beyond that which I learned during my foundation training, I will acquire by the end of my hospital placements and the relevance of this to general practice. It seems incredible to me that I have little real notion of what being a GP entails and I will not have that insight until I am over halfway through my training.

When I trained as an anaesthetist, I did not have to spend time working taking bloods on the surgical ward. The idea seems absurd, as well as demeaning. It is easy to imagine how the status of anaesthetists would be undermined if such training were to exist. General practice deserves better too. By all means, keep a component of hospital experience within the training, but let it be what we choose as best for the development of good GPs. For example, paediatric experience is arguably valuable, but perhaps it should be a series of short secondments to paediatric outpatient clinics, which is where the two specialties interface after all.

Fundamentally, Steven Taylor is right that the training of GPs should be in general practice.