Future GPs could benefit from longer training

Newly-qualified GPs could be better prepared for practice by increasing the variety and duration of their training programme, according to research being published in the April 2015 issue of the British Journal of General Practice.

The study, by Abigail Sabey from the University of the West of England (UWE Bristol) and Holly Hardy from Severn Postgraduate Medical Education, explored the views of newly-qualified GPs about their training and preparedness for specific aspects of the GP's role. It found that they lack confidence in a range of skills and experience, such as the financial and business aspects of practice and clinical commissioning. In addition, they would benefit from exposure to a greater variety of patient populations during training.

The authors recommend extended training to allow experience in different general practice settings, such as both rural and inner city practices, and increased opportunity for involvement in business and leadership roles.

The Royal College of General Practitioners, which publishes the journal, has already argued for an extension of vocational training from the current three years to four years.

Abby Sabey, who is a senior lecturer in UWE's Faculty of Health and Applied Sciences, said, "General practice is becoming increasingly complex because of an ageing population with multiple morbidities, higher public expectations, and advances in health technologies. This is driving changes in health policy and a shift of services from secondary to primary care.

"New patterns of healthcare delivery will require a flexible workforce that trains and works across traditional primary and secondary care boundaries, and postgraduate medical training is under review. This includes recommendations for extended GP training with at least 24 months spent in primary care.

"Knowledge from this study about how well training prepares GPs for their role could inform plans for optimisingextended training."

Detailed recommendations for planning extended training include:

• Provide GP placements of a few months in different types of practice during the period of training
• Provide new GPs with a leadership mentor to support involvement in roles and projects relating to quality improvement, teamwork and service development
• Provide shadowing opportunities for all trainees to work with both clinical and non-clinical professionals involved in business aspects of practice management
• Support GP practices with widening opportunities for newly-qualified sessional doctors to further develop their generalist and enhanced skills, and to be mentored by an experienced GP to help avoid a divide deepening between sessional doctors and partners
• Develop opportunities for integrating training across different specialties such as psychiatry, paediatrics, and care of older people, for example, through community clinics.