The Future of General Practice – Destination GP

The Royal College of General Practitioner’s released its report Destination GP, in November 2017.

“Students are the future of medicine and the future of our profession” Professor Helen-Stokes Lampard, RCGP Chair

Recruitment into General Practice has become a major issue, and we do not have enough doctors in primary care to support the increasing pressures. The importance of medical students and medical schools has now been highlighted, in an attempt to ensure the future of this field. There are more than 1 million consultations in primary care everyday and it is the backbone of the NHS. It is imperative we plan for the future, to maintain and provide this high quality service for our patients. The General Practice Forward View (GPFV) commits to a goal of increasing the number of doctors working in general practice in England by 5,000 by 2020.

This is a document which builds on the By Choice – Not by Chance report by Higher Education England and the Medical Schools Council, published in November 2016. The report outlined a number of recommendations to better support medical students towards a career in general practice. There were three major problems identified:

1. “Tribalism” – This describes the distinction between primary and secondary care. Primary care is often associated with a ‘lower status’ – you do primary care if you are not clever enough or interested in hospital medicine, would not be an uncommon thought. Students also believe that is does not provide the academic challenges of hospital medicine.
2. “Negativism” – There is negativity from the profession itself. GP’s face a stressful daily workload and this influences their career decisions. In some cases, students were actively being dissuaded from the profession.
3. “Finance” – Tensions around funding for undergraduate education. The current system needs reviewing to allow students to have adequate good exposure to General Practice, in a structure and with the support the medical school needs.

The Royal College of Psychiatrists has previously released research suggested that 27% of medical students would change their career path due to “badmouthing” of a speciality. They found that this denigration was happening particularly in General Practice.

The key findings of this report:

3,680 medical student from across 30 medical school in the UK took part in this study, representing 9.4% of all students.

Recommendations:

1. The power of peers and role models

• RCGP should continue to support student GP societies (with medical school support)
• A network of champions
• Awareness needs to raised to GPs as to the importance of their influence

2. The impact of clinical contact and need to change discourse

• Work with medical students to address unintentional denigration to primary care in introductory lectures and the curriculum
• High-quality placements should be sought
• Better collaboration between medical professionals
• Work should be continued to dispel misconceptions about the career

3. The need for an accurate and informative picture of the future of General Practice

• RCGP should further develop it’s Discover General Practice programme
• Evidence and accessible information should be consolidated into a series of accessible resources to showcase the opportunities within the career (including special interests)
• Pathways to academic medicine need to be clearer and improved accessibility to them in the curriculum
• The holistic and community component of General Practice should be promoted

4. Influences beyond the taught environment

• Co-ordination between influencing bodies to ensure information is clear and accurate
• Continue investment to make it a more attractive place to work
• People are often put off by workload and increasing pressures, the government need to address these issues and act in the short term to ensure students are not dissuaded to maintain the career long-term

Destination GP report can be found: http://www.rcgp.org.uk/policy/rcgp-policy-areas/destination-gp.aspx

By choice, not by chance can be found: https://www.hee.nhs.uk/sites/default/files/documents/By%20choice%20not%20by%20chance%20web%20FINAL.pdf