A taste of rural Highlands and Islands general practice: evaluation of remote placements in GP specialty training

Abstract

Despite being home to the most remote GP practices in the UK, the Highlands and Islands GPST programme offers its trainees limited opportunity to gain experience in remote general practice. In an attempt to remedy this situation, a pilot of short remote placements was carried out in spring/summer 2010. The aims of the pilot were to assess the placements' feasibility including level of interest from GPSTs and remote GPs; evaluate the perceived benefits to GPSTs and their hosts; and consider the impact such placements might have on recruitment to remote and rural general practice. Following the placements, semi-structured interviews were conducted with participating GPSTs and host GPs. In addition, written statements were collated from interested GPSTs prior to their placement indicating why they wished to take part. Parties who had expressed an interest but for whom a placement did not take place were asked to complete a follow-up questionnaire. Placements were highly valued by both GPSTs and their host GPs. In particular, the GPSTs valued being able to 'put themselves in the shoes of a remote GP' and being able to discuss potential career pathways with a remote practitioner. The participating GPSTs all had pre-existing interests in a career in remote and rural general practice, but found this was reinforced by their remote placement experience. Sufficient host GPs were identified to accommodate all of the interested GPSTs and placements were successfully organised despite a limited budget. Difficulties obtaining study leave did hinder some GPSTs, and this consideration along with resource limitations are potential barriers to the scheme being continued in the future. Remote placements are valued by GPSTs considering a career in remote and rural general practice and tend to reinforce their interest in this area. However, it is unknown whether this will impact on recruitment. Inviting GPSTs from outwith the North of Scotland to experience a remote placement might allow them an insight into remote and rural general practice that is not possible from their host deanery. The benefits of a remote placement to GPSTs without a pre-existing interest in remote and rural general practice have not been assessed.