General practice careers: choices and judgements

Abstract

> ‘... the idea was to prove at every foot of the way up that pyramid that you were one of the elected and anointed ones who had the right stuff and could move higher and higher ...’. > > Tom Wolfe, in The Right Stuff (1979) Almost every patient in the UK is affected by the capacity of the medical work force to contribute to the delivery of primary care, and by the personal qualities, skills, and training of the GPs who make up that workforce. Little wonder then that the general practice workforce features high on the political agenda. In terms of workforce capacity, concerns are mounting in view of the demographics that predict unfilled retirement vacancies.1 The target set by the Department of Health that 50% of new medical graduates should be recruited to general practice each year2,3 is still recognised as important, but is proving difficult to achieve when the percentages of recent graduates naming general practice as their first choice remains constant at little over 20%.4 Health Education England (HEE) have reported only an increase of 95 recruits to GP training this year, and they have demanding targets to meet in terms of increasing numbers in training as well as enhancing training.5 Although the government’s mandate to HEE endorses extending GP training to 4 years, this has not yet become part of the business plan. With quantity and quality of recruits a matter of considerable public and professional concern, it is worth unpicking four issues which impact on the quality …