Abstract
BackgroundGP training practices are less likely to be situated in areas of deprivation; little is known about GP views of postgraduate training in such areas.AimTo explore the views of GPs working in deprived areas about GP speciality training (GPST).Design & settingQualitative in-depth interviews with GPs working in practices in deprived areas in Scotland.MethodTen in-depth interviews were conducted with GPs in training and non-training practices, to explore views on training. Interviews were audiotaped and transcribed verbatim, and inductive thematic analysis was undertaken.ResultsThe importance of producing ‘well-rounded’ GPs who are able to work in a variety of environments was highlighted. Trainees need exposure to the specific challenges of deprived contexts (such as early multimorbidity, child protection, and addiction) and the benefit of this for trainees was thought to be invaluable. GPs identified many perceived barriers and benefits to training, some generic but some — such as inspiring the next generation (benefit) or overwhelming workload (barrier) — may be more relevant in areas of high deprivation. Overwhelming workload was the main reason for not becoming a training practice, though some would consider it if supported to develop a training culture. All the GPs, including non-trainers, were involved in optional activities which were felt to be important for resilience.ConclusionGPs in areas of deprivation highlighted specific skills that could be gained by undertaking at least a part placement in deprived areas, with different skills likely to be gained from affluent areas. National education bodies should consider GP training rotations ensure a variety of training environments.
Highlights
In the UK, GP speciality training (GPST) usually involves a 3-year training programme with 18 months of this programme spent in an approved GPST practice supervised by a named GP educational supervisor
GPs in areas of deprivation highlighted specific skills that could be gained by undertaking at least a part placement in deprived areas, with different skills likely to be gained from affluent areas
Author Keywords: Postgraduate education, Inequalities, Family medicine, Primary care, General practice, Socioeconomic factors. How this fits in GP practices in deprived areas are proportionately less likely to become training practices, and there is a paucity of literature looking at the views of GPs who work in these areas on training
Summary
In the UK, GPST usually involves a 3-year training programme with 18 months of this programme spent in an approved GPST practice supervised by a named GP educational supervisor. In Scotland, there are significantly more GPST training practices in affluent areas than deprived;[1,2] in England, training practices are under-represented in ethnically diverse inner-city areas;[3,4] and in France, training practices have fewer low-income patients than the national average. Size is a significant predictor of training status:[1] in Scotland, practices in deprived areas tend to be smaller.[5]. A recent review of GPST recognised trainees needed to experience different types of general practice to gain additional, wider skills.[6] A recent survey of GP trainees in Yorkshire and Humber suggested that most trainees were keen to work in areas of high socioeconomic deprivation.[7]. GP training practices are less likely to be situated in areas of deprivation; little is known about GP views of postgraduate training in such areas
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