Letter - Response to 'Future-proofing primary health care: GP recruitment and retention in the new NHS'

Abstract

I am increasingly bemused by the narrowing and blinkered view of training to becoming a GP. Rosenthal and Chana1 comment 'many trainees still spend part of this time in posts that offer traditional hospital-based experience that may not reflect the context of new community based service models'. Cautiously I would like to add the comment 'so what?' We do want 'well rounded' GPs, people open to new ideas, and who are open to 'lifelong learning.' Many who qualified at a similar time to me will have done hospital jobs as 'part of the team.' Six months at the end of which we were hopefully competent but also confident. Confident. Now that's a word we haven't been using too much recently but, as long as not false, important.Doing 6 months and making a good job of a delivery or episiotomy repair, doing pleural taps or biopsies, covering the paediatric clinic when the consultant had to rush off. Not perhaps relevant to my job now but it did instill a confidence and satisfaction to my work. There is now much less 'hands on'.Interestingly a local gastroenterologist recently told me he used to teach his GP trainees to do endoscopies, no longer, as 4 months is 'not enough.' We now have tasters that might encourage some degree of competence ('please sign me up' ) but are we creating doctors with no confidence in their own abilities?I like the idea of First5, encouraging doctors as they start their careers as GPs, dealing with issues, and educating around the GP mantle. It is a long career and may become longer so we need to generically give new GPs the tools to handle the future. Are we narrowing so much and trying too hard with training that we're taking the enjoyment out of the process, when perhaps some of this could be done later? It is now rare to have colleagues, who had done several years as gynaecologists/surgeons, join our ranks and I think we have lost something here.In my GP career I have been very grateful for sabbaticals to try working in different places/environments. This also seems to becoming more difficult and not encouraged generally while trying to achieve CCT. That great idea of learner-led education, particularly for trainees, seems to have gone out of the window.I suppose I am saying, can we be a bit more generic in our training years, widen our horizons again, and use First5 to help settle doctors into the rewarding job we do?