Strengthening general practice by extending specialty training?

Abstract

European legislation obligates member states to have a full-time postgraduate GP specialty training for ≥3 years, with a minimum of 6 months spent in general practice. Across Europe, GP specialty training varies from 3 years (for example, in the UK and the Netherlands) to 6 years (Finland), with training time in general practices varying between 6 months (Austria) and 4 years (Norway). Recently, across Europe a strong movement in favour of extending the minimum duration of GP specialty training from the current 3 years to 4 or even 5 years has developed.1,2 Supporters of this measure state that this will ‘build the same level as specialty as other disciplines’ and therefore strengthen GPs’ standing across Europe.3,4 This is important because a strong primary care is needed to have a high-quality healthcare system accessible for all citizens, in which GPs function as key stakeholders.5,6 However, not every country values GPs in this way. Across Europe GPs’ positions vary from being a strong gatekeeper with free access for patients to easily accessible secondary care and paid GP visits. Another argument for extending the duration is that more time spent in training will give trainees ‘greater exposure to real world setting’ , and therefore better developed competencies important for future GPs.2 Recently, extension of GP training programmes in Scotland and the West of Ireland reported positive …