The future of GP specialty training: enhanced and extended

Abstract

Whether driven by statute or by societal and scientific forces, the NHS is undergoing radical change. How, then, will training adapt so that future GPs have the skills and, importantly, the motivation to meet the challenges ahead? Here, drawing on our experience with the Royal College of General Practitioners’ curriculum and assessments, we comment on the why, the what, and the how. Given the limited exposure that GP specialty trainees have to the community context, it is remarkable that GP training achieves the standards that it does. The recent acceptance by the Medical Programme Board (of Medical Education England) of the educational case for enhanced and extended training has reinforced the need for the changes we set out here. If enacted as we hope, these changes will equip future trainees to address the significant challenges, some of which are illustrated below, that they will face as independent GPs. GPs must be simultaneously proficient in using communication to develop trusting relationships, make decisions in situations of uncertainty, manage time and events, and grasp learning opportunities. They also need to show commitment to values and to people, including themselves. This remarkable conjunction is required for the majority of problems, however small. In the future, GPs will need to engage proactively with their communities and take greater responsibility for leading improvements in population health and reductions in health inequalities.1 On the demographic front, we are moving from an era of mortality from misadventure or ‘straightforward’ causes of …