The Impact of General Practice Attachments on Foundation Doctors: Achieving the Goals of Modernising Medical Careers

Abstract

Modernising Medical Careers saw the introduction of four-month attachments in primary care during the second Foundation Year, to foster a broader understanding of healthcare settings. The North West Deanery offered this opportunity to virtually all trainees. Previous work had captured poor impressions of undergraduate experience in general practice. This study aimed to explore Foundation Doctors' perceptions of Foundation primary care attachments before and after the experience. Qualitative methodology was used. Two focus groups were held with 12 trainees at the end of their first Foundation Year to explore their expectations of pending rotation in general practice. Eighteen individual interviews were conducted with Foundation Doctors after the attachment. Themed analysis of transcripts revealed a striking contrast between trainees' perceptions of general practice before and after undertaking F2 rotations. Undergraduate exposure and secondary care bias in training had a significant negative impact on trainees' perceptions of general practice. The one-to-one opportunities for educational supervision, the range of patients seen and the opportunity to understand communication at the primary/secondary interface dispelled these concerns. The findings highlighted the beneficial impact of foundation posts in general practice for training, career planning in general and, as outlined in the initial goals of the programme, the interaction between primary and secondary care.