Natasha Szmidt is a newly qualified general practitioner working in Glasgow and an Academic Fellow in General Practice at the University of Glasgow
Last month I completed specialist training in general practice. I am now a fully qualified, fully cooked GP. This is, if I do say so myself, a huge achievement. It is the culmination of six years at medical school and ten years of post-graduate work and study. The trainee portfolio is but a distant memory and I am eagerly looking to pastures new. Alongside the elation and excitement of reaching Certificate of Completion of Training (CCT) however, is a feeling of being somewhat cast adrift. There is a distinct lack of celebration and more importantly perhaps, a distinct lack of support.
Periods of transition though frequent in medical training, are challenging. The final transition from specialty training to independent practice feels particularly momentous and disconcerting. The formal network of support and supervision you once relied on is gone and though most colleagues are happy to offer advice to their newly qualified colleagues, this is often ad-hoc and informal. Increasing numbers of trainees practice Less Than Full Time (LTFT) resulting in a fragmented and disparate peer support network. A generous study leave allowance shrinks and formal teaching and training opportunities are thin on the ground.
Increasing numbers of trainees practice Less Than Full Time (LTFT) resulting in a fragmented and disparate peer support network.
Shockingly, given the palpable and unrelenting demand for general practice services, newly qualified GPs are also finding it increasingly difficult to get a job. Workforce recovery plans highlight the urgent need for further investment and recruitment in general practice, yet opportunities for substantive and locum employment in primary care are much less readily available than they once were.1,2 GP practices continue to have their income squeezed and many are unable to advertise for locum doctors or recruit direct replacements for colleagues leaving or retiring. Recruitment freezes on larger employers such as health boards make it increasingly difficult to find work in traditionally hard to recruit areas of primary care such as out of hours services.
Positions which are advertised have increasing numbers of applicants and there are reports of many newly qualified GPs unable to find employment.
As always, there is geographical variation in post-availability, but it is not always possible to move for a job. The assumption that newly qualified GPs can do just that does not appropriately contextualise this cohort as adults with dependents, commitments and roots in places they may have spent many years living and working in to date. Moreover, without credible opportunities for employment, we risk losing newly qualified GPs to other clinical and non-clinical roles both in the NHS and outside it.
Locally, boards should consider how they support newly qualified GPs working or hoping to work in their area.
Unlike our colleagues in secondary care, there is no grace period for a GPSTs3 – when you’re done, you’re done. Trainees in some circumstances can celebrate passing an exam on Monday and find themselves jobless on Tuesday. While senior hospital trainees and newly qualified consultants undoubtably face their own challenges, they do at least have this option on CCT.
There are examples of tailored support for newly qualified GPs at a national level. These could surely be expanded. Locally, boards should consider how they support newly qualified GPs working or hoping to work in their area. There are post CCT GP fellowship posts, but these can only support relatively small numbers of doctors. Governments must look urgently to address the mismatch between the acute and ongoing need to recruit more GPs, and financial constraints preventing practices from doing just that.
Organisations, employers and individuals can all play a role in helping newly qualified GPs to navigate uncertainty the post CCT period. Mentorship, development of professional networks and clear signposting to CPD offerings may help newly qualified GPs feel valued and acknowledged in an uncertain time. The GP workforce is diverse and one size will not fit all.
References
- Scottish Government. NHS recovery plan. 25 Aug 2021. https://www.gov.scot/publications/nhs-recovery-plan
- Kahn, N. Amidst a GP workforce crisis, where did all the jobs go? BJGP 2024; 74 (739): 72-73. DOI: https://doi.org/10.3399/bjgp24X736233
- https://eastmidlandsdeanery.nhs.uk/policies/period_of_grace [accessed 14/5/25]
Featured Photo by JOHN TOWNER on Unsplash
