Nabila Rehnnuma is a first year graduate-entry medical student at Cambridge University.
A funding crisis, increasing workload, falling real income and continuing negative media press, these are just a few of the reasons why general practice is decreasing in its level of popularity amongst medical students.1 This problem is further exacerbated by medical schools, which have cultivated a culture where general practice is seen as the “second-choice”. This is despite the fact that general practice can be one of the most challenging and equally rewarding professions. Headlines describing the rising patient expectations, reduced resources and poor staffing levels further dissuades potential general gractitioners, with more than 400 GP trainee posts left vacant in 2014.2 This diverges from governments’ current plans which have stipulated that Health Education England should ensure that, by 2015, half of all medical students are to become GPs.1 Therefore, the question remains, how do we meet this target? And more importantly, how do we make the role of a general practitioner more appealing to the current medical student?
One of the important determining factors behind medical students’ career preferences tend to be their attitudes towards the medical specialities.3 Experiences at medical school tend to dictate an individual’s attitude, with attitude being one of the most important driving forces. Positive previous experiences on placement stood as one of the greatest influences affecting medical students’ career choices, according to a study carried out on medical students, trainees and practicing physicians regarding the factors which influence career preferences.4 Therefore one of the potential strategies medical schools can employ is to increase exposure to primary care experiences during the early years of medical school and emphasise primary care experiences during training years. Medical schools should allocate more funding towards GP delivered in the community. Increasing exposure enables medical students to be exposed to positive role models, such as Dr Weatherburn5, an Academic Fellow in General Practice in the University of Dundee, whom is able to “lead by example”, and illustrate why a career in GP is so rewarding. By providing high quality career’s advice regarding the flexibility and variety of avenues that a GP career can take, it enables a re-focus on why such a career still remains a good career choice.
Another means to curb the current decline in primary care, is to improve satisfaction among family physicians.4 As previously mentioned, it is positive experiences on placement which to some extent dictate a medical student’s career preferences. However, in order for the experience to be positive, current physicians must be content with their career and current lifestyle. One means to achieve this is to enable a greater employer focus on retaining and investing in their current staff.6 This can be via commissioning education and training opportunities to train and develop current staff, and attract the future workforce. Financial incentives such as the ‘golden handshake’, where GPs are offered higher salaries for working in rural areas, as well as greater flexibility in working hours are other means to retain the current GP workforce. If the government is able to reduce the pressure on GPs and invest in the future of general practice2, particularly in their training and education, this can attract potential medical students into the profession.
The final means suggested to attract the future GP workforce, is the opportunity to be able to vary career direction or combine careers.7 Offering clinicians the opportunity to combine a specialism with generalism may be another mechanism to attract more general practitioners needed to cater for large scale shifts from secondary care. This is where general practitioners are able to gain experience and qualifications in a field of particular interest to them, such as psychiatry or dermatology. Given recruitment problems often reside in the fact that students seek to train in fields where employment opportunities align with career preference, as opposed to service needs, dual training opportunities provide an appropriate means to accommodate for this. Therefore if students are able to combine career and training opportunities, this might be attractive to some doctors whom may not primarily consider general practice.
These are just a few of the means to attract the next generation of General Practitioners. However, it appears that what matters most to current medical students is personal interests. Could they see themselves as a GPs and more importantly what is the greatest factor that can sway their vote?
Links
1. http://careers.bmj.com/careers/advice/view-article.html?id=20017562
5. http://www.bmj.com/content/349/bmj.g6245/rr/786933
6. http://hee.nhs.uk/wp-content/blogs.dir/321/files/2014/12/HEE-investing-in-people-20151.pdf
7. http://careers.bmj.com/careers/advice/view-article.html?id=20018623
