Training for GPs should be extended - RCGP reports on first
three years of GP curriculum
27/10/11
The length of general practice training needs
to be extended so that new GPs feel better prepared and more
confident for independent practice.
That is the one of the main recommendations of a three-year
evaluation study of the RCGP training curriculum.
Commissioned by the RCGP, the independent study was carried out
by Professor Hywel Thomas and a team of researchers from the
University of Birmingham’s Centre for Research in Medical and
Dental and Education (CRMDE) and the University of Warwick Medical
School.
The study is based on data from trainees, trainers and deanery
leads gained through interviews, focus groups, case studies, a
national survey and analysis of an ePortfolio database of 11,812
trainees maintained by the RCGP.
The report concludes that the new GP training curriculum
introduced in 2007 has been successfully received and that its
components - the written curriculum, the ePortfolio and new
assessment system for MRCGP - have had a significant impact
on the learning experience of trainees.
Findings over the three years of the study demonstrate that both
trainers and trainees developed greater confidence and competence
using three components of the curriculum and there was growing
recognition and realisation of its future potential in assessment
and CPD, particularly in relation to appraisal and
revalidation.
It was viewed as a useful bridge between the hospital based and
general practice components of training, ensuring the former has a
stronger general practice focus.
The report says the curriculum provides clear aims and
objectives that ensure broader coverage and relevant learning
throughout training, allowing weaknesses to be identified and
empowering trainees as self directed learners. It points out that
the new curriculum has increased the workload of the trainer, but
that new trainers generally welcome the structure it provides.
While the new training curriculum prepares trainees well for
clinical practice, the study reports that it does not prepare them
fully for independent practice and recommends that the period of
general practice training be extended to allow greater
consolidation of learning and address gaps in learning.
Training for future GPs would ideally provide the skills
required for running a business, clinical governance, academic and
research skills as well as providing the necessary experience of
continuity of care and, crucially, dealing with uncertainty.
English deaneries also need to consider how training can prepare
future GPs for their proposed role in the commissioning of services
but this might be achievable only if the overall period of general
practice training is extended, says the report.
The study also recommends further work to enhance the
reliability of the Workplace Based Assessment component of the
curriculum and for greater consistency in the quality of hospital
posts undertaken during general practice training. It highlights
instances of user criticisms of the trainee ePortfolio and
recommends developments to make it easier to navigate. The College
is already addressing both the technical and navigational issues in
response to user feedback. The RCGP is also working with the other
Medical Royal Colleges to address the shared issue of variation in
assessment performance by particular demographic groups.
Dr Bill Reith, Chair of the RCGP Postgraduate Training Board,
said: "The GP training curriculum and new arrangements for MRCGP
are transforming our whole approach to the training of GPs. The
curriculum is an ongoing developmental process which will be
constantly adapted to reflect the changing nature of general
practice.
“We commissioned this study as a 'stock take' and the research team
have produced an excellent piece of work that acknowledges
how far we have come, along with sensible recommendations for
further development, many of which we have already put in place or
are working towards.
"What we did not anticipate was that the findings would make such a
compelling case for enhanced GP training which the College has been
calling for for some time.
“We are extremely grateful to Professor Hywel Thomas and his team,
particularly Dr Julie Bedward, Dr Ian Davison and Dr Sarah Burke,
and to Professor Neil Johnson of Warwick Medical School for
providing such comprehensive feedback.
“We will continue to build on the work we have started so that we
are raising standards ever higher and ensuring that future
generations of GPs have the confidence as well as competence to
meet the needs of patients in the increasingly complex world of
general practice."
Professor Hywel Thomas who led the research adds: “We were
delighted to be able to undertake this independent three-year long
assessment of GP Training for the Royal College. Our
evaluation demonstrated both the overall strength of the new
training curriculum as well as identifying some areas of
weakness.
“The curriculum provides clear aims and objectives that help
trainees develop the skills they need to work in General Practice
and provides a framework for the trainers who support them.
However, while the new curriculum prepares trainees well for
clinical practice, it does not fully prepare them for independent
practice which includes developing the skills required for running
a business, clinical governance, academic and research skills and,
crucially, dealing with uncertainty.
“With GPs likely to take a leading role in commissioning NHS
services in the future these skills will become more important not
less. One solution could be to extend the period of training to
help embed and consolidate these skills.”
ENDS
FURTHER INFORMATION
RCGP Press office – 020 3188 7574/7575/7576
Out of hours: 0203 188 7659
press@rcgp.org.uk
Ben Hill, PR Manager, University of Birmingham,
Tel 0121 4145134, Mob 07789 921163
NOTES TO EDITORS
The Birmingham report is available at
http://www.birmingham.ac.uk/research/activity/education/crmde/research/index.aspx