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GP Recruitment

I have read many articles on GP numbers tumbling in England due to a recruitment crisis and have listened to many GP's in interviews blaming politicians for this crisis.

I have been a successful hospital doctor for the past 6 years and have developed a CV beyond most GP training programme applicants during this period. I wanted to change to a GP training programme this August but I was informed that I was unsuccessful in getting a post. There are currently over 450 GP training posts unfilled within the UK and I am willing to work in any of them. How is it possible that they turn me down even though there is a huge requirement for GP's?

The GP recruitment system has been created by GP's not politicians. Many GP's blame politicians for the crisis in GP even though it is GP's who are causing a large number of problems themselves. If these training posts are not filled then there will be less GP's and patients will have to wait even longer to see their GP. Additionally, the GP recruitment process does not even take into account the applicants CV in the overall scores, which can not be right.

The recruitment process needs to change and the BMA should take this forward.

16 replies

  • Anonymous
    Anonymous

    Just because there are vacancies does not mean General Practice should lower its standards for applications.

    The quality of primary care will only be maintained by investing in trainees who have the appropriate skills and potential to become excellent GPs.

    A CV full of hospital-related courses or competencies does not equate to desirable qualities for primary care.

    The author of this theme should reflect on why they were unsuccessful in the GP selection process, rather than blaming others.

  • Anonymous
    Anonymous

    In reply to Anonymous:

    Insulting, childish appraisals and now livelihood-threatening revalidation every five years is predictably seriously adversely affecting recruitment and retention.  The brightest children are no longer choosing to study Medicine, especially children of doctors, and the most experienced doctors are retiring early or leaving the country.  Doctors and the medical profession are being systematically undermined by people who have never been to medical school and who do not know how much they do not know and who do not understand the practice of Medicine.  The war against doctors and the medical profession has been going on for at least 20 years.  Doctors' intellectual powers do not match their academic powers, so most doctors are unaware that they have been in a war, never mind that they have already lost the war.  This should be of concern to all British citizens.  By the way, let's be honest: the NHS is dangerous.  Sack the bureaucrats, administrators, managers and train doctors properly.  Everyone should read Socrates in the Boardroom by Amanda Goodall.  My email address is [email protected] should anyone wish to contact me.

  • Anonymous
    Anonymous

    In reply to Anonymous:

    Having loads of courses on your CV and having worked in hospital widely doesn't automatically mean you'll make a good GP - it's about the person not the number of courses they've done. The lack of GPs is a product of the above posters (2:01am) comments with which I fully agree. The answer to this problem is not to lower the standards of who can train, this would be completely inappropriate, as it would be for any other area of medicine...it's a very difficult job even if you are perfectly suited for it...filing the profession with people who aren't (and can't appreciate the fact that they might not be - in to which category the original poster appears to fall) would be a very bad idea not least for patients but also for the ill suited Dr

  • Anonymous
    Anonymous

    In reply to Anonymous:

    Tricky. I don't think we have anywhere enough information to make a judgement here.  I have seen "failed" hospital Drs become excellent GPs, and some rather less successful. Actually you could speculate that they may fail because they really have the personality and skills which would make them good GPs.

    The OP should seek direct feedback from at least on appointment panel or a GP tutor, and find out what the barrier is here.

  • Anonymous
    Anonymous

    I'm sorry to hear this. We certainly need good GPs. I have just retired and my old practice has not been able to replace me with a full-time partner.

    All systems for making decisions (interviews, exams) are flawed, and we still need to use them. I used to organise a local recruitment process for entry to the local GP VTS, and now still take part in the national one. Please ask for all the information that the local deanery (HEE) organiser can give you. Ask for as much specifics as you can.

    I believe that research shows us that those leaving OSCEs have very different ideas on how they have performed at each station compared to their "real" marks. I would think that the same is true of performance at the different stages of the GP interview process.

  • Anonymous
    Anonymous

    For too many years General Practice was seen as the speciality to take anyone who asked, and it was seen as a right....."well he/she can always be a GP"

    Those of us proud to be GPs wanted the skills and depth of knowledge needed to do it well to be acknowledged and not to meet fellow GPs clearly not cut out for the task, and I for one as a GP trainer am delighted that the standard of Registrars is improving

    This person does not seem to consider that they may after going through selection, have not exhibited the attributes looked for. If you are 6 years a consultant why change? You would have to give good reasons and show a degree of humility to get a post.....

  • Anonymous
    Anonymous

    Why do you want to be a GP?  Is it because you really love working in primary care, or because you think it's the default career for any doctor who's fed up with hospital medicine?

  • Anonymous
    Anonymous

    In reply to Anonymous:

    I agree with the original post. I equally was unsuccessful in the recruitment process- having missed 2 points in the situational judgement test. I am about to finish F2 and have been passionate about GP.

    No other specialty requires a "pre-test" and how can it already select if I was to make a good GP? I thought I that I was at applying for GP "training". It's another 3 years in various specialties to  enhance and develop my skills to become a good GP. Or am I missing the point? That's the same for other specialties which take  even 7 years to train someone to be near consultant level.

    There are people like me who want to be and become good GPs who are not allowed the opportunity. Why for example was I not allowed a second chance to resit the exam? Knowing that there were unfilled posts.

    I am not asking for the standards of recruitment to be lowered but there must be a different and better strategy. Situational judgement testing has no right or wrong answer.

    It is not an over subscribed speciality that needs two stages to select a candidate.

    If I was not a good or safe doctor, surely someone would have mentioned or eliminated me from medical school or during foundation year.

    It is hoops and many more hoops that one has to jump through to become a GP.

  • Anonymous
    Anonymous

    In reply to Anonymous:

    GP training (and revalidation) have been taken over by career educationalists who have a rigid interpretation of what makes a good GP. Many of them remember the days when 'anyone' could be a GP after house jobs and bear the scars of this historic inferiority complex.

    Yes - GP is no easy option and should not be an automatic fall-back for those who 'fail' in other specialities. GPST applicants should reach minimum standards for communication skills etc. However GP is also a broad field of medicine that can accommodate many types of doctor, and blind tribalism helps no-one. Many excellent GPs have switched from hospital careers and it is unfortunate if this path is to be blocked by what looks like a biased recruitment process.

  • In reply to Anonymous:

    Interesting debate and questions about the GP selection process.  To clarify a few things:

    GP Selection has indeed evolved over time.  It (the SJT in particular) is based on evidence, and selection process requires assessment of suitability for GP training.  The stakes are indeed much higher than ever before for selection, training and exit assessments.  Stereotyping 'former hospital trainees' and 'foundation trainees' is not necessarily useful in GP.  Everyone brings a different set of skills and most of them are useful in general practice.

    The points about revalidation are indeed much more broad ranging and do have a negative on retention of GPs.

    The GP posts need to be filled by encouraging doctors of a good standard from a wide range of backgrounds to opt for GP as their preferred choice.  Merely filling the training post is not going to give us good jobs.  If the selection process deemed someone unsuitable for GP training, that is by no means the end of it.  I would suggest you get in touch with your deanery/LETB careers department to find out more about the process.  The BMA also runs a course in November for doctors considering a career in GP - do keep an eye out on the website, and the details will be available next month.

    Krishna

    Outgoing chair of the GP Trainees' Subcommittee of the BMA

    (former Orthopaedic trainee, completed GP training earlier this year).

  • Anonymous
    Anonymous

    In reply to Krishna Kasaraneni:

    Dear All

    1) The skills required to be a good hospital doctor are very similar to the skills required to be a good GP eg good communication, teamwork, medical knowledge etc. These skills are all transferable to GP and someone with experience of 6 years is much more likely to have developed these skills than a foundation doctor. Furthermore, the whole point of a training programme is to give you the skills needed to be a good GP. Otherwise what is the point of a training programme?

    2) Just because someone wants a change from hospital practice to GP, does not mean it is a 'default' career choice. Perhaps they wanted to try hospital practice first or maybe even develop further skills that may aid them with a career in GP.

    3) In all jobs people apply for eg lawyers, hospital doctors, councilors, teachers etc the CV is looked at in great depth as it gives a good insight into the candidate. I have looked into the GP recruitment process and it does not even consider the candidates CV or portfolio. Additionally, there is no interview station whereby the candidate is asked why they want to become a GP, what they will bring to the profession etc.

    4) I have all reviewed the feedback given to a couple of candidates unsuccessful at the Selection Centre stage. The feedback is so brief and non specific that it is simply useless in order to reflect upon.

    5) The above authors assume that the GP recruitment process selects only suitable candidates for GP. The National GP recruitment office states on its website  that the recruitment processes have been validated. However, I have reviewed these validation studies and they are hugely flawed, making me doubt that the selection process will pick up the best candidates.

    6) If people are good enough to graduate from Medical School then they should be given the opportunity to enter GP. The only way to tell if someone will be a good GP is to do the job. A  flawed recruitment process based on actors will not tell you that you will be good or bad as a GP trainee.

    On the basis of the above aspects  there are clearly major issues with the GP recruitment process which GP's and the BMA need to resolve.

    As an additional point, revalidation also needs to be scraped. It is hugely time consuming, expensive and does not improve patient care or doctor performance. The BMA represents the interests of thousands of doctors and the vast majority of doctors are against it, so why have the BMA not acted to try to get it removed?

  • Anonymous
    Anonymous

    In reply to Anonymous:

    You could always try working for the DWP benefit denial factorys, Atos and capita But I would think you guys are way overly qualified and probably have professional morals unlike the dregs that work for them just now.

  • In reply to Anonymous:

    I had a similar experience. I am an ST5 in anaesthetics, and wish to leave and do GP. Got to the final round, only to be told I was deemed unsuitable after the OSCE. I am totally committed to GP, and have planned everything around making this change despite all the rubbish happening at the moment. I have an excellent CV and receive consistently excellent reports and feedback. London Deanery have a policy of not giving feedback unless you make a data protection act request. My supervisors are all gobsmacked that I have been rejected as they are very keen to hang on to me in anaesthetics. I despair to then hear about a recruitment crisis. Something is seriously wrong, and I have heard of other fairly senior trainees also having problems. Do you want excellent committed clinicians or not? The Osce felt incredibly forced and unreal. Being a professional is Not about 10 minute chats completely out of context, it is about making an effort, day in day out, building relationships and keeping on top of your game. Will be applying again this year (outside London), and if I don't get it will consider leaving the country.

  • Anonymous
    Anonymous

    I agree to some extent. The whole system is blinkered.Any mature GP will know they are looking for transferable skills  and experience!I completed my  basic specialist training in psychiatry and then decided  to become a GP  as i was attracted to it.NOt because of lack of opportunities etc as there was

    plenty of scope to progress.

    fortunately in my hospital posts i worked with a few consultants who had switched careers from being a  GP to a obs/gynae and from being a paediatrician to  child psychiatrist etc.they were not rigid  or judgemental and quite broadminded and welcomed people with different areas of expertise and said it would only enhance your practice and working together with secondary care.

    I think NHS culture and mindset has to change .In fields like IT etc  the culture is so different.

    I am a  GP partner  and we have been struggling to recruit despite attractive salary packages and are at the mercy of  salaried and locum GP,s who have sensed the gap  in service  and make  preposterous demands.  cant wait to retire!but unfortunately that will have to wait another 15 years at least!

    add to this the endless paperwork,bureaucracy , targets,loss of income  and of course the helpful 'press and politicians .What is the point  anyway ?we are expected now to be 24 hours at the beck and call  of anyone.With due respect o retired GP,s etc medicine has become so much more complex and demanding and it is not as simple as in the good old days we used to do' etc .probably what we are doing now will be obsolete in a few years time .

  • Anonymous
    Anonymous

    In reply to Anonymous:

    agree,i have been agp for 25years ,having moved from surgical practice,My skilss were highly valued in primary care at that time,the sjt tests are too rigid right now ,needs to change