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Academic General Practice – a personal viewpoint
My experience of academic general practice, is that for many including GP trainees, it is shrouded in mystery. “What’s academic about general practice?” said a hospital registrar.
Well, current data shows that UK academic general practice punches above its weight, outperforming others according to international comparison. Academic general practice influences both clinical practice and medical education. However, senior academic GPs currently make up only around 6.5% of the GP workforce, so there is likely much more we can do by increasing numbers. This has the possibility to support primary care. Firstly, by ensuring that we produce primary care focussed research and guidelines (rather than use research predominantly generated in secondary care). Secondly, it would support recruitment and retention to our specialty.
To achieve these aims we need to do more to support GP researchers and medical educators. The current structures are not supportive, but in fact seem purposefully inhibitive. Funding bodies, application forms and structures are not set up with a GP career trajectory in mind and many avenues are realistically closed to GPs. Routes that do exist, such as the in practice fellowship are limited (only 10 per year). If we are serious about promoting academic general practice then this has to change. Is it time to call for a specific primary care pool in all application rounds, including doctoral research fellowships?
A further challenge for academic GPs is the lack of pay parity with their NHS colleagues. Academic pay-scales are based on those in secondary care and so academic GP trainees post CCT face challenges in achieving parity of pay compared to clinical colleagues. Does this system need a serious rethink?
Registration for COMAR, The BMA conference which discusses all things academic is currently open and it would be great to see some more GP academics represented. If you are an academic GP or interested in helping affect change, I would urge you to share your views with our subcommittee as we lobby for change. Please ensure your BMA membership information states that you are an academic GP so that the right information gets to you.
The case of Bawa-Garba
I like most medical professionals have been troubled by the tragic case of Bawa-Garba. Sad as a life has been lost and a doctor charged in the courts and then erased from the medical register. I think it is fair to say this case has sent shockwaves through our profession, as the wider implications are uncertain.
GP trainees have been asking what this means for reflective practice? What do we do when we turn up to work and staffing levels are short? The GMC have provided some useful information on raising concerns and reflective practice. There are many unanswered questions and I met with the GMC last month to raise the concerns of GP trainees, particularly around SEA reflections and supporting a culture of reporting.
There has been much conversation around ethnicity and the fact that BME groups are disproportionately represented in complaints made to the GMC. A letter from BAPIO to the GMC is here and the response here. As a committee, we continue to ask all groups to work towards looking at this in more detail and will continue to call for more focus on establishing why.
Alongside the BMA’s response to the Bawa-Garba ruling, there are a number of grass roots campaigns to raise awareness and drive forwards meaningful change. You may write to your MP or the GMC. We all have a part to play in keeping the momentum going.
Dr Shaine Mehta is Education & Training Lead, GP Trainees Subcommittee. Follow him on twitter @DoctorShaine
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