Fears that training may put young doctors off being GPs

Trainee doctors are being denied experience in general practice and may be put off primary care by biased careers advice, a review of the foundation programme warns.

Dr Croton: broad experience is vital

The review also warned that some trainees are being asked to practise beyond their level of competence and without adequate supervision.

The review, led by Professor John Collins of the University of Oxford's Nuffield department of surgical sciences, said training placements were dominated by adult medicine and adult surgery.

'A greater share of healthcare is now delivered in the community and the NHS is moving increasingly towards a model in which this will expand. The balance of placements in the foundation programme does not reflect this change,' the review says.

The review, Foundation for Excellence, warned of a 'limited range of posts and learning environments' in community paediatrics, general practice and psychiatry. It recommended the distribution of speciality posts is reviewed by 2013 to ensure 'broader based beginnings' and 'closer matching with current and future workforce requirements'.

Dr Lizzie Croton, a GP in Birmingham and member of GP's panel of GPs aged under 35, said trainees need a broad range of experience. 'There is a fundamental difference between hospital and community medicine, and that is widening all the time,' she said.

Meanwhile, the report also suggested biased careers advice is putting medical trainees off general practice. 'Those in established medical practice tend to support their own speciality area or, through the "hidden curriculum", deter trainees from pursuing certain careers', the review warns.

GMC chairman Niall Dickson said: 'We support Professor Collins' conclusion that the foundation programme has many strengths and that, while some changes are needed, they should be approached in a spirit of evolution, not revolution.

Young GP blog: Should GP training be extended?

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