Inspiring the next generation of GPs: Dr Donna Tooth interview

It could take five years to persuade half of trainee doctors to choose careers in general practice, says GP trainee subcommittee chairwoman Dr Donna Tooth. David Millett reports

Dr Donna Tooth: GP trainee subcommittee chairwoman
Dr Donna Tooth: GP trainee subcommittee chairwoman

Dr Donna Tooth is looking forward to the summer – but it’s not the promise of a beach holiday she has in mind.

Summer is when her 18-month hospital placement will come to an end and she can get involved in the job she really wants to do, in general practice.

The head of the GPC’s GP trainee subcommittee, Dr Tooth is – as the post demands – a trainee herself, just starting her second year of GP training.

She replaced prior chairman Dr Krishna Kasaraneni, now the GPC education, training and workforce subcommittee chairman, in September.

Full-time general practice

‘I'm very much looking forward to being based full-time in general practice,’ she says. Her outlook exudes a passion for the profession that seems to have been whittled out of some of its more seasoned members, as mounting workforce pressures leave many GPs counting the days to retirement.

But Dr Tooth is not your typical wet-behind-the-ears student. She was 10 years older than her classmates and pregnant with her first child when she began her medical degree.

Life experience and meeting people, she says, finally turned her on to general practice after years of working in the pharmaceutical industry, in competitive intelligence – and even a stint of teaching English in Japan.

‘All of it was not as fulfilling as I find my medical career now.’

Despite her enthusiasm, she is not blind to the problems facing general practice. Now a mother of two, she wryly says that juggling a young family, training to be a GP and managing her committee role should ‘prepare her well for general practice’.

One thing worrying GP trainees is that there's extra work to do and they can see the workforce is diminishing.'

Dr Donna Tooth, GPC trainee subcommittee chairwoman

She is keenly aware of the burgeoning workforce crisis, exacerbated by a deluge of workload responsibilities from secondary care and the increasing complexities of an ageing population.

Statistics showing the extent of GPs on the verge of retiring or plotting to leave the profession are ‘quite frightening’, she says.

‘That’s one of the things that’s worrying GP trainees,’ she warns. ‘There's going to be all this extra work to do, and they can see that the workforce they're going to be part of is diminishing.

‘That’s a huge concern, because effectively that has an impact on the care that you can provide for each of your patients.

‘And that’s even more daunting for the trainees I represent now, because they’ve got to deal with these challenges while they're still getting their experience under their belts.’

Careers in general practice

There will be ‘no short-term fix’, but Dr Tooth is working to change opinion in medical schools, at the root of peoples’ careers in general practice.

‘Something we’re keen to do is work with medical schools to try to increase the interest in general practice. That involves getting people who are really passionate about it and want to get involved working with schools.

But she is doubtful that Health Education England (HEE) can fulfil its mandate to get 50% of medical students choosing general practice by 2016.

The target has already been pushed back by a year once, and GP revealed earlier in the year that only 25% of 2014 student doctors planned to choose general practice as a career.

‘I think it’s a great goal,’ she says. ‘But I'm not hopeful it will happen in that timeframe. 

‘Some of the work we’re doing with the GPC is to see how we can help with that – it’s us as GP trainees and us as GPs that will be affected. We want to be part of the solution.

‘And if we can work with medical schools as we do already we will do that – I’d say maybe in five years’ time.

GP curriculum

‘That’s the people starting medical school this September. If we could have input with their medical schools and work with them on their general practice curriculum, and if we can work to ensure their general practice placements are really effective, then maybe by the time they qualify they might be thinking "yes, 50% of us do want to go into general practice".’

Her main targets as chairwoman include contract negotiations and trying to improve the GP curriculum.

‘We want to make sure the curriculum is actually preparing trainees for what it means to be a GP.

‘One of the difficulties is that the training is only three years long. If you compare that to most specialty training, it’s significantly shorter.

‘One of my motivations is making sure that in that short time trainees are getting the best deal and a good education.’

Contract negotiations are on hold for the general election at the time of our interview.

Although a lot of medical students are well-exposed to general practice during their studies, Dr Tooth says it’s important to ‘optimise the experience they receive’ to ensure more go on to choose it as a career. Extra funding needs to be set aside for this purpose, she says.

She also suggests dangling ‘bigger carrots’ to tempt students into general practice.

‘Everyone always talks about incentivising certain specialties, and general practice is currently in a crisis. That decision is not down to me, but it’s about whether that’s something that needs to be addressed.’

You cannot help but wonder whether Dr Tooth will one day be in a position to sway these decisions.

Her medical career has involved the BMA since day one of her student days – and this is not set to change once Dr Tooth dons the stethoscope for real.

‘This is the crux of where it all lies: being involved in the BMA; trying to get the best for colleagues in the profession; hearing what problems need sorting,’ she says.

‘I anticipate that I will always be involved with the BMA in some way, whether that’s a local thing with the LMCs, or at a national level.

‘For me, that’s where the important discussions are had that will affect general practice and therefore the care we provide to patients.’

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