Viewpoint: Are GPST1s and 2s the forgotten GP trainees?

GP registrars spend a significant amount of their training in hospital or community-based posts - but it is important that general practice ensures they remain engaged with and are valued by the profession, argues Dr Zoe Brown.

Dr Zoe Brown

I’m now four months into my GPST1 year and over half way through my six months in paediatrics. I practically bounce up and down when I think about what’s coming next – six months in general practice.

When it comes to change over in February, I will get to start actually being a GP (for six months). The majority of my GP trainee colleagues won’t be in the same position – they will be moving into other hospital posts, not working in primary care until their ST2 year.

I feel very fortunate that my rotations have fallen like this because I think I could struggle otherwise. Why? Because I sometimes almost forget that I am training to become a GP.

It is quite a strange thing that, having chosen general practice we are then sent to work in hospital departments or alternative community settings. For those who did not have an FY2 post in general practice, they go even longer without experiencing what life as a GP will be like.

Hospital rotations

Having fostered an excitement and enthusiasm for general practice, it can be difficult trying to keep that spark alive while heading off to yet another night shift or scrubbing up for a procedure or theatre list of some sort.

To non-medics, it simply doesn’t make sense: ‘What do you do?’ ‘I’m a GP trainee.’ ‘Lovely, what practice are you at?’ ‘Well, I’m not actually. I’m currently working at the hospital as an A&E doctor/cardiology SHO/ENT trainee.’ ‘For how long? A few weeks?’ ‘No - 18 months.’

When you hear it from their point of view, you realise how silly it sounds.

It’s not that we shouldn’t spend time working in hospital departments. It is a valuable part of our programme for many reasons. But I think it is important to recognise this phase of GP training as a time when trainees can feel further away from their career ambitions than ever.

Facing the harsh reality of over-filled hospital wards and heaving emergency departments during the winter months can cloud the view of the end goal. Eighteen months may be short in the long run, but if you’re going to work every day to do something you don’t particularly enjoy or feel passionate about, that eighteen months can feel like a very long time indeed.  

Forgotten trainees

I have spoken before about my concern for FY1s and FY2s, and how this group can be the forgotten trainees when it comes to primary care careers guidance and promotion. Disillusionment is unfortunately common. But having become a GP trainee in August, and in my efforts as part of the Severn Deanery GP Trainees’ Committee to gauge how local ST1s/ST2s are feeling, I am concerned for this group too. Do they not fall into a similar category?

I know things are changing, and that work is happening all the time to see how the GP training programme can be developed. Health Education England continues to look at five-year training pilots based completely in general practice, and it is not a new message from the RCGP that the programme should be extended.

I am not opposed to any of this, and I am not against the principle of hospital rotations for GP trainees in general. My message is simply this; don’t forget about us.

Yes, we’ve definitely chosen to join the ranks of GPs; yes, we’re passionate and enthusiastic about primary care. But that doesn’t mean that the general practice community should immediately move focus onto the next budding group of wannabe GPs, such as medical students or sixth form students even.

Keep some of the focus on those of us in our first two years of training; keep us engaged and invigorated; remind us regularly why we have made the right decision, and make us feel valued while we complete this important part of our training in secondary care. 

  • Dr Brown is an ST1 GP trainee in Gloucestershire

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