Scrapped training programme was helping to increase GP numbers, review finds

Authors: Abi Rimmer 

Publication date:  05 Jul 2017


A broad based training programme that was scrapped in 2015 was encouraging more trainees into general practice, including those who were not of a “generalist disposition,” a review of the programme has concluded.[1]

The Academy of Medical Royal Colleges introduced a two year broad based training programme in 2013. It gave trainees experience in general practice, psychiatry, paediatrics, and general medicine. In 2015, however, Health Education England decided to end recruitment to the programme,[2] although the programme is still available in Scotland and Wales.

A review of the training programme, conducted by Cardiff University, has found that most of the trainees who took part chose to enter GP training.[1] This supported the programme’s aim of “providing the service with opportunity to recruit into this priority areas,” the authors said. The programme attracted a broad range of trainees, their report noted, “not only those with a generalist disposition.”

Recruiting enough trainees to fill all vacancies in GP training has been difficult in recent years, and in 2014 Health Education England began opening a third round of recruitment to help fill these vacancies.[3] [4]

The Cardiff researchers evaluated the characteristics of broad based trainees and divided them into three groups: “patients at the centre,” “the working doctor,” and “the open-minded specialist.” Their report said, “It is interesting, and perhaps surprising, that the broad based training participants were spread across all three groups.”

It added, “Given the generalist drive of the broad based training scheme, we may have expected those on the broad based training programme to align themselves with the first group along with the majority of the GPs.

“This may suggest that the broad based training programme is not just attracting and developing trainees with a generalist focus but also those who have an open-minded specialist leaning and/or value a work-life balance.”

The programme prompted trainees to “think about pursuing previously unconsidered specialties after experiencing them during [broad based training] which adds weight to existing evidence that experience in under-subscribed specialties increases recruitment,” the report said.

It also found that broad based trainees were “were notably more confident that their training would lead to being able to manage complex patients and provide patient focused care . . . Exposure across the specialties enabled them to better understand the patient journey through the healthcare system and foster a more patient centred approach.”

Broad based trainees were also more self directed and demonstrated leadership and management skills, the report said, and were able to “take a more holistic approach to the care of their patients.”

The authors wrote, “Educational supervisors suggested that [broad based training] trainees were better equipped to deal with the more complex patients which they linked to their wider perspective. One commented: ‘They were an answer to the future of the training in my view, or the future specialists.’”

Alison Bullock, from the School of Social Sciences at Cardiff University, which conducted the research, said that broad based training benefited patients and doctors “by giving doctors a wider knowledge and greater skills which are transportable across specialties.” She said that it also enfranchised trainees and gave them a “greater sense of self-determination over their career.”

“We are pleased that the broad based training approach has been taken up in Wales and Scotland and hope that in time it will be re-adopted in England too,” said Bullock.

References

  1. Bullock A, Webb K, Pugsley L, MacDonald J, Allery L. Evaluation of broad based training, final report. Cardiff University. 5 May 2017. [Link] .
  2. Health Education England. Broad based training (BBT) programme: important announcement about broad based training. 5 Nov 2015. [Link] .
  3. Rimmer A. A sixth of GP training places are unfilled after two recruitment rounds. BMJ Careers 13 Aug 2015. [Link] .
  4. Rimmer A. GP recruitment opens for unprecedented third round after low fill rates. BMJ Careers 9 Jul 2014. [Link] .

Abi Rimmer BMJ Careers

 arimmer@bmj.com

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