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Opinion

Why should you care about academic general practice?

Authors: Faraz Mughal 

Publication date:  31 May 2012


Faraz Mughal explains the importance of academic general practice for the ongoing improvement of primary care

When I tell people I want to be an academic general practitioner they look bewildered. Some even retort with more than a hint of quizzical cynicism, “Is that not an oxymoron?” This kind of general misconception about academic general practice seems to be common among fellow junior doctors and even some senior colleagues.

What is academic general practice?

Academic general practice encompasses three key roles: research, teaching, and the clinical work of a GP. It is a field of academia that does not get much publicity or acknowledgment but has consistently proved to be a vital component of many innovations in the NHS, altering the way generalists think and contributing vastly to evolving good practices in primary care. The university departments of primary care, which include senior teachers and researchers, also receive considerable input and contributions from many eminent epidemiologists, statisticians, health psychologists, and sociologists. Academic GPs undertake wide ranging research activities in many disciplines to develop and promote optimum methods and processes of patient care. A substantial proportion of clinical academics also have a strong interest in teaching.

Why is it different from general practice?

GPs with an interest in academia can have an exceptional working lifestyle. Greater diversity in day to day activities satisfies individual curiosity. Academic generalists have defined objectives within their schedule to inquire into, consider, and plan concepts they believe will benefit wider society. This may include pursuing research ideas and applying for funding, contributing to national policy, leading clinical commissioning groups, or making personal and professional contributions through undergraduate and postgraduate teaching and mentoring medical students. The work of academic GPs is multidimensional: undertaking clinical duties and then upholding academic commitments. They have to be almost doubly qualified—as clinicians and then as researchers—earning their spurs through masters and then doctorate level work. No two weeks are the same, resulting in a vibrant and dynamic career.

Why should people know about it?

The case for academic general practice is simple. GPs make up the largest branch of the medical profession. Despite my limited exposure so far to the field of medicine, it is not difficult for me to see that the demands placed on primary care will inevitably rise as a result of increased awareness and expectations among patients. This will put great pressure on improving the efficiency of the service provided. In addition, the growing shift towards a research and audit culture in primary care will require greater use of evidence based medicine.[1] These factors collectively point to the importance of academic general practice, in improving the professional standards of those who work in the discipline and in creating opportunities for setting a higher quality of patient care.[1]

This view was strongly emphasised at the recent conference of the Society of Academic Primary Care, which brought together some of the leading thinkers in the field of academic primary care. The key learning point for me was that primary care led research has consistently helped to alter traditional thinking in many important areas of healthcare, such as the management of meningitis and heart failure.[2] [3] I also learnt that academics play an increasingly crucial part in undergraduate medical education through the expansion of community based teaching and the development of more effective teaching methods. Over time, many of these developments are integrated into general practices, as well as medical school curriculums.[4]

Why should people care about it?

Over 90% of patient interaction in the NHS occurs in primary care, and to sustain this level of service in a climate of prolonged pressure on costs and budget controls will require new ways of doing things. Academic GPs are ideally placed to develop good general practice. An international study has indicated that primary care research output from the United Kingdom consistently places UK researchers among the best in the world.[5] Every medical school has a department of primary care, and the research in this field is rapidly expanding. Some of the most insightful teaching I received in my five years at medical school came from GPs.

What the experts say

  • Liam Smeeth, professor of clinical epidemiology, London School of Hygiene and Tropical Medicine, and GP—Believes that the widening recognition in countries such as Brazil and India of the model that UK primary care offers, where health systems provide cost effective healthcare for large populations, would not have occurred without serious input from academic general practice. Primary care is the cornerstone of healthcare, and without academic general practice this discipline might stand still.

  • David Fitzmaurice, clinical lead, primary care clinical sciences, University of Birmingham—Thinks that academic general practice is not seen as a serious subject among specialist colleagues and that to sustain academic credibility is a challenge.

Competing interests: None declared.

References

  1. Rashid A, Allen J, Styles B, Pereira Gray D. Careers in academic general practice: problems, constraints and opportunities. BMJ  1994;309:1270-2.
  2. Thompson MJ, Ninis N, Perera R, Mayon-White R, Phillips C, Bailey L, et al. Clinical recognition of meningococcal disease in children and adolescents. Lancet  2006;367:397-403.
  3. Mant J, Doust J, Roalfe A, Barton P, Cowie MR, Glasziou P, et al. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technol Assess  2009;13:1-207.
  4. Jones R, Higgs R, de Angelis C, Prideaux D. Medical education: changing face of medical curricula. Lancet  2001;357:699-703.
  5. Glanville J, Kendrick T, McNally R, Campbell J, Hobbs R. Research output on primary care in Australia, Canada, Germany, the Netherlands, the United Kingdom and the United States: bibliometric analysis. BMJ  2011;342:d1028.

Faraz Mughal foundation year 2, paediatrics, Heart of England NHS Foundation Trust, UK

 Farazm@doctors.org.uk

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