A new study by the University of Warwick indicates that only two in three doctors who are completing their training to become GPs plan to work in NHS general practice. Of those intending to remain in the NHS, most propose working as locums or salaried GPs rather than entering a GP partnership.

The study, ‘Factors influencing career intentions on completion of general practice vocational training in England: a cross-sectional study’, was conducted by a team led by Professor Jeremy Dale at the university’s Warwick Medical School and is published in BMJ Open. An online survey was completed by 178 GP trainees employed in the West Midlands who were within three months of achieving their certificate of completion of training (CCT).

The quality of general practice experience during all training (including student years) was reported as influencing personal career plans, and in particular perceptions about workload pressure and morale within training practices.

Professor Dale said explained, ‘The study highlighted a number of potentially modifiable factors related to GP training programs that are detrimentally influencing the career plans of newly-trained GPs. Many of these relate to how general practice had been experienced across undergraduate, foundation and vocational training, and in particular perceptions about workload pressure and morale within practice placements.

‘The negative portrayal of general practice by politicians and the media was experienced as having had a detrimental effect on personal career intentions. Also, sociodemographic factors, such as age, gender, and having children, influenced career plans indicating a need for these to be considered within workforce planning.

‘A sizeable proportion of individuals did not describe their future career plans, perhaps expressing ambiguity about career direction.’

Just over half of the respondents, 62.8 per cent, stated that they expected to be working in six months as a salaried, locum or other non-principal NHS GP, dropping to a third (33.9 per cent) at five years. Conversely, the proportion expecting to become a GP principal increased from less than five per cent at six months to a third (33.9 per cent) at five years.

As well as experience during training, the study found three other factors that were influencing respondents’ career plans for the following five years. These were the: GP workload and work / life balance; practice morale; and media and political commentary.

The research team found that there was an association between participants’ rating of how well their specialist training had prepared them for a career in general practice and intended career plans for the next three years. Those who felt well prepared were more likely to plan to become partners (28.0 per cent compared to 12.5 per cent who didn’t feel well prepared). Those who felt ill-prepared were more likely to anticipate becoming locums (37.5 per cent compared to 10.0 per cent of those who felt well prepared).

In terms of five-year intentions, those who felt their GP training had prepared them well were more likely to aspire to becoming a GP partner (59.8 per cent compared to 7.7 per cent of those who didn’t indicate either way) whereas those who responded neutrally about how well-prepared they felt were more likely to anticipate being a salaried GP in five years (84.6 per cent compared to 38.1 per cent who were well-prepared).

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