>The development of vocational training for general practice was an
>outstanding achievement and GP training, along with the standards set
>for training practices, remains the RCGP's jewel in the crown.
The RCGP has tried, on the whole to do good things, but some of its eminent
members have been equally concerned about empire building and their own
self-promotion.
Strangely enough, on the quotation above with which many or most would
agree, there is virtually no evidence of benefit.
GP training has become an empire in itself, no longer focused on the needs
of intending GPs and their patients - and now it is to be extended. Indeed
recent discussions have highlighted how in the UK (and this has
implications well beyond medicine) training is sneered at by "educationalists".
After 20+ years experience of suburban general practice what, if any
hospital and community attachments seem as though they would have been useful?
Rheumatology, rehabilitation and orthopaedic medicine.
Psychiatry - child & adolescent, adult and psychogeriatrics
Dermatology including clinical photography and skin surgery
Geriatric and palliative care medicine
General and community paediatrics, perhaps including some OP ENT?
OP Antenatal care, Gynaecology, FP and GU medicine.
Radiology, particularly the acquisition of skill in diagnostic US.
If all this was complemented by some IT skills, team and practice
management, maybe some basic Occupational Health and medicine as it happens
in general practice, together with a little more support for regular
sabbaticals there could be a real sea change.
What was and IS delivered includes very little of this. No wonder those
coming off training schemes feel so unready to become principals. Will
David Haslam be the last chairman in any meaningful sense of a Royal
College of General Practitioners (as opposed to primary care)? In the
papers Mayur Lakhani says not. The next 3 years will tell.
Julian
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