Longer in primary care: a mixed-methods study of the Welsh GP training model

Abstract

BackgroundA new model of general practitioner (GP) training was introduced in Wales, whereby trainees spend one year in hospital and two years in general practice (the 1+2 model), a change from the previous model of 18 months in each setting.AimTo evaluate the 1+2 model of GP training in Wales.Design & settingLongitudinal mixed-methods evaluation via repeated surveys and focus groups with GP trainers and trainees across the Welsh training schemes.MethodYearly surveys and focus groups between June 2020 and December 2022. Quantitative survey data was analysed in SPSS. Qualitative survey data and focus group transcripts were analysed thematically.ResultsSpending more time in general practice was seen as a major benefit. The consensus was that general practice is the best place to learn essential consultation skills. Furthermore, general practice was viewed as a flexible educational setting where knowledge gaps can be addressed.The main concern about the 1+2 model was that trainees would miss experience of key specialties. However, as trainees progressed through the training programme, this concern diminished. All trainees and most trainers thought that the benefits of the 1+2 model outweighed drawbacks.ConclusionSpending more time in general practice during GP training appears to improve how prepared trainees felt for practice. Future changes should explore options to enhance hospital experience without reducing time spent in general practice.