The influence of training experiences on career intentions of the future GP workforce: a qualitative study of new GPs in England

Abstract

BackgroundThe capacity of the UK GP workforce has not kept pace with increasing primary care workloads. Although many doctors successfully complete GP specialty training programmes, some do not progress to work in NHS general practice.AimThis article explores the training experiences and perceptions of newly qualified GPs to understand how their education, training, and early experiences of work influence their career plans.Design and settingA qualitative study of doctors in their final year of GP training (ST3) and within 5 years of completion of GP training (F5).MethodParticipants across England were recruited through training programmes, First5 groups, and publicity using social media and networks. Open narrative interviews were conducted with individuals and focus groups. Audiorecorded interviews were transcribed, and a thematic analysis was supported by NVivo and situational analysis mapping techniques.ResultsFifteen participants engaged in individual interviews and 10 focus groups were carried out with a total of 63 participants. Most doctors reported that training programmes had prepared them to deal confidently with most aspects of routine clinical GP work. However, they felt underprepared for the additional roles of running a practice and in their understanding of wider NHS organisational structures. Doctors wished to avoid unacceptably heavy workloads and voiced concerns about the longer-term sustainability of general practice.ConclusionStrategies to attract and retain enough GPs to support delivery of comprehensive primary care should consider how doctors’ early career experiences influence their career intentions. A coherent plan is needed to improve their preparation and increase confidence that they can achieve a professionally satisfying, effective, and sustainable career in NHS general practice.

Challenges to well-being for general practice trainee doctors: a qualitative study of their experiences and coping strategies

“…To date, more attention has been focused on other stages of the GP recruitment pipeline,29 but it is important that the experiences GP trainees encounter during their secondary care placements are also considered as a potential source of discontent. On this point, our findings add to those of Spooner et al , whose research on career intentions of new UK GPs found that many felt that hospital placements had done ‘little to prepare them for GP work’ 12…”

“…Our participants felt that educationally fulfilling LTFTW options were less accessible to them in secondary care placements than in primary care. Such issues may relate to senior staff in hospital settings prioritising service delivery or the needs of trainees in secondary care specialty training programmes 12. With increasing numbers of trainees having family and caring commitments, and fewer trainees following linear or direct pathways through to completion of training, prioritising flexibility could help improve job satisfaction and retain trainees in the workforce.…”

“…Factors contributing to GPs’ decisions to leave practice have been identified as including growing workload, resultant stress and low morale 5 9. Other research has found that many GPs within their first 5 years of independent practice and postgraduate GP trainees had reservations about continuing their careers in UK primary care,10 with workload pressures, morale and poor work–life balance during training identified as factors influencing career decisions at the end of GP training 11 12…”

RCGP Research Paper of the Year 2019: impact of COVID-19

“…Highly commended A study led by Dr Sharon Spooner in Manchester titled 'The influence of training experiences on career intentions of the future GP workforce: a qualitative study of new GPs in England', 4 was 'highly commended' by Panel 3. Dr Spooner reflects:…”

Regional variation in practitioner employment in general practices in England: a comparative analysis

“…15 Workforce modelling indicates a continuing projected shortage of GPs and practice nurses. [19][20][21] An insufficient number of GPs will be available as a result of historic recruitment deficits and poor career retention, [22][23][24][25] and there has been little increase in the number of nurses. 26 Increasing workloads have led to government policy changes including recent recommendations regarding the deployment of a broader range of practitioner types.…”