Provision of medical student teaching in UK general practices: a cross-sectional questionnaire study

Abstract

Background: Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning

Aim: This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision.

Design and setting: A cross-sectional questionnaire in the UK.

Method: A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined.

Results: General practice teaching for medical students increased from <1.0% of clinical teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000.

Conclusion: Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve this.

Keywords: cost; general practice; medical students; primary healthcare; teaching; workforce.

Figure 1.

Mean percentage of total clinical curriculum delivered in general practice, 1968–2013.–

Figure 2.

Historical and current mean number of 3.5-hour sessions of teaching per medical student delivered in UK medical schools.–

Figure 3.

Historical and current numbers of general practices involved in teaching with UK medical schools.,

Figure 4.

Number of integrated university departments of general practice.–

Figure 5.

Total months of vocational training in general practice, 1995–2010. Number of GP registrars multiplied by the duration of training. Source: Health and Social Care Information Centre.