Encouraging more students to choose General Practice as a vocation

The NHS is under intense pressure, and the high and increasing patient demand for primary care is only exacerbated by long hospital waiting lists.

The number of GP training places has been increased in recent years, with a plan to expand numbers from the current 4,000 a year to 6,000 postgraduate training posts by 2031.¹ At the same time, more GPs are retiring, and the number opting to work part-time hours has been steadily climbing as people look to adopt working patterns that help them to reduce stress, avoid burnout and improve work/life balance. Since 2015 the NHS has lost more than 2,000 full time GPs.

All this means that there are now fewer doctors looking after greater numbers of patients, many of whom have more complex medical problems in the context of an ageing population. In fact, a single full-time GP is now responsible for an average of 2,300 patients, 362 more than in September 2015². 

As is the case for other Russell Group Universities, a small proportion of graduates from the GKT Medical School at King’s previously went on to train as GPs. However, thanks to measures that the Faculty of Life Sciences & Medicine has put in place, this number has increased by 227% since 2007.³ In 2015 GKT ranked 18th among UK medical schools for graduates entering GP training, but by 2018 we had risen to 4th out of 31 schools, and in 2021 we ranked 3^rd.

As we head towards King’s 200^th anniversary in 2029, being of service to wider society remains at the heart of our vision. The local community plays an important part in training medical students, and the fact that more of them now want, on graduation, to take an active role within those communities as GPs is something we are very proud of. Moreover, King’s has just agreed a branch campus partnership with the University of Portsmouth, one of the areas of the country with the fewest GPs per head of population, to deliver a King’s Medical Degree in Portsmouth while the University establishes its own medical school, a crucial step in helping to redress health disparities in the region and train the next generation of doctors.

So just what steps have been taken to help students see just how rewarding a career in general practice can be?

Impactful primary care placements

The King’s Undergraduate Medical Education in the Community Team (KUMEC) leads on the development and delivery of undergraduate medical education in primary care across more than 200 community settings, 30% of which are in South London, 30% in other parts of Greater London and 40% in other areas of the UK.

In our last MBBS undergraduate medical degree programme review, a longitudinal GP placement was added to Year 2 of the programme to complement the existing eight week long placement in the final year. Now students, in groups of eight, get to spend a day a week in a GP practice for the entirety of their second year. The placement (rated by 87% students as ‘good’ or ‘excellent’) focuses on patient contact, health and illness and how patients are supported in primary care. It provides an excellent foundation for the further eight-week block placement towards the end of the course where students are placed individually in practices, which encourages development of skills in consultation, diagnosis and management. Having the support of a dedicated KUMEC GP tutor enables students to build relationships with staff and patients at a particular practice and encourages many to go on to further their careers in primary care. In fact, 92% students would recommend the practice in which they were based as a placement for other students.

Students also have the option during their degree to complete primary care focussed Student Selected Components and Scholarly Projects in areas of personal interest, as well as Quality Improvement Projects focused on general practice. In addition, more and more students are choosing to undertake their elective or career development period in primary care.

GP Simulation Clinics

Martin Sands, Lecturer in Medical Education, has recently been part of the team delivering KUMEC’s successful simulation clinics which take place in consultation rooms at the Royal College of General Practitioners Headquarters in Central London. These simulation clinics are delivered for second, third and final year medical students, providing an opportunity for students to develop clinical, diagnostic and patient engagement skills. They are also part of the University’s Widening Participation Activity (King’s +) helping local sixth form pupils experience what it might be like to do a medical degree.

Sixth form students engage in patient consultations and receive feedback (with the ‘patient’ being either an actor or someone with lived experience of a particular medical condition) to experience scenarios that medical students co-write. Year 5 (Stage 3) undergraduates teach the secondary school pupils, helping to consolidate their own learning.

Option to complete an Intercalated BSc degree in Primary Care

Developed by Dr Russell Hearn in 2019 and now led by Dr Niki Jakeways, the Intercalated BSc (iBSc) degree in Primary Care, which students can choose to complete between Stages 2 and 3 of their medical degree programme, provides a great opportunity to get further clinical experience in general practice alongside developing skills in leadership, teamwork and research. All students taking the degree in last year’s cohort (2022-23) described the quality of the learning experience as either good or excellent.

Find out more about our Extended Medical Degree Programme, specifically designed for students studying A-levels or Access to Medicine at a non-selective state school. The programme offers a more graduated introduction to medical studies than the standard medical degree programme, with greater academic and pastoral support during the first two years.

References

1. NHS Long Term Workforce Plan (June, 2023), p19. Available at: https://www.england.nhs.uk/publication/nhs-long-term-workforce-plan/

2. The state of medical education and practice in the UK: The workforce report 2022 (GMC, October 2022). Available at: https://www.gmc-uk.org/-/media/documents/workforce-report-2022---full-report_pdf-94540077.pdf

3. Data sourced via the GMC reporting tool.

4. Carlin, E. Alberti, H. and Davies, K. (2021) Denigration of general practice as a career choice: The students’ perspective. A qualitative study. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960518/