GP trainers face a period of adjustment because of the many changes to vocational training for general practice expected under the Modernising Medical Careers reforms.
From August 2007, training new GPs will follow a similar pattern to training for other specialities. After graduation, all doctors now have to do two foundation years, known as FY1 and FY2. These are usually divided into four-month posts, so a doctor will do six posts in all.
There will eventually be funding for at least 80 per cent of doctors to do one four-month post in general practice during FY2. So doctors who started their FY1 year in August 2006 will do their GP attachment in FY2 for four months starting in August 2007, December 2007 or April 2008.
After completing FY2, the future GP will embark on a specialist vocational training programme in general practice lasting a minimum of three years. Previous experience may exempt certain candidates from some of this. However, for most GP registrars, it is advisable to apply for the whole three-year programme.
Longer GP placements
In most cases the deaneries hope to change the VTS programme by moving away from the traditional four six-month SHO posts in hospital and one year in general practice towards longer periods in general practice and shorter attachments to hospital and community posts. Unfortunately, severe financial constraints are slowing the pace of these developments.
There are two VTS intakes a year, in February and in August, and applications are generally invited about six months in advance. As now, the prospective GP registrars apply to a deanery of their choice and they decide beforehand in which part of the country they wish to train.
Registrars’ choice of where to train may be partly based on personal considerations. Otherwise the candidates can look at the of different deaneries’ prospectuses and individual VTS to decide what suits them best.
Issues they need to take into account include the range of posts on offer, whether it is a predominantly urban or rural environment and the size of the schemes.
The application form tends to be quite lengthy and typically asks for information to ascertain eligibility for GP training, the type of scheme that is most suitable for the candidate (whether the full three years or shorter), places where they want to train and the details of referees.
Deaneries are moving towards a uniform system of selection. Shortlisting in all deaneries is likely to be done by means of written work carried out under examination conditions.
First, there will be a multiple choice paper to test the basic knowledge of medicine relevant to general practice.
The second part of the written work will consist of a series of short questions that will mainly ask candidates to reflect on their experience in various areas (such as working in teams, methods of learning and career aspirations). Marks will not be scored for the experiences as such but for the ability to learn from them.
Only those applicants whose multiple choice paper is up to a minimum standard will have the second part considered.
The proportion of candidates who are shortlisted will vary from deanery to deanery and from year to year. Factors such as the availability of VTS places and the capacity of the local assessment centre will affect numbers.
Assessment centres will soon replace interviews in all deaneries. The assessment centre method is designed to test various competencies, (key attributes) shown to be associated with effective GP performance.
These competencies include empathy and sensitivity, communication skills, problem solving, coping with pressure, and professional integrity. A number of methods will be used to assess them, including written assessments, simulated consultations and group exercises.
The methods to be used are likely to be spelled out in the instructions that candidates are directed to beforehand and will probably be posted on the deanery website.
When the successful candidates have been chosen, they will be matched to a rotation on a local VTS. Usually there will be some choice in the practices that the GP registrar can join and the hospital posts.
Dr Sackin is a VTS course organiser and sessional GP in Cambridgeshire
Changes to vocational training
From August 2007 training for general practice will follow a similar pattern to that for other specialties.
Applications are generally invited about six months in advance. There are two intakes annually — in February and August.
Short-listing of GP registrars is likely to be based on written work under exam conditions in future.
The shortlisting process will include a multiple choice paper and a series of short questions that asking applicants to reflect on their experience in various areas.
Local assessment centres will soon replace interviews in all deaneries.
The assessment centre method is designed to test various competencies associated with effective GP performance.
Successful candidates will be matched to a rotation on a local VTS.