GP speciality training in areas of deprivation: factors influencing engagement. A qualitative study

Marianne McCallum; Sara MacDonald; John McKay

doi:10.3399/bjgpopen19X101644

GP speciality training in areas of deprivation: factors influencing engagement. A qualitative study

BJGP Open. 2019 Jul 23;3(2):bjgpopen19X101644. doi: 10.3399/bjgpopen19X101644. Print 2019 Jul.

Authors

Marianne McCallum¹, Sara MacDonald², John McKay³

Affiliations

¹ GP Clinical Academic Fellow, General Practice and Primary Care, Institute of Health and Wellbeing, Glasgow University, Glasgow, UK marianne.mccallum@glasgow.ac.uk.
² Senior Lecturer in Primary Care and GP Clinical Academic Fellow, General Practice and Primary Care, Institute of Health and Wellbeing, Glasgow University, Glasgow, UK.
³ GP Assistant Director, Quality Improvement and Performance, Medical Directorate, NHS Education for Scotland, Glasgow, UK.

Abstract

Background: GP training practices are less likely to be situated in areas of deprivation; little is known about GP views of postgraduate training in such areas.

Aim: To explore the views of GPs working in deprived areas about GP speciality training (GPST).

Design & setting: Qualitative in-depth interviews with GPs working in practices in deprived areas in Scotland.

Method: Ten in-depth interviews were conducted with GPs in training and non-training practices, to explore views on training. Interviews were audiotaped and transcribed verbatim, and inductive thematic analysis was undertaken.

Results: The importance of producing 'well-rounded' GPs who are able to work in a variety of environments was highlighted. Trainees need exposure to the specific challenges of deprived contexts (such as early multimorbidity, child protection, and addiction) and the benefit of this for trainees was thought to be invaluable. GPs identified many perceived barriers and benefits to training, some generic but some - such as inspiring the next generation (benefit) or overwhelming workload (barrier) - may be more relevant in areas of high deprivation. Overwhelming workload was the main reason for not becoming a training practice, though some would consider it if supported to develop a training culture. All the GPs, including non-trainers, were involved in optional activities which were felt to be important for resilience.

Conclusion: GPs in areas of deprivation highlighted specific skills that could be gained by undertaking at least a part placement in deprived areas, with different skills likely to be gained from affluent areas. National education bodies should consider GP training rotations ensure a variety of training environments.

Keywords: Family medicine; General practice; Inequalities; Postgraduate education; Primary care; Socioeconomic factors.