In parallel with hospital training, doctors who aspire to become General Practitioners (Family Doctors) also undertake a period of hospital-based experience, working as SHOs for two years. The two years must include not less than six months in each of two of Medicine, Geriatrics, Accident and Emergency, Paediatrics, Psychiatry and Obstetrics & Gynaecology. The remaining year is commonly made up of another two from the list, although other options (e.g. Orthopaedics) are permitted. These posts are specifically accredited for General Practice training by the Royal College of General Practitioners, but in practice are virtually indistinguishable from speciality training posts. Many Hospitals, partly in order to solve recruitment difficulties and effort, offer GP training scheme contracts of two years duration at SHO grade during which time the doctor will work in a variety of specialities as required by the RCGP for accreditation. It is not obligatory to gain training accreditation by means of a hospital scheme; indeed approximately 30% of doctors who gain GP accreditation do so via a 'DIY' scheme. Terms and Conditions of Service, hours of work, remuneration and Malpractice arrangements are as for speciality training SHOs.
Following the proscribed hospital two years, Vocational Trainees for General Practice undertake a year working in an approved General Practice Partnership under the guidance and instruction of an approved GP Trainer. During this time, the Trainee gradually gains in experience until working with the same freedom and responsibilities towards the patients as the Partners. The Trainee year is characterised by compulsory attendance at a weekly full day-release vocational training course, during which topics as diverse as Practice Finance, Man Management, Transactional Analysis and Group Dynamics might be taught. Therapeutics and more clinical skills are often left to the recommended additional 3 hours a week dedicated one-on-one teaching with the Trainer. Malpractice insurance is arranged privately by the individual Trainee, current cost is approximately £1100 annually. Working hours are probably about 72 hours a week. Remuneration is less than for hospitals, being 122% of the basic salary for an SHO of the same seniority (the 15% is a flat rate payment for all On-Call) and a further £3928 for the Car expenses.
At the end of the Trainee year, it is common to take the examination of the Royal College of General Practitioners by way of an exit examination. This is not a necessary requirement (yet) of acquiring full accreditation for completion of GP training. Having completed this training vocationally trained GPs are free to apply for posts as a Partner in General Practice whenever and wherever the vacancies appear. Malpractice Insurance remains the responsibility of the individual GP, and costs upwards of £1500 annually (I think...)