GP training in the UK - recent changes and future plans
There are many changes planned to GP training over the next few years, and this article outlines the current state (including recent changes) as well as exploring some of the changes planned in the next few years.
Currently most GPs are trained as part of a Vocational Training scheme (VTS). A full VTS scheme last 3 years, and consists of either four 6 month hospital jobs and 1 year in a practise as a GP Registrar. More recently hybrid schemes have started up which consist of 18 months in hospital and 18 months in practice, or even 12 months in hospital and two years in practice (with day release to various hospital specialities for 1 year).
Some doctors can apply for a shortened scheme if their previous jobs were educationally approved for training in general practise. Training jobs in the following specialities are usually recognised for GP training: General medicine, general surgery, accident and emergency, paediatrics, general psychiatry, obstetrics and gynaecology. You can have upto 1 year of jobs in any one of these specialities recognized (i.e. 1 year A and E and 1 year general medicine = 2 years hospital jobs completed, so you would only need to do 1 year as a GP Registrar).
Once in the registrar year, the conditions are very good, with very little antisocial hours, and a good pay and allowance package. GP registrars typically work about 36 hours per week (eight clinical sessions, one session for a half day of protected teaching, and one half day for private study). plus one 6 hour shift out of hours (evening / weekend / overnight) per MONTH. There are plans to change the standard week to 40 hours (the private study session will be dropped). This is likely to come into effect in the next year or so.
During the VTS, doctors MUST complete summative assessment in order to qualify as a GP. This consists of four components, which can be taken at no charge, and at any time in the three years. The components are:
1. MCQ exam
2. written work (an audit or research paper review or project)
3. video or simulated surgery
4. trainers report
Many people also choose to complete the MRCGP - this is optional and considered the gold standard for newly qualified GPs. Those that sit and pass the MRCGP MCQ are exempt from the summative assessment MCQ, and those that pass the MRCGP video are exempt the summative assessment video. There are talks going on about plans to make MRCGP the new standard exit exam, but this is unlikely to occur until 2007 at the earliest. The MRCGP is also a modular examination, and consists of four modules:
1. MCQ paper
2. Written paper (modified essay questions)
4. Oral examination (viva)
Each component cost £295 to sit.
GP Registrars are paid a 65% allowance on top of basic pay to cover the extra responsibility they take on as well as the out of hours work. Indemnity fees are currently about £1400 per year for a full time GP Registrar, but the difference between the SHO rate and the registrar rate is reimbursed by the practice. A car allowance of just under £4600 is paid to cover expenses relating to home visits and maintaining a car. Total GP Registrar pay is therefore £50-60k depending on the number of years previous experience.
For more advice on all aspects of GP Training, including practice exam questions, you can visit my website
gpvts.info this is a free information site which does not need registration.
I am currently a Gp Registrar in South Wales, as well as the Gp Registrar representative on the Welsh Standing Committee on Postgraduate Education for General Practice, and the Royal College of General Practitioners (Wales).