A continuous curriculum for general practice? Proposals for undergraduate-postgraduate collaboration.

The development of a seamless general practice 'spiral' curriculum, in which topics may be revisited at different levels of intensity and complexity during the learning process, has been discussed in the context of undergraduate-postgraduate co-operation. Although the lifelong curriculum for all doctors contains a number of core competencies that aim to produce a 'stem' doctor, concerns remain about the effects of excessive reductionism. It is therefore essential that the content and delivery of the spiral curriculum ensure that intellectual interest is nurtured, by containing both taught theory and training in a hospital context. The opportunity for generalists to teach core competencies such that general practice is at the centre of the undergraduate curriculum--emphasising working within primary health care teams in teaching and training practices--is an ideal area for undergraduate-postgraduate co-operation. The use of the directly observed measures of performance would bring the undergraduate approach to assessment closer to that used in postgraduate general practice. However, supporting the tutors' network is crucial in undergraduate departments where much can be gained by joint working with postgraduate colleagues.