Division of Health Sciences, Warwick Medical School, Coventry, CV4 7AL, UK.
Department of Psychology, University College London, Gower Street, WC1E 6BT, London, UK.
BMC Med Educ. 2018 Apr 27;18(1):81. doi: 10.1186/s12909-018-1160-z.
There is currently a shortage of qualified GPs in the UK and not all of the training posts available each year are filled. Changing the way in which GP trainees are selected could help increase the training post fill rate and the number of new entrants to the GP Register. The aim of this study was to model the impact of changing the selection process for GP training on the number of trainees obtaining GP Registration, either with or without extensions.
This was a cohort study using UK applications for GP training in 2011-14. Application data were linked using GMC numbers to training outcome data where available, and imputed using multiple imputation where missing. The number of trainees appointed and GP Registrations within three and five years' full-time-equivalent were estimated for four different selection processes.
The cut scores used in the actual 2015 selection process makes it impossible to fill all training posts. Random selection is the worst option, but the difference between this and other processes modelled falls as more trainees are selected. There are large marginal effects on outcomes: those with the highest selection scores are more likely to obtain GP Registration than those with the lowest scores.
Changing the selection process alone would have a small impact on the number of GP Registrations; reducing/removing cut scores would have a much larger impact. This would also increase the number of trainees requiring extensions and being released from training which would have adverse consequences for the profession.
目前英国合格的全科医生短缺，每年并非所有可用的培训岗位都能招满。改变全科医生培训生的选拔方式可能有助于提高培训岗位的填补率和新进入全科医生注册的人数。本研究旨在通过建模来评估改变全科医生培训选拔流程对获得全科医生注册的培训生人数的影响，包括是否需要延期。
这是一项使用 2011-14 年英国全科医生培训申请的队列研究。在可用的情况下，使用 GMC 号码将申请数据与培训结果数据相关联，在数据缺失的情况下，使用多重插补进行插补。为四种不同的选拔流程估算了三年内和五年内全职同等数量的培训生人数和全科医生注册人数。
实际 2015 年选拔流程中使用的截止分数使得无法填满所有培训岗位。随机选拔是最差的选择，但随着选拔的培训生人数增加，这种选择与模型中其他流程之间的差异会缩小。对结果的边际影响很大：选拔分数最高的培训生比分数最低的更有可能获得全科医生注册。
仅改变选拔流程对全科医生注册人数的影响较小；降低/取消截止分数的影响要大得多。这也将增加需要延期和被取消培训的培训生人数，这将对该行业产生不利影响。
