McCallum Marianne, MacDonald Sara, McKay John
GP Clinical Academic Fellow, General Practice and Primary Care, Institute of Health and Wellbeing, Glasgow University, Glasgow, UK
Senior Lecturer in Primary Care and GP Clinical Academic Fellow, General Practice and Primary Care, Institute of Health and Wellbeing, Glasgow University, Glasgow, UK.
BJGP Open. 2019 Jul 23;3(2). doi: 10.3399/bjgpopen19X101644. Print 2019 Jul.
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.
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.
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.
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.
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.
全科医生培训机构较少位于贫困地区;对于这些地区的全科医生对研究生培训的看法知之甚少。
探讨在贫困地区工作的全科医生对全科医生专科培训(GPST)的看法。
对在苏格兰贫困地区工作的全科医生进行定性深入访谈。
对参与培训和未参与培训的全科医生进行了10次深入访谈,以探讨他们对培训的看法。访谈进行了录音并逐字转录,然后进行归纳主题分析。
强调了培养能够在各种环境中工作的“全面发展”的全科医生的重要性。实习生需要接触贫困环境中的特定挑战(如早期多种疾病并存、儿童保护和成瘾问题),并且认为这对实习生的益处是非常宝贵的。全科医生确定了培训中许多可感知的障碍和益处,有些是普遍存在的,但有些——如激励下一代(益处)或工作量过大(障碍)——在高贫困地区可能更为相关。工作量过大是不成为培训机构的主要原因,不过如果得到支持以培养培训文化,一些机构会考虑成为培训机构。所有全科医生,包括未参与培训的医生,都参与了一些他们认为对适应能力很重要的选修活动。
贫困地区的全科医生强调,在贫困地区至少进行部分实习可以获得特定技能,而在富裕地区可能会获得不同的技能。国家教育机构应考虑全科医生培训轮转,以确保有各种培训环境。