College of Life Sciences, University of Leicester, Leicester, UK.
Medical Education, University of Nottingham, Nottingham, UK.
Educ Prim Care. 2021 Jan;32(1):10-18. doi: 10.1080/14739879.2020.1831970. Epub 2020 Nov 24.
Challenges facing general practice are multiple and extreme. Amongst them is the increasing difficulty of recruiting and retaining General Practitioners (GPs). GPs cite heavy workload, work-related stress, little family time and psychological ill-health as factors influencing their decisions to leave or reduce working hours. Analysis of the literature suggests that these factors, amongst others, are present in GP training and trainees have similar experiences. An in-depth understanding of the challenges trainees in difficulty face is lacking.Our research aim was to better understand the factors that trainees perceive contribute to their failure to progress in training. A qualitative approach was adopted using semi-structured interviews with GP trainees identified as failing to progress satisfactorily or failing the MRCGP examinations. Interviews were audio-recorded and transcribed. Thematic analysis was used to understand the unique experiences of GP trainees and find common themes.Twenty-three interview transcripts were analysed. Emergent themes were presented using a framework of three distinct categories to aid data organisation and allocating themes and sub-themes: professional factors, personal factors, and social factors. Difficulties with managing work-load, poor motivation, lack of family time and psychological ill-health were significant themes for many. This study supports the evidence that difficulties facing GPs take root in training. Failure to fully understand trainees' journeys and associated challenges reduces opportunities to provide bespoke packages of care and remediation that fully address their needs.
全科医学面临的挑战是多方面的，也是极端的。其中包括越来越难以招募和留住全科医生（GP）。全科医生提到工作负荷大、与工作相关的压力、很少有家庭时间和心理健康不佳等因素影响了他们离职或减少工作时间的决定。文献分析表明，这些因素以及其他因素存在于全科医生培训中，受训者有类似的经历。对处于困境中的受训者所面临的挑战的深入了解是缺乏的。我们的研究目的是更好地理解受训者认为导致他们培训失败的因素。采用了定性方法，对被认为未令人满意地进步或未能通过 MRCGP 考试的全科医生受训者进行了半结构化访谈。访谈进行了录音并转录。使用主题分析来理解全科医生受训者的独特经历，并找到共同的主题。分析了 23 份访谈记录。使用三个不同类别的框架呈现了新兴主题，以帮助组织数据并分配主题和子主题：专业因素、个人因素和社会因素。许多人都面临着管理工作负荷困难、缺乏动力、缺乏家庭时间和心理健康不佳等问题。这项研究支持了这样一种证据，即全科医生面临的困难源于培训。未能充分了解受训者的经历和相关挑战，减少了提供全面满足其需求的个性化护理和补救方案的机会。
