The problem
There is currently a national General Practitioner (GP) recruitment crisis with only half of GP trainee places in some areas being taken.  Many influences are known to affect students’ and young doctors’ career choice; one such influence is their clinical teachers.  It has been suggested and there is anecdotal evidence that negative comments may be made to students and young teachers towards a career choice of General Practice but little robust evidence exists.
Approach
We conducted an explorative, qualitative study asking groups of GP trainees about comments made to them, both positive and negative, by all clinical teachers, towards their stated choice of General Practice as a career.  New GP trainees from the two largest training programmes in the Northern region (HENE), where the recruitment crisis is particularly acute, were invited to participate. Six focus groups were undertaken within the trainees current study groups using a semi-structured question format.  Full transcripts of the focus groups were thematically analysed by the research team.
Findings
Active denigration of General Practice as a career is evident though not consistent to all participants and is seen as a generic, ‘cultural’ issue in the hospital setting.  A recurring theme was the notion of trainees becoming “just a GP” and interestingly some participants found themselves also using this phrase.  A GP career was noted by some hospital clinicians to be a “cop out” for the “easy life” and trainees were told they were “wasted as a GP” or “too good to be a GP”.  Conversely, some participants noted positive comments centring around it being a good choice for those wanting a family and a good work/life balance. Other participants perceived their hospital clinical teachers to be promoting their own specialities rather than demoting General Practice.  Comments from General Practitioners were mixed with some being notable encouraging role models but others making negative comments about the current workload and stress involved.  Participants broadly perceived that the negative comments they heard had not influenced their own career choice but may have led to their colleagues not following a career in General Practice.
Consequences
Our findings disturbingly support the anecdotal evidence that active denigration of General Practice as a career choice does exist in the hospital setting in our region.  We would strongly recommend that further explorative work and quantitative surveys are undertaken to explore the extent to which these findings are confirmed and to what extent they are discouraging students and trainees from following a career in GP.  Badmouthing of General Practice as a career must be addressed urgently as a discriminatory issue.

Joanna Hall
Kym Merritt
Hugh Alberti
Newcastle Medical School
Presented at SPAC national conference, July 2016