“I was lucky!” A mixed methods study exploring how practice placements affect F2 doctors’ attitudes to a GP career

Background The United Kingdom’s National Health Service has a workload which is increasingly moving from secondary to primary care. The proportion of Foundation Year 2 (F2) doctor specialty training applicants appointed to General Practitioner (GP) training programmes has historically been in decline. Though recent figures show an increase in applications, the pattern of high competition and many F2s not progressing directly into GP training is ongoing.

Aim To explore the features of F2 GP placements that influence career choice

Design & setting A retrospective mixed methods study using an on-line survey followed by semi-structured interviews.

Method A survey of 77 F2 doctors from 3 Health Education England regions was completed, of which 20 took part in interviews following their 4-month GP placement. Survey data were analysed using descriptive statistics, and qualitative data using thematic analysis.

Results This study found considerable variation between practice placements in terms of F2s’ workload, the quality of supervision and support, whether they encountered inspiring GP role models, the degree of isolation, educational opportunities and the culture of the practice. F2 doctors consider that their GP placements are invaluable for their learning. However, placement experiences were mixed, with F2 doctors being attracted and “put off” a GP career in equal numbers.

Conclusion There is a need to ensure consistently high-quality GP placement experiences for F2 doctors’ that can best inform their career choice. F2 doctors made several recommendations following their GP placement which, if implemented, may help to increase the attractiveness of GP as a career.