Benefits generic to training
  • Trainee–trainer relationship:

    ‘It can be rewarding and stimulating. It’s persistent learning from each other, so we learn from the trainees, they learn from us.’ (GP 1, training)

  • CPD and learning from the trainee:

    ‘I’m picking up stuff from them all the time, new developments, new treatments, stuff like that, stuff they’ve read, so I’m ... I get a lot personally, em, professionally, I get a lot of, I think my professional performance is improved by exposure to junior doctors.’ (GP 3, training)

  • Passing on skills and enjoying teaching:

    ‘I hope that I have experience and skills that are useful to pass on to others and that could help to nurture them ... It does have its moments, if you get someone who’s got challenging problems, but on the whole I get a buzz out of it.’ (GP 4, training)

  • Increased practice morale:

    ‘ ... the most important bit is the ethos of the practice being open, that we are happy to review our own clinical practice as partners but also the admin team, that they know how to support these young trainees.’ (GP 1, training)

  • Value of peer support from trainer groups:

    ‘I think it is important to meet other colleagues if you can, and as much as I am really fond of all of my partners, it’s good to meet colleagues in other practices. You know, just for interest and comparison and, yeah, just as another reference point.’ (GP 7, training)

Universal benefits, but more pertinent in deprived areas
  • Trainees as an extra pair of hands:

    ‘ ... for your more challenging patients they may see the registrar for a period of time and you can get that bit of a break. And there is an awful lot to be said for that, to be keeping going.’ (GP 8, training)

  • Future workforce planning:

    ‘I would want to encourage people to put their energies and efforts into an area of deprivation, if possible.’ (GP 7, training)

  • Inspiring the next generation:

    ‘It’s part of why I want to do it as well, I suppose, you know, I don’t want to see general practice fizzle out and die because I think it’s brilliant and really, really important.’ (GP 6, non-training but hoping to train)

Benefits of training in deprived areas
Value of exposure:
  • Exposure and management of challenges more common in deprived areas:

    ‘So, I do think there is something about being exposed to the problems, and having to solve those problems, or at least ameliorate those problems, which is valuable to, eh, a young registrar.’ (GP 3, training)

  • Multimorbidity (earlier age and later presentations):

    ‘ ... when people present, the degree of illness they have is often hugely different from what you would do in an affluent area. They are usually more diseased, more if that ... if you understand what I mean. So that when they present, they present further down the line.’ (GP 9, non-training)

  • Managing illness in the context of social complexity:

    ‘They also learn, um, complexity … and they also learn the whole benefits system, social issues like child protection and lots of palliative care as well, because we have so many people basically dying. And especially sudden deaths, so our rate of sudden deaths is higher than the average, so they learn how to deal with the procurator fiscal, so overall I think they get a very wide spread of clinical exposure … they might be missing the worried well.’ (GP 1, training)

  • Low health literacy:

    ‘Yes, I mean, a huge number of our patients can’t read or write, so the spoken word, you still have to use very simple language with them, so it’s a different way of communicating. You can’t just hand a leaflet out.’ (GP 10, non-training)