..and so, again and again, that GPs are in some way ‘undertrained’. We aren’t specialists – we are generalists. It’s a different job, with different skills. But it’s a myth to repeat that just because a GPs doesn’t have specialist training somehow means that the doctor is incompetent or lacking in training. GP training consists of an undergraduate career, a year as a preregistration doctor, and typically two years of further house jobs before another year as a GP trainee. There are exams from the RCGP and then a postgraduate career where one is responsible for a lifelong commitment to continuing education, and annual appraisal when this is discussed. If you are useless, incapable of learning, or unable to spot your deficiencies, your trainer will see your videos, read your notes, meet your patients and find out. As a GP trainee, you may have done jobs in psychiatry, paediatrics, gastroenterology and obstetrics. You may not have done a job in geriatrics or in rhematology. If one spent time in every possible hospital based speciality before reaching a GP training post they would be very old by the time they emerged. The GP trainee year is used to learn about medicine as it presents in general practice, and this is different to hospital medicine.
So when I qualify as a GP, I haven’t just received ‘six days’ training in dermatology – my training in dermatology has been something different, a professional development which continues. What was recommended fifteen years ago is not quite the same today. I’ve a duty to keep up.
It’s incredibly irritating to have single issue pressure groups constantly insisting that ‘they’ are the Cinderella service (something the BMJ has previously found to be a description many specialities believe that they own). I’d like to know what ‘awareness’ charities for psoriasis have about heart failure, what heart failure charities know about brain tumours, what brain tumour charities know about cervical cancer and what those charities in turn know about learning disability. Not much, I’d wager; what we have is a competition for your attention and your wallet. Naturally, it’s very unusual for a health charity to want to play down it’s importance.
The thing is, that GPs are in the unusual position of seeing people who are people first and who are not defined by their disease. Health charities are only interested in ‘their’ disease. They are biased, for right or wrong. Charities may or may not do useful things, and may or may not help patients or do decent research. But they are biased, and I think healthcare charities can be no longer to be assumed as good thing. I think they need as much scrutiny as, for example, the pharmaceutical industry.