Extended GP placements in final year - why do students choose them?

Talk Code: 
4A.7
Presenter: 
Lloyd Thompson
Co-authors: 
Author institutions: 
University of Dundee

Problem

Presently there is a national shortage of medical graduates choosing General Practice (GP) as a career leading to a national shortage of GPs in the UK. It has been shown that medical student experience whilst at medical school has a significant impact upon their perception of General Practice as a career. In the final year of the undergraduate medical course at UofD, students have the option to undertake an extended GP placement whereby a 4-week SSC placement is combined with the standard 4 week GP placement to allow an 8-week continuous placement in one practice. It is not known what factors influence students’ choice to undertake this extended placement. If this was understood better, it may be possible to encourage more students to undertake it and therefore improve application rates to postgraduate GP training.

Approach

All students in final year currently on GP placement (both traditional and extended) across a four month period were invited to take part in a semi-structured interview. This allowed for a more iterative approach, allowing different areas of interest to be explored as they came up in the interview. The data from these interviews was analysed using a thematic analysis approach to derive themes.

Findings

Career intentions were a motivator of choosing the extended GP placement, with students both seeking to affirm or further "test the water" with their intention for a career in GP. Those students who undertook the extended GP placement reported improved educational experiences as a result. This improved learning was due to the increased patient exposure that an extended placement offers, but this exposure was proportionally greater than the extra time allocated to the placement as students reported having greater clinical exposure in the latter half of their placements compared to the earlier half. This improved educational experience was further enhanced by the strong sense of belonging to the primary care teams that students described on an extended placement. This sense of belonging improves the student’s enjoyment of the placement but also appears to empower the student to more proactively engage with the clinical workload and gain a more valuable educational experience as a result.

Consequences

The improved educational experience of an extended placement should be made more explicitly clear to students. The medical school should attempt to encourage students who feel they will not be a GP to undertake the extended placements owing to the improved educational experience offered. The concern that undertaking an extended GP placement might limit experience in other areas of medicine should noted, and consideration given to requiring all students to undertake an extended GP placement. This would increase GP content in the delivered curriculum, in line with the requirements of Scottish Government to do so.

Submitted by: 
Lloyd Thompson
Funding acknowledgement: