22nd September 2017, Volume 130 Number 1462

Samantha A Murton, Susan RH Pullon

New Zealand has a primary care-led health system, with increasing emphasis on effective care in the community, yet there is a declining proportion of doctors working in primary care and…

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Summary

Most general practices in the lower North Island and South Island are already involved in training doctors and nurses. There is little room for increasing the number of trainees in the current teaching practices using current models. Recruiting and training new practices, better supporting existing teaching practices, coordinating placements, training more supervisors and supporting teaching in different ways will help to make more room for quality teaching in general practice.

Abstract

Aim

General practices are providing clinically-based training for rapidly increasing numbers of medical (and other health professional) trainees. This study investigated capacity and intention of general practices to additionally teach junior doctors (now required to undertake community-based attachments by the New Zealand Medical Council) alongside current trainees in their service.

Method

A web-based/telephone survey of all general practices was developed and administered November 2015–April 2016.

Results

In the Otago study region (lower North Island, South Island), 463 currently operating practices were identified. (A companion Auckland-based study concurrently investigated the upper North Island.) Of the 280/463 (60%) responding practices, 93% (261/280) were currently taking health professional trainees, with 86% (241/280) taking at least one type of medical trainee. Practices indicate that 14% fewer of them will take undergraduate medical students than previously (199 practices down to 162), but more would take junior doctors (42 up to 79) and GP registrars (129 practices up to 142).

Conclusion

Most practices in these regions already contribute to teaching. Practices indicated limitations in accommodating continued increases in numbers of trainees in the current poorly coordinated system. Improved support and training for practices is needed to enable practices to take more trainees of multiple types per practice, both concurrently and sequentially.

Author Information

Samantha A Murton, Senior Lecturer, Department of Primary Health Care and General Practice, University of Otago, Wellington; Susan RH Pullon, Professor and Head of Department, Primary Health Care and General Practice, University of Otago, Wellington.

Acknowledgements

Professor Felicity Goodyear-Smith (Academic Head, Department of General Practice and Primary Health Care, University of Auckland) was instrumental in initating the project. Professor Peter Crampton (Pro-vice Chancellor, Health Sciences) and Professors Tim Stokes and Les Toop (Heads of Department in Christchurch and Dunedin) supported the project from the outset. Dr Lynn McBain, Lesley Gray, Dr Ben Hudson and Dr Branko Sijnja provided valuable assistance in the early stages of the project. Thanks are due to staff at the Department of Primary Health Care and General Practice Wellington, the Department of General Practice Christchurch, the Department of General Practice and Rural Health Dunedin, Health Workforce New Zealand (HWNZ), General Practice New Zealand (GPNZ), NZ Rural General Practice General Practice NZ and the Royal NZ College of GPs (RNZCGP). Isabella Tennant and Helena Botes undertook much of the data collection. The study would not have been possible without the help of all the practice managers, general practitioners and other staff who assisted with survey completion, for which the authors are most grateful.

Correspondence

Samantha Murton, Senior Lecturer, Department of Primary Health Care and General Practice, University of Otago, PO Box 7343, Wellington South 6242.

Correspondence Email

samantha.murton@otago.ac.nz

Competing Interests

Both authors work for University of Otago, Wellington.

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