No 93: Do you work hard enough as a GP Registrar? Survey Results from the West Midlands
Tldr
GP Registrars (trainees) work long hours. We work hard and we act like adult learners. Most of us pass the MRCGP exams without additional help.
GP Registrars should be aware of what is a “normal” amount of work and what time and support they are supposed to get as part of the training programme.
There is significant variation, locally and nationally.
I really should publish this survey data, but its been sitting in my to do list for over a year and its becoming a mental block. I can’t face the faf of having to go through the official publishing route at this time. I just want to get the results out there so that other trainees can make the most of it.
If you want to replicate the survey and publish it then please do!
The West Midlands GPVTS - Self Study Survey 23-24
West Midlands GPVTS - Self Study Survey Results 23-24
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Introduction and background
and have inspired me to self publish. I know that for my academic career it would be better to submit this article to a journal and do it officially, but I just need this off my to do list for now.I created this survey last year after attending a GP Education Committee meeting as a GP trainee / registrar representative for South Birmingham. There was discussion at the meeting that trainers were concerned that GPSTs were failing exams, not working hard enough and not using their time productively.
There were also concerns that some GPSTs were not using the 4h self study period for entirely study purposes. During this meeting there was no data discussed and it was all anecdotal. During the meeting there was no appreciation that GPSTs might be doing study in their evenings and weekends, which is outside of “paid” time and might compensate for any time not used directly during the self study period. There was no appreciation that we are independent, adult learners and not typists on an hourly contract.
Readers of this Medicurious substack will know that I love data. I also enjoy standing up for my colleagues and trying to push back on anyone who tries to give trainees more work, without appreciating how burnt out many are right now.
So, I pushed back at the meeting and said that I would survey the trainees and present the results at the next meeting. So, that’s what I did.
I have now stepped down as the rep. I like to think this survey made a difference.
Useful Resources and Summary of the GPST Education Schedule
I have included this section here, because many GP Registrars seem to be unaware of what their training programme should be and how much training they should be receiving. I would encourage all trainees to review this summary below and to look at the attached links to make sure that you are getting as much training and study time as you should be.
The standard GP trainee working week consists of 10 sessions. These will be divided into 7 clinical sessions, and 3 educational sessions.
A session is defined as 4 hours.
Educational Sessions are also 4 hours but they can be split up across the week e.g. half-hour debriefs can be added together to make up educational time and personal study can be split into smaller blocks across the week.
Structured educational time in practice can include tutorials, debriefs, clinical meetings, protected learning time sessions and joint surgeries but not OOH sessions.
Joint surgeries are considered educational time if clinical workload is reduced by 50% e.g. 20 minute appointments instead of 10 minutes.
Many trainers prefer having split tutorial times that one big lump sum. Remember, the trainer and trainee cannot concentrate for a full 3 hours; hence most prefer 2 sessions per week of 1.5 h duration.
It is important to ensure the GP trainee undertakes at least one independent educational session per week due to the intensive training nature of the GP trainee year. This should be timetabled in as a ‘personal study’ session of 4 hours duration.
On days where there is no Half-Day Release (HDR) session, this does not become an automatic day off.
All surgeries must be followed by a debrief. This must be scheduled in and clearly visible on the trainee’s timetable.
Debriefs should be 20 mins for a 2 hour surgery and 30 minutes for anything longer.
Clinical Supervision: GP trainees must be supervised at all times. In other words, someone has to be available for giving advice (and be available on site). This cannot be a locum GP. It has to be a GP partner or regular salaried GP. Someone should be available even when a trainee engages in baby clinic or child immunisations with the practice nurse. It must be clear from the timetable WHO is the Clinical Supervisor for that day.
https://www.bma.org.uk/media/2u4bo4s3/gp-registrars-survey-results-2024.pdf - Similar results to this survey were found by the BMA GPRC Survey (which was conducted after mine but published before).
Method
The survey was created in Google forms and distributed via Whatsapp groups and word of mouth to trainees in the West Midlands and then also disseminated nationally.
It was anonymous, short and obviously, only completed by motivated individuals. A limitation of this survey is that it is likely to be only representative of “motivated” trainees.
Another limitation is that it was not an “official” survey and not endorsed by any training or regulatory bodies. I suspect it would have had more responses if it had been emailed from the deanery or RCGP.
Results
West Midlands GPVTS - Self Study Survey Results 23-24 You can review the full set of results automatically produced by Google Forms here. It will also show you a huge number of white space responses that trainees suggested for improving their training.
245 respondents, please see the below table for the demographics. Mostly from the Midlands and a good spread of UK graduates and IMGs, and a mix of years.
There are roughly 17000 GP trainees in the UK at present and I was not able to get a figure for the number within the West Midlands but it is roughly about 1500. Approximately, a 15% response rate for the Midlands.
My key take home findings from this survey are:
The trainees who completed this survey are mostly using their “self-study time” for studying, and most trainees report doing more studying in their own time plus extra portfolio work.
The tables with the heat graphs give a good breakdown of just how much extra work GP trainees are doing on a regular basis.
90% of the survey respondents wanted BLS and safeguarding to be included within their VTS training and I suspect this is because these courses are mandatory and actually quite difficult and time consuming to arrange.
I would say that a significant number of respondents are not getting the VTS, GP tutorial time and self-study time that they should be.
90% of the respondents do not want their freedom restricted by their ES. They want to be treated like independent adult learners.
Conclusion
What do you think? Do you think you are working hard enough already?
If you found this post useful, then please “like it”, share it and if you have the time, replicate it in your region. If you do replicate it, then please let me know what you find. Thank you for reading.