Funding the teaching of medical students in general practice: a formula for the future?

UK general practice faces a recruitment challenge.1 The major policy intervention in England has been for the Department of Health to task Health Education England to ensure that 50% of UK graduates enter general practice training.2 Given that historically the proportion who enter general practice has fallen short of this target,3 the recent GP Taskforce report is important and timely.4 It has made multiple recommendations which include increasing the number of GPs and promotion of general practice as a career. We know that undergraduate experiences shape career choices in the USA5,6 and UK;7,8 and that high-quality undergraduate experiences in general practice encourage recruitment.7,8 This emphasises the current importance of undergraduate medical education in general practice. However, undergraduate education in general practice is under pressure from increasing service demand, the introduction of foundation placements in general practice and large increases in postgraduate teaching. In another paper we have shown that the steady increase in the proportion of undergraduate curricula delivered in general practice between the 1970s and the early 2000s has stalled and that the average general practice placement duration has dropped by 2 weeks in the last 10 years.9 While doctors are often attracted to teaching because it is enjoyable and important to them, as teaching load increases, teaching needs to be adequately resourced otherwise motivation to teach may wane.10,11 It is important, therefore, that the formula for funding teaching in general practice is realistic and faithfully reflects the costs. At present, the funding for teaching medical students in general practice is being reviewed. In this paper, we propose a model that may faithfully reflects the costs of this teaching.