Longer in primary care: a mixed-methods study of the Welsh GP training model

Background: A new model of GP training was introduced in Wales, whereby trainees spend 1 year in hospital and 2 years in general practice (the 1+2 model), a change from the previous model of 18 months in each setting.

Aim: To evaluate the 1+2 model of GP training in Wales.

Design & setting: Longitudinal mixed-methods evaluation via repeated surveys and focus groups with GP trainers and trainees across the Welsh training schemes.

Method: Yearly surveys and focus groups were undertaken between June 2020 and December 2022. Quantitative survey data were analysed in SPSS. Qualitative survey data and focus group transcripts were analysed thematically.

Results: Spending more time in general practice was seen as a major benefit. The consensus was that general practice is the best place to learn essential consultation skills. Furthermore, general practice was viewed as a flexible educational setting where knowledge gaps can be addressed. The main concern about the 1+2 model was that trainees would miss experience of key specialties. However, as trainees progressed through the training programme, this concern diminished. All trainees and most trainers thought that the benefits of the 1+2 model outweighed drawbacks.

Conclusion: Spending more time in general practice during GP training appears to improve how prepared trainees felt for practice. Future changes should explore options to enhance hospital experience without reducing time spent in general practice.