Trainees' experiences of a four-year programme for specialty training in general practice.

In 2012 the first Scottish cohort of trainees completed a four-year training programme in general practice. In the same year, the Royal College of General Practitioners (RCGP) successfully made the educational case for lengthening training from three to four years in the rest of the UK. This project sought to evaluate the experiences of the initial four-year cohorts (2012 and 2013) to gain the Certificate of Completion of Training (CCT). We aimed to capture trainees' experiences of the training programme and how well it prepared them for independent general practice. We also investigated whether perceived levels of clinical confidence in key areas of the curriculum improved over time. To achieve this we undertook a cross-sectional online questionnaire survey. Open-ended questions were included to elicit more in-depth responses by participants on all issues. A total of 20/49 trainees in 2012 (40%) and 46/50 trainees in 2013 (92%) completed the survey. Perceived mean levels of clinical confidence in the key curriculum domains surveyed in 2012/13 were generally high, particularly in clinical domains or topics such as cancer management (94%) and paediatrics (94%). It was lowest in non-clinical domains such as GP partnership (57%), practice management (68%) and leadership (65%), but also in some skills specific to general practice that are of importance where healthcare delivery is increasingly community-based such as public health (63%) and caring for the long-term unemployed (33%). This small study will inform the implementation of an integrated, community-based model of training to enable GP trainees to achieve the clinical and generalist skills required in the immediate future.