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Having completed my registrar training in September 2005, an area that I believe needs to feature clearly in the nMRCGP is business management related to general practice.
The existing examination comprehensively addresses knowledge base (MCQ); the ability to integrate and apply theoretical knowledge and professional values (written paper); decision making (oral); and the assessment of consulting skills (video). Having completed the MRCGP, I feel the exam has provided me with greater skills and confidence in many aspects of my life as a GP.
However, the existing exam does not focus enough on business management within general practice. Arguably, the oral component could explore this, but in my experience did not. During my registrar training, I learned a limited amount about business aspects through attending practice meetings, the occasional tutorial and reading through the weekly rags.
What I feel would be invaluable to all registrars would be to incorporate business management in the nMRCGP. This may take the form of an OSCE or viva station exploring common business dilemmas within the clinical skills assessment (CSA) component or integrated into the workplace based assessment (WPBA).
Making GP registrars more aware of business aspects within general practice will make them better prepared as they begin life as a GP, particularly with the evolving nature of the new contract and the underlying political forces that continually shape the future of general practice.