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Roger Tisi1 writes that funding had not been obtained in vocational training to support 18 months of practice-based training, and that he was asked to redesign his scheme to include 2 years in hospital posts.
This is a serious and pitiable situation with some similarities to that in Italy, where 18 months in practice-based training has not been scheduled yet, as it is difficult enough to find funds for 12 month periods.
The situation is wrong from a professional development point of view, and in contrast with the European indications themselves.
This situation indicates, in the UK as well as in Italy, a political dilemma: how high is the credibility and consideration for general practice?
In no other speciality are periods of training shifted or mainly based in other sectors: it would be nonsense. A GP will not specialise by spending more time in an opthalmology department, just as opthalmologists would not specialise by spending more time in orthopaedic departments.
Roger Tisi is facing a ‘frankly bewildering proposal that doctors specialising in general practice will receive the vast majority of their education and training delivered by colleagues in other specialities’. This is a ‘frankly bewildering’ and in contrast with the European Directives, WONCA European Definition and the EURACT Educational Agenda, where a clear specialist status and a clearly detailed curriculum for teaching in general practice is described. No other specialists would be able to teach the specificities of general practice.
However, I would argue that other specialists should be obliged to spend time in practices to learn something about general practice's specificities and keep them in mind during their professional life.