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Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 2008 August 1; 58(553): 581.
PMCID: PMC2486387

General Practice Stigma at Medical School and Beyond — Do We Need to Take Action?

Disappointingly, I write as a fourth year medical student to express my concern at the attitudes experienced by many medical students and indeed junior doctors towards general practice as a career choice.

Time and time again, in the clinical setting I am asked what I might like to do as a career. My usual reply of General Practice or Accident and Emergency is almost always greeted with a somewhat bemused expression from the enquiring doctor. I can almost see the look of distress in their eyes; how could he want to become a GP? Some offer advice, ‘Stick with emergency medicine’ they'll tell me, ‘at least there are some exciting moments in A&E’.

Unfortunately among many of my medical student colleagues the same foregone conclusion has already been reached, perhaps partially a result of exposure to these views. At a recent get-together some friends and I were discussing career options. ‘You don't still want to be a GP do you Dan?’ enquired one. Well, actually yes I would rather quite like to. ‘But Dan, it's a waste, you'll be so bored’. So, I tell them I'm considering a career in academic general practice with an interest in medical education. Does that make it seem better? No. They're still hugely underwhelmed.

While I believe the profile of general practice is being raised in some areas, these negative attitudes make me uneasy. Far too frequently I am subject to criticisms about a career path I am interested in following. At times, the negativity has been so profound that I've found myself thinking that perhaps I shouldn't be a GP. Would my friends lose respect for me if I was? Varying views of hospital practitioners concerning general practice exist but I must protest at the widespread stigmatisation of this hugely rewarding branch of primary care in full view of somewhat impressionable medical students.

Although naturally, general practice isn't for everyone, I wholeheartedly disagree that it is an unexciting speciality. Far from it; where else in modern medicine do doctors have the chance to form a doctor–patient relationship, rich both medically and socially? The old cliché that anything can and does present to general practice certainly applies. GPs are required to maintain a vast knowledge of medicine and perform many other roles. There are of course, emergencies in general practice not to mention the wealth of exciting teaching and research opportunities available.

General practice in the UK is fast becoming the flagship of the NHS with reform and a wider range of primary care-based services. To reflect these changes, competition for GP training posts is fierce, an encouraging sign. Nevertheless, it is important to recognise that many extremely able candidates may be being actively discouraged from following a career in general practice, with constant negative comments and connotations arising from a predominantly hospital-based life as a medical student.

There is a glimmer of hope in some areas of undergraduate education, with ever-increasing proportions of medical programmes carried out in the community, increasing exposure to GP teachers. However, raising the profile of general practice is an absolute necessity, particularly among medical undergraduates and junior doctors. It provides a challenge which must not be taken lightly by the Royal College of General Practitioners and other primary care institutions. Medical schools must do much more to actively promote and dedicate time to the speciality. Academic departments of primary care surely also have a role in inviting and encouraging students into the rich world of primary care academia, even if just for a flitting undergraduate project.

It is about time medical students had real exposure to the innovative, exciting, and tremendous world of general practice and more importantly to have someone to champion its cause and tell the other side of the story.

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners