’I was lucky!’ Exploring how practice placements affect F2 doctors’ attitudes to a GP career: a mixed-methods study

BACKGROUND: The NHS has a workload that is increasingly moving from secondary to primary care. The proportion of foundation year 2 (F2) doctor specialty training applicants appointed to GP training programmes has historically been in decline. Though recent figures show an increase in applications, the pattern of high competition and many F2s not progressing directly into GP training is ongoing. AIM: To explore the features of F2 GP placements that influence career choice. DESIGN & SETTING: A retrospective mixed-methods study using an online survey followed by semi-structured interviews. METHOD: A survey of 77 F2 doctors from three Health Education England regions was completed, of which 20 took part in interviews following their 4-month GP placement. Survey data were analysed using descriptive statistics and qualitative data using thematic analysis. RESULTS: This study found considerable variation between practice placements in terms of F2s' workload, the quality of supervision and support, whether they encountered inspiring GP role models, the degree of isolation, educational opportunities, and the culture of the practice. F2 doctors consider that their GP placements are invaluable for their learning; however, placement experiences were mixed, with F2 doctors being attracted to and 'put off' a GP career in equal numbers. CONCLUSION: There is a need to ensure consistently high quality GP placement experiences for F2 doctors that can best inform their career choice. F2 doctors made several recommendations following their GP placement, which, if implemented, may help to increase the attractiveness of general practice as a career.