General practitioner in UK
Posted on:3/23/2006
| In the United Kingdom, doctors wishing to become GPs take at least 4 years training after medical school, which is usually an undergraduate course of five to six years (or a graduate course of four to six years), leading to the degrees of Bachelor of Medicine and Bachelor of Surgery (MB ChB): |
one year as a pre-registration house officer (PRHO) (formerly called a houseman);
two years as a senior house officer (SHO) - often on a General Practice Vocational Training Scheme (GP-VTS);
one year as a general practice registrar.
At the end of the one year registrar post, the doctor must pass an examination in order to be allowed to practice independently as a GP. This summative assessment consists of a video of two hours of consultations with patients, an audit cycle completed during their registrar year, a multiple choice questionnaire (MCQ), and a standardised assessment of competencies by their trainer.
Membership of the Royal College of General Practitioners is optional and can be awarded by examination, or by systematic assessment of an existing practitioner. After passing the exam or assessment, they are awarded the specialist qualification of MRCGP – Member of the Royal College of General Practitioners. General practitioners are not required to hold the MRCGP, but it is considered desirable. In addition, many hold qualifications such as the MRCP (Member of the Royal College of Physicians) and/or the DRCOG (Diploma of the Royal College of Obstetricians and Gynaecologists).
There are many arrangements under which general practitioners can work in the UK. While the main career aim is becoming a principal or partner in a GP surgery, many become salaried or non-principal GPs, work in hospitals in GP-led acute care units, or perform locum work. Whichever of these roles they fill the vast majority of GPs receive most of their income from the National Health Service (NHS). Principals and partners in GP surgeries are self-employed, but they have contractural arrangements with the NHS which give them considerable predictability of income.
The MBChB medical degree is generally considered equivalent to the North American MD medical degree. Doctors educated in the United States, Canada, Ireland, and Great Britain have more ability to move between the countries than other national systems.
Visits to GP surgeries are free in the United Kingdom, but most adults of working age who are not on benefits have to pay a standard charge for prescription only medicine.
Recent reforms to the NHS have included changing the GP contract. General practitioners are now not required to work unsociable hours, and get paid to some extent according to their performance, e.g. numbers of patients treated, what treatments were administered, and the health of their catchment area. They are encouraged to prescribe medicines by their generic names. The system for assessing their income based on these criteria is called QMAS. A GP can expect to earn about 70,000 pounds a year without doing any overtime.
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