Recruitment of UK-trained doctors into general practice: findings from national cohort studies

Background: In recent years there have been difficulties with recruitment in the United Kingdom (UK) to principalships in general practice. Aim: To compare recruitment trends in cohorts defined by year of qualification and to report attitudes of young doctors about the attractiveness of a career in general practice. Design of study: Cohort studies. Setting: UK medical qualifiers in the years 1974, 1977, 1983, 1988, 1993, and 1996. Method: Postal questionnaire surveys conducted from 1975 to 1999. Results: Five years after qualification, 23.8% of 1993 qualifiers were in UK general practice, compared with 25.9% and 32.8% of 1988 and 1983 qualifiers respectively. Six percent of responders in the 1993 cohort were general practitioner (GP) principals, compared with 10% of the 1988 cohort and 20% of the 1981 cohort. Ten years after qualification, 37.7% of 1988 qualifiers and 42.7% of 1983 qualifiers were in UK general practice. Older GPs had lower job satisfaction than their contemporaries in hospital practice, while younger GPs were more satisfied than younger hospital doctors with the time available for leisure. Although young doctors are less inclined to enter general practice nowadays, over half of the 1996 qualifiers, when surveyed in 1999, actually regarded general practice as a more attractive career than hospital practice. Conclusion: Patterns of entry into and commitment to UK general practice are changing. Fewer young doctors are choosing and entering general practice and early commitment to full-time principalships is falling. The 1996 cohort, however took an encouragingly positive view of the attractiveness of careers in general practice.