背景和目的:慣例在英國正經曆困難與醫務人員招聘和保留,減少數字選擇職業慣例或進入天下,並增加在less-than-full-time工作,職業休息,提前退休和臨時代理工作。信息缺乏對這些變化的原因和因素,可能會增加招聘和保留。英國醫學職業研究集團(UKMCRG)定期調查群英國醫學畢業生來確定自己的職業選擇和發展。我們也邀請受訪者對他們的職業生涯和書麵意見影響他們的因素。大多數受訪者表示高水平的工作滿意度。然而少數值得注意,做出重要的評論慣例。盡管他們的觀點並不代表所有的全科醫生(GPs),他們仍然顯示一係列的擔心應該被理解。本文報告受訪者評論慣例。分析醫生的評論:訓練更多的暴露於慣例在本科水平可以幫助促進全科事業和更好的通知職業決策。研究生全科培訓醫院的帖子被視為質量差,無關緊要的和運行,就好像它是次要的服務承諾。 In contrast, general practice-based postgraduate training was widely praised for good formal teaching that met educational needs. The quality of vocational training was dependent upon the skills and enthusiasm of individual trainers. Recruitment problems Perceived deterrents to choosing general practice were its portrayal, by some hospital-based teachers, as a second class career compared to hospital medicine, and a perception of low morale amongst current GPs. The choice of a career in general practice was commonly made for lifestyle reasons rather than professional aspirations. Some GPs had encountered difficulties in obtaining posts in general practice suited to their needs, while others perceived discrimination. Newly qualified GPs often sought work as non-principals because they felt too inexperienced for partnership or because their domestic situation prevented them from settling in a particular area. Changes to general practice The 1990 National Health Service (NHS) reforms were largely viewed unfavourably, partly because they had led to a substantial increase in GPs' workloads that was compounded by growing public expectations, and partly because the two-tier system of fund-holding was considered unfair. Fund-holding and, more recently, GP commissioning threatened the GP's role as patient advocate by shifting the responsibility for rationing of health care from government to GPs. Some concerns were also expressed about the introduction of primary care groups (PCGs) and trusts (PCTs). Together, increased workload and the continual process of change had, for some, resulted in work-related stress, low morale, reduced job satisfaction and quality of life. These problems had been partially alleviated by the formation of GP co-operatives. Retention difficulties Loss of GPs' time from the NHS workforce occurs in four ways: reduced working hours, temporary career breaks, leaving the NHS to work elsewhere and early retirement. Child rearing and a desire to pursue interests outside medicine were cited as reasons for seeking shorter working hours or career breaks. A desire to reduce pressure of work was a common reason for seeking shorter working hours, taking career breaks, early retirement or leaving NHS general practice. Other reasons for leaving NHS general practice, temporarily or permanently, were difficulty in finding a GP post suited to individual needs and a desire to work abroad.

結論:在醫學教育家文化變革需要促進全科醫院作為職業選擇,同樣有吸引力。預先登記房子的介紹官(PRHO)配售慣例和提高靈活性的全科醫生職業培訓計劃,一起計劃提高高級房子的質量(商店)培訓在未來,是受歡迎的發展和應解決的一些問題關於我們的受訪者提出的質量差的全科醫生培訓。不情願的GPs進入天下,和增加的需求經曆了GPs less-than-full-time工作,表明需要更多種類的合同安排,以反映醫生的欲望更靈活的工作模式的慣例。