Do integrated training programmes provide a different model of training for general practice compared to traditional vocational training schemes?

In the United Kingdom, traditional vocational training schemes (VTSs) for general practice generally comprise four hospital posts lasting six months each, followed by a year in a practice which has been approved for training. It has long been argued that this training model does not fully prepare future GPs with the knowledge and skills needed for their career. Early evidence suggests that integrated training programmes (ITPs) provide a different model of training, which may better prepare trainees for a career in general practice. In Wessex, an ITP that offered integrated training prior to the final registrar year was devised and piloted. Each week, two days were spent in general practice and three days attached to a hospital specialty. The purpose of the research was to see if the integrated model of training provided measurable differences to the experience of training, when compared with the traditional model. Four years of post-evaluation data for Southampton were statistically analysed to compare the responses of trainees on the ITP with those of trainees on the VTS. In addition, four focus groups explored the strengths and weaknesses of each model of training. Significant differences were found between the two groups of trainees. In each case, the ITP group of trainees showed significantly more positive responses to the Senior House Officer (SHO) Educational Audit Project (SEAP) questionnaire than the VTS group. In no questions did the VTS trainees show significantly more positive responses than the ITP trainees. The findings of the statistical analysis were explored further through the reflections of the focus groups. The two models of training were perceived to have very different effects on the training process, most markedly when both types of trainees joined together at the start of the final general practice registrar (GPR) year.