Progress with ScotGEM, the first rural generalist focused UG programme in the UK

Problem

There is a workforce crisis in general practice which is particularly acute in remote and rural areas. In response the Scottish Government commissions ScotGEM in 2016. This is the first mission based rural generalist MBChB programme in the UK and will produce its first 55 graduates in 2022. Creating such a programme, at speed and in the context of COVID-19 has provided a challenge, but fortunately the considerable experience available from Canada and Australia have offered us some tried and tested approaches.

Approach

In 2018 we admitted our first entrants to this novel programme which involves a number of innovations. These include a bespoke selection approach, a backbone of GP educators and an immersive GP based longitudinal integrated clerkship (LIC) in the third year. Overall, across all 4 years more than 50% of clinical teaching will be provided by GPs. Securing additional clinical teaching capacity is, of course, a recognised challenge and one that has been exacerbated by COVID-19. A reflective synopsis will be provided focusing on entrant characteristics, the formation of a programme based educational community of practice and the introduction of the first full scale GP LIC in the UK.

Findings

ScotGEM applicants are atypical, with over 70% reporting an intention of a GP career. Despite challenges, the programme has secured the necessary teaching capacity without directly displacing existing teaching. This has been largely provided by GPs acting in a new role as Generalist Clinical Mentors, which will be briefly described. A very broad distribution of placements has been sourced, in particular for the 3rd year LICs, drawing extensively on a collaborative partnership with our (so-called) ‘non-teaching’ board partners.

Consequences

ScotGEM has introduced a number of innovations and some disruptive approaches which may or may not prove themselves over time but have successfully established a novel programme which students and staff are relishing, not least due to high levels continuity. Some of the resulting challenges and opportunities will be considered as will the implications for the workforce and increasing GP led education.