Editing General practitioner (section)

=== United Kingdom ===
{{See also|General practice}}
In the United Kingdom physicians wishing to become GPs take at least five years' training after [[Medical school (United Kingdom)|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 Surgery|Bachelor of Medicine and Bachelor of Surgery]].

Until 2005, those wishing to become a general practitioner of medicine had to do a minimum of the following postgraduate training:
* One year as a [[pre-registration house officer]] (PRHO) (formerly called a house officer), in which the trainee would usually spend six months on a general surgical ward and six months on a general medical ward in a hospital;
* Two years as a [[senior house officer]] (SHO) – often on a General Practice Vocational Training Scheme (GP-VTS) in which the trainee would normally complete four six-month jobs in hospital specialties such as obstetrics and gynaecology, paediatrics, geriatric medicine, accident and emergency or psychiatry;
* One year as a general practice registrar on a GPST.

This process changed under the programme [[Modernising Medical Careers]]. Medical practitioners graduating from 2005 onwards have to do a minimum of five years postgraduate training:
* Two years of ''Foundation Training'', in which the trainee will do a rotation around either six four-month jobs or eight three-month jobs – these include at least three months in general medicine and three months in general surgery, but will also include jobs in other areas;
*  A three-year "run-through" GP Speciality Training Programme containing (GPSTP): This comprises a minimum of twelve months as a hospital based Specialty Trainee during which time the trainee completes a mixture of jobs in specialties such as [[obstetrics]] and [[gynaecology]], [[paediatrics]], [[geriatric medicine]], [[Emergency department|accident and emergency]] or [[psychiatry]]; eighteen to twenty-four months as a GP Specialty Trainee working in General Practice.<ref>{{Cite web|title=CCT|url=https://www.rcgp.org.uk/training-exams/discover-general-practice/qualifying-as-a-gp-in-the-nhs/certificate-of-completion-of-training-cct-guidance-for-gp-trainees.aspx|access-date=2021-12-29|website=www.rcgp.org.uk}}</ref> The balance of training time spent in hospital versus in GP is planned to shift in 2022 to be consistently 12 months' hospital training and 24 months' training time in general practice.<ref>{{Cite web|date=2020-02-07|title=GP trainees to spend longer training in general practice under new contract|url=https://www.pulsetoday.co.uk/news/uncategorised/gp-trainees-to-spend-longer-training-in-general-practice-under-new-contract/|access-date=2021-12-29|website=Pulse Today|language=en}}</ref>
<div>
{|
|{{NHS medical career grades}}
|}
</div>

The postgraduate qualification [[Membership of the Royal College of General Practitioners]] (MRCGP) was previously optional. In 2008, a requirement was introduced for physicians to succeed in the MRCGP assessments in order to be issued with a certificate of completion of their specialty training (CCT) in general practice. After passing the assessments, they are eligible to use the [[post-nominal letters]] MRCGP (so long as the physicians continued to pay membership fees to the RCGP, though many do not). During the GP specialty training programme, the medical practitioner must complete a variety of assessments in order to be allowed to practice independently as a GP. There is a knowledge-based exam with multiple choice questions called the Applied Knowledge Test (AKT). The practical examination takes the form of a "simulated surgery" in which the physicians is presented with thirteen clinical cases and assessment is made of data gathering, interpersonal skills and clinical management. This Clinical Skills Assessment (CSA) is held on three or four occasions throughout the year and takes place at the renovated headquarters of the [[Royal College of General Practitioners]] (RCGP), at [[30 Euston Square]], [[London]]. Finally, throughout the year the physician must complete an electronic portfolio which is made up of case-based discussions, critique of videoed consultations and reflective entries into a "learning log".

In addition, many hold qualifications such as the DCH (Diploma in Child Health of the [[Royal College of Paediatrics and Child Health]]) or the DRCOG (Diploma of the [[Royal College of Obstetricians and Gynaecologists]]), the DPD (Diploma in Practical Dermatology) or the DGH (Diploma in Geriatric Medicine of the Royal College of Physicians). Some General Practitioners also hold the MRCP (Member of the [[Royal College of Physicians]]) or other specialist qualifications, but generally only if they had a hospital career, or a career in another speciality, before training in General Practice.

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 contractual arrangements with the NHS which give them considerable predictability of income.

[[Image:Jericho Health Centre 20050326.jpg|thumb|left|GPs in the United Kingdom may operate in community health centres.]]Visits to GP surgeries are free in all countries of the United Kingdom, but charges for prescriptions are applied in England (except for those over 60, under 18, and those on low incomes and welfare). Wales, Scotland and Northern Ireland have abolished all charges.<ref>{{Cite news|url=https://www.bbc.com/news/uk-12928485|title=Scots prescription fees abolished|date=2011-04-01|access-date=2019-08-15|language=en-GB}}</ref>

Recent reforms to the NHS have included changes to the [[General medical services|GP contract]]. General practitioners are no longer required to work unsociable hours and get paid to some extent according to their [[Pay for performance (healthcare)|performance]], (e.g. numbers of patients treated, what treatments were administered, and the health of their catchment area, through the [[Quality and Outcomes Framework]]). The IT system used for assessing their income based on these criteria is called [[Quality Management and Analysis System|QMAS]]. The amount that a GP can expect to earn does vary according to the location of their work and the health needs of the population that they serve. Within a couple of years of the new contract being introduced, it became apparent that there were a few examples where the arrangements were out step with what had been expected.<ref>{{cite news |url=http://observer.guardian.co.uk/uk_news/story/0,,1759412,00.html |title=Perks of an island GP: seals, scenery and £300,000 |publisher=The Observer |author=Jo Revill |access-date=2008-06-17 |date=2006-04-23 |location=London |url-status=live |archive-url=https://web.archive.org/web/20080102130550/http://observer.guardian.co.uk/uk_news/story/0,,1759412,00.html |archive-date=2008-01-02 }}</ref> A full-time self-employed GP, such as a GMS or PMS practice partner, might currently expect to earn a profit share of around £95,900 before tax<ref>{{cite web|url=http://www.mysalary.co.uk/average-salary/Gp_1231|title=Gp Average Salary|website=www.mysalary.co.uk|url-status=live|archive-url=https://web.archive.org/web/20130331084926/http://www.mysalary.co.uk/average-salary/Gp_1231|archive-date=2013-03-31}}</ref> while a GP employed by a [[clinical commissioning group|CCG]] could expect to earn a salary in the range of £54,863 to £82,789.<ref>{{cite web |title=Pay for doctors |url=http://www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-doctors/ |publisher=NHS careers |access-date=2014-05-11 |url-status=live |archive-url=https://web.archive.org/web/20140512231540/http://www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-doctors/ |archive-date=2014-05-12 }}</ref> This can equate to an hourly rate of around £40 an hour for a GP partner.<ref>{{cite news |url=https://www.theguardian.com/g2/story/0,,1756277,00.html |title=The question: Is your GP worth £250,000? |work=The Guardian |access-date=2008-06-17 | location=London | first=Sarah | last=Boseley | date=2006-04-19}}</ref>

A survey by [[Ipsos MORI]] released in 2011 reports that 88% of adults in the UK "trust doctors to tell the truth".<ref name=IpsMor2011>{{cite web | url = http://www.ipsos-mori.com/researchpublications/researcharchive/2818/Doctors-are-most-trusted-profession-politicians-least-trusted.aspx | title = Doctors are most trusted profession – politicians least trusted Trust in Professions 2011 | access-date = 2011-07-03 | date = 2011-06-27 | publisher = [[Ipsos Mori]] | url-status = live | archive-url = https://web.archive.org/web/20110701203202/http://www.ipsos-mori.com/researchpublications/researcharchive/2818/doctors-are-most-trusted-profession-politicians-least-trusted.aspx | archive-date = 2011-07-01 }}</ref>

In May 2017, there was said to be a crisis in the UK with practices having difficulties recruiting GPs they need. [[Helen Stokes-Lampard]] of the Royal College of General Practitioners said, "At present, UK general practice does not have sufficient resources to deliver the care and services necessary to meet our patients' changing needs, meaning that GPs and our teams are working under intense pressures, which are simply unsustainable. Workload in general practice is escalating – it has increased 16% over the last seven years, according to the latest research – yet investment in our service has steadily declined over the last decade and the number of GPs has not risen in step with patient demand ... This must be addressed as a matter of urgency.".<ref>{{cite news|url=https://www.theguardian.com/society/2017/may/12/gp-recruitment-crisis-intensifies-as-vacancies-soar-to-122|title=GP recruitment crisis intensifies as vacancies soar to 12.2%|agency=Press Association|date=11 May 2017|url-status=live|archive-url=https://web.archive.org/web/20170512085935/https://www.theguardian.com/society/2017/may/12/gp-recruitment-crisis-intensifies-as-vacancies-soar-to-122|archive-date=12 May 2017|newspaper=The Guardian}}</ref> Professor [[Azeem Majeed]] from Imperial College has also raised concerns about general practice in the UK.

In 2018 the average GP worked less than three and a half days a week because of the "intensity of working day".<ref>{{cite news |title=GP hours and the much needed tech-care revolution |url=https://www.hsj.co.uk/gps/gp-hours-and-the-much-needed-tech-care-revolution/7023199.article |access-date=1 October 2018 |publisher=Health Service Journal |date=22 August 2018}}</ref>

There is an [[NHS England]] initiative to situate GPs in or near hospital emergency departments to divert minor cases away from A&E and reduce pressure on emergency services. 97 hospital trusts have been allocated money, mostly for premises alterations or development.<ref>{{cite news|title=Further £21m allocated for services set to move 200 GPs into hospitals|url=http://www.gponline.com/further-21m-allocated-services-set-move-200-gps-hospitals/article/1436698|access-date=14 July 2017|publisher=GP Online|date=16 June 2017|url-status=live|archive-url=https://web.archive.org/web/20170619130145/http://www.gponline.com/further-21m-allocated-services-set-move-200-gps-hospitals/article/1436698|archive-date=19 June 2017}}</ref>