Trainee doctors will have to pass four elements in a tough new examination, including video assessment of consultations, from September 1996. At present they need only complete a year in general practice to gain a certificate.
There are fears that the stringent new rules, to be imposed by the Joint Committee for Post-Graduate Training in General Practice, may deter some doctors from becoming GPs. The number of new entrants is already at a record low.
Trainee doctors are angry that the changes are to be introduced, without their agreement, after many have chosen to go into general practice without knowing that the rules would be revised.
The four elements of final assessment will be a multiple-choice questionnaire, a written project, a trainer's report and video assessment A pilot study has been carried out in the West of Scotland Region since 1993 and about 250 trainee GPs have been assessed on their video-taped consultations.
"The essence of video assessment is to protect the public from non-competent doctors, and we have established that it is successful in doing so in the pilot project," said Glasgow GP Dr Malcolm Campbell, an education adviser in the department of post-graduate medicine at Glasgow University.
He said that while only 1 per cent of trainees are refused certificates every year at present, the the figure for the pilot study was about 5 per cent.
Dr Will Coppola, chairman of the British Medical Association's Trainee Committee, said that young doctors were opposed to the principle of "end- point" examination.
Trainee doctors currently have to complete three years of approved posts - usually two years in hospital and one year in general practice - before qualifying as a GP.
The number of GP trainees has fallen from 2,102 in 1991 to 1,515 last year, and doctors' leaders say that there is a crisis in recruitment. The BMA has launched an inquiry into the "disappearance" of many doctors in the NHS after finishing their training.Reuse content