How do General Practice trainees experience the transition from hospital to General Practice: a qualitative study

Background: Specialist training in General Practice (GP) incorporates hospital and community-based training. The transition from hospital to General Practice can be a challenging experience. A negative experience of this transition has been shown to impact the trainee’s desire to remain in General Practice. Aim: The aim of this study was to explore GP Trainees’ experiences of moving from hospital medicine to General Practice in Ireland. Methods: This qualitative study involved an initial focus group with GP trainees. The results of this focus group informed the development of a topic guide for subsequent one-to-one semi-structured interviews with General Practice Trainees from thirteen General Practice Training Schemes nationally. Interviews were analysed using reflexive thematic analysis. Results: 15 interviews were undertaken. The main themes identified were: 1) Finding your way - the trainer as a navigator 2) Running your own ship–developing autonomy and 3) Balancing the competing demands of General Practice. The evolving role of the trainer in supporting the transition was highlighted, as was the GP trainers’ role in navigating clinical uncertainty and in shaping the participants’ professional identities. The nuances of challenges such as time pressure and increased clinical responsibility were identified. These challenges were exacerbated by the pressure of clinical decision-making and a lack of confidence in applying this judgement in the community setting. Conclusion: The results of this study can be used to inform the development of improved structures to support GP trainees in their transition from hospital to community-based practice.