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First published on the University of Exeter Collaboration for Primary Care (APEx)

Written by Drs Sam Merriel and Polly Duncan.

A career in general practice provides a myriad of opportunities for young and aspiring GPs. The core work as a generalist of providing holistic, patient-centred care to our patients ‘from the cradle to the grave’ and establishing continuity of care with our patients over a long period of time is truly rewarding. GPs can also lend their unique skill sets to other elements of primary care to improve the health of our patients and our community. Developing and building a GP practice or practices through partnership, commissioning NHS services as part of a CCG, and teaching the next generation of GPs are all possibilities open to early career GPs. Academic general practice, contributing to the improvement of primary care through research, is another vital area that GPs can turn their hand to.

But where to start? And how?

First5 GPs and GP trainees are busy people. As GPs we are trained to be lifelong learners, and there is a steep learning curve to begin with in transferring from hospital to community care. Newly qualified GPs need time to find their feet. Some opportunities exist for formal academic training through academic foundation posts in primary care departments, academic clinical fellowships for trainees, and in-practice fellowships for GPs, but these posts are very competitive and require commitment to an academic career. Opportunities to ‘dip one’s toe in the water’ in primary care research are harder to find.

Trainee research collaboratives

A successful model for trainee-led research, audit and quality improvement that has been used by other medical specialties in recent years is that of trainee research collaboratives. These local, regional and national groups exploit the networks of hospital specialty trainees across multiple sites to conduct research and audit projects. The advantages of this approach are that patients can be recruited and data can be quickly and cheaply collected across a number of centres(1). For doctors involved, they can engage in the process on many levels, from identifying patients or collecting data at their local site right through to developing and proposing new ideas for research, audit or quality improvement projects. They can also develop their teamwork, leadership and communication skills(2). Medics without any research experience have the opportunity to gain an insight into how studies are conducted, and their eyes may just be opened to the world of academia.

Trainee research collaboratives in the UK have rapidly expanded in some disciplines in the last 10-15 years. Surgery and anaesthetics in particular have a number of established regional research collaboratives and networks, including the Severn and Peninsula Audit and Research Collaborative for Surgeons (SPARCS) and the South West Anaesthesia Research Matrix (SWARM) in the south west of England. Between 2012 and 2016, the proportion of general surgery units across the UK which participated in at least one study run by trainee research collaboratives grew from 44% to 99%(3). Numerous randomised controlled trials and national audits have been delivered by these collaboratives, resulting in truly impactful research that is improving patient care(4).

PACT – Primary care Academic Collaborative for Trainees

General practice is ideally placed to take full advantage of the trainee research collaborative model. GP trainees are embedded in GP surgeries in all parts of the UK and cover all sections of the population. Electronic medical records can easily be searched for patients who meet inclusion criteria for research and audit, and the general practice model means changes arising from quality improvement projects can more easily be implemented at a local level. General practice in the UK is moving towards networks and federations of practices, making engagement in a collaborative a great opportunity for GP trainees and First5 GPs to experience working with colleagues across multiple GP surgeries towards a common goal.

The Primary care Academic Collaborative for Trainees (PACT) was launched by its chair, Dr Polly Duncan from the Centre for Academic Primary Care in Bristol, at the recent National GP ACF and early career researcher conference in Manchester. We have established a core committee of GP trainees and First5 GPs from right across the UK, and we will be coming to the 48th SAPC Annual Scientific Meeting in Exeter in July to deliver a workshop to develop the very first collaborative project PACT will undertake. PACT will generate numerous opportunities for GP trainees and First5 GPs to bring forward their ideas, and will seek to support them in delivering these projects to improve care for our patients across the UK.

Dr Sam Merriel GP and Clinical Senior Research Fellow, University of Exeter
Vice chair, PACT – Primary care Academic Collaborative for Trainees
@sammerriel

References

  1. Kasivisvanathan V, Kutikov A, Manning TG, McGrath J, Resnick MJ, Sedelaar JPM, et al. Safeguarding the Future of Urological Research and Delivery of Clinical Excellence by Harnessing the Power of Youth to Spearhead Urological Research. Eur Urol [Internet]. 2018;73(5):645–7. Available from: https://doi.org/10.1016/j.eururo.2017.10.026
  2. Kasivisvanathan V, Ahmed H, Cashman S, Challacombe B, Emberton M, Gao C, et al. The British Urology Researchers in Surgical Training (BURST) Research Collaborative: an alternative research model for carrying out large scale multi-centre urological studies. BJU Int. 2018;121(1):6–11.
  3. Nepogodiev D, Chapman SJ, Kolias AG, Fitzgerald JE, Lee M, Blencowe NS. The effect of trainee research collaboratives in the UK. Lancet Gastroenterol Hepatol. 2017;2(4):247–8.
  4. Jamjoom AAB, Phan PNH, Hutchinson PJ, Kolias AG. Surgical trainee research collaboratives in the UK: An observational study of research activity and publication productivity. BMJ Open. 2016;6:e010374.