The First G P Term : a curriculum for the first three months which the intending practitioner spends in general practice

\THE FIRST G P TERM\" a curriculum for the first three months which the intending practitioner spends in general practice addresses three questions: why is there a need for such a curriculum; how should it be constituted and how should it be presented? The need for this curriculum is explored in terms of the background education with which medical graduates approach general practice. Medical science learned in Universities and Teaching Hospitals requires adaptation and additional competencies have to be acquired if the doctor is to become a general practitioner. In this process the first three months in general practice is critical. Patterns of effective practice need to be established at the outset patterns which will last a lifetime with continuing refinement. Among the comparatively modest literature about education for general practice I have been unable to find a comprehensive curriculum for this significant transition from hospital to domiciliary practice the first G P term. The body of the curriculum addresses the other two questions; how and what to learn? Throughout I have drawn on my own experience of over twenty years in general practice education as scholar tutor and administrator. Three considerations are common to the whole dissertation: what is the present state of affairs; what alternatives are feasible; and why do I prefer my particular choice? The curriculum is presented in nine sections. These are: the 'school' of Teaching Practices; Scholars and their scholarship; Tutors and teaching; Management and co-ordination of the curriculum; the syllabus; evaluation of expectations progress and outcomes; continuing medical education; an overview of these components; a summary of recommendations. In each of the first seven sections as listed here a pattern is followed; namely what selection is made (of Teaching Practices Scholars Tutors Managers syllabus methods of evaluation and continuing education) on what basis and how might this be improved; what expectations are involved and to what extent are these met ? Consideration of the most cost-effective alternative is a recurring theme. Ways of learning particularly the implementation of selfdirected contract learning are central to the dissertation. The selection of the most appropriate syllabus is studied to facilitate the transition from hospital to general practice avoiding the already known and the irrelevant. Evaluation is built in to every aspect of the curriculum along the lines of illuminative evaluation (Parlett & 1 Hamilton 1972) . The central features of the curriculum together with recommendations for change are drawn together in conclusion. Appended to the dissertation are documents in current use during the first G P term."