title: GP training in out-of-hours care: implications for the future workforce.
abstract: OBJECTIVE
  To understand GP trainees' experience of out-of-hours (OOH) training in England; whether it is achieving educational aims, and to highlight potential improvements. Additionally to explore factors that influence the decision to work in OOH care.
  
  
  METHODS
  An online survey was sent to 1091 GP trainees in England. Odds ratios were calculated for factors correlating with intention to work in OOH, or confidence and effectiveness in OOH work. Free text responses were coded and organised thematically.
  
  
  RESULTS
  Trainees' experience of OOH care influences the decision to work there once qualified. Although this experience has positively influenced over three-quarters of trainees, it can be improved. Training is not achieving competencies in managing psychiatric emergencies and personal safety. Half of trainees received formal teaching in OOH skills; 3% receiving assessments in telephone triage. Only a quarter of trainees had worked with their usual GP trainer. Influential features of training included trainer enthusiasm and continuity, familiarity with the workplace, and confidence in OOH skills. Financial and lifestyle considerations were also important.
  
  
  CONCLUSIONS
  OOH training in England has an impact on the future workforce and could be improved. The planned transition to a 4-year GP training structure offers an opportunity to address this.
authors.affiliation: Academic Clinical Fellow, University of Oxford, Nuffield Department of Primary Care Health Sciences, New Radcliffe House, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK. gail.hayward@phc.ox.ac.uk.
authors.forename: Gail
authors.initials: G
authors.lastname: Hayward
authors.affiliation: NIHR In-practice Fellow, University of Leeds, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Drinkwater
authors.affiliation: NIHR In-practice Fellow, University of Southampton, UK.
authors.forename: Magdy
authors.initials: M
authors.lastname: El-Gohary
authors.affiliation: NIHR In-practice Fellow, University of Southampton, UK.
authors.forename: Hana
authors.initials: H
authors.lastname: Burgess
authors.affiliation: Professor of Evidence Based Medicine, University of Oxford, UK.
authors.forename: Carl
authors.initials: C
authors.lastname: Heneghan
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods* / Q000458:organization & administration; D004739:England; D058006:General Practice / Q000193:education*; D058005:General Practitioners / Q000193:education / Q000523:psychology*; D006280:Health Workforce; D006801:Humans; D011795:Surveys and Questionnaires; D017132:Workplace