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Selection for Dutch postgraduate GP training; time for improvement.

Margit I Vermeulen1, Marijke M Kuyvenhoven, Nicolaas P A Zuithoff

  • 1Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. m.i.vermeulen@umcutrecht.nl

The European Journal of General Practice
|April 21, 2012
PubMed
Summary

Department choice significantly impacts admission to postgraduate GP training, raising fairness concerns. Candidate qualities also play a role in the selection process.

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Area of Science:

  • Medical Education
  • Health Services Research
  • General Practice Training

Background:

  • The Netherlands selects General Practice (GP) trainees via interviews assessing personal qualities.
  • Variations in candidate-to-vacancy ratios across GP training departments prompted an investigation into potential disparities in rejection risk.

Purpose of the Study:

  • To determine the extent to which department of choice, candidate characteristics, and interview-assessed qualities influence admission to GP training.

Main Methods:

  • A nationwide observational study of 542 applicants for GP training in 2009/2010.
  • Data collected included application ratios, candidate demographics (gender, age, region), and assessed qualities (motivation, job orientation, personal attributes, learning needs).
  • Outcomes measured were admission to interview and final admission to GP training.

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Main Results:

  • 11.6% of candidates were rejected at the application stage; 71% of interviewed candidates were admitted to training.
  • Gender and non-North West European medical school region were linked to interview admission.
  • Department of choice strongly affected admission at both stages (RR 0.30-0.79), while candidate qualities showed a moderate association (RR 1.09-1.25).

Conclusions:

  • The significant influence of department of choice raises questions about the fairness of the current GP selection procedure.
  • The study discusses the pros and cons of national versus departmental selection processes and competency-based approaches.