A comparison of the practice activities of trainees and principals

The practice activities of trainees are compared with those of principals using a large data base to provide a factual basis for the discussion of the workload and activities of trainees.Trainees undertook an average of 187 consultations including 32 home visits over two weeks compared with 301 consultations and 50 home visits for principals. These values show that trainees are seeing sufficient patients for adequate learning and are not being exploited. There were relatively more children and more patients with acute respiratory disorders among the patients consulting trainees compared with those consulting principles.However, trainees saw fewer elderly patients, fewer patients presenting for preventive care and fewer patients with cardiovascular disorders than principals. These deficiencies in the range of patients that trainees are seeing are undesirable. Antibiotics were prescribed more frequently by trainees than by principals but trainees prescribed fewer psychotropic drugs especially as repeat prescriptions and their referral rates and investigation rates were both lower. This probably reflects a consulting profile in which there are more young patients with acute than chronic problems.