Hospital rotations in general practitioner training: a scoping review of strengths, issues and concerns

Workplace learning in hospitals is a cornerstone of postgraduate medical education, enabling junior doctors to develop specialist expertise and generalist skills. General Practice (GP) trainees often spend significant time in hospital-based rotations to acquire broad clinical experience. However, the hospital environment poses challenges for GP trainees, who may find it disconnected from their primary care focus. The aim of this scoping review is to map out existing literature regarding strengths, issues and concerns associated with hospital rotations in GP training.

This scoping review adhered to the PRISMA-ScR guidelines. A systematic search across MEDLINE, Embase, Scopus, and APA PsycInfo identified relevant literature. Eligible studies included those addressing strengths, issues, and concerns of hospital rotations for GP trainees published since 2000 in English or Scandinavian languages.

A total of 31 studies met the inclusion criteria. Most studies employed mixed-methods approaches, reflecting a focus on nuanced trainee and trainer experiences. Key findings highlighted mismatches between hospital rotation objectives and trainees' future roles, insufficient supervision, and limited integration with primary care. Structured connections between hospital and GP training environments were identified as potential strategies to enhance learning transfer and relevance. Variability in training organisation across settings underscored the need for tailored approaches aligned with healthcare system constraints.

This review emphasises the importance of strategic planning in hospital rotations for GP trainees to address identified challenges. By fostering supervision, collaboration, and primary care integration, hospital training can better support GP trainees' professional development and preparation for practice.