Consult the members

In the correspondance (CFP May 2023, 69(5) 308) section I read with interest the comments of Drs. Johnson, Murray and Zalan, with whom I generally agree. While I understand the reasons for increasing FP training the important fact is that training - hands-on in the field - must not be underestimated. An enormous amount of learning happens in practice, and colleagues can be very helpful. After a couple of decades working in small rural towns, especially in northern BC, I can attest to that reality. One has to actually practice in such areas to gain the necessary skills, experience and, eventually, confidence to become an all-round generalist.

There is never enough comprehensive training to completely prepare a new FP to tackle the practice of a generalist FP. To think that more hospital training can virtually eliminate the sense of insecurity and uncertainty inherent in general practice is illusory. Confidence is gained only through real-life practice, with the assistance of colleagues and CME. (The team approach is often a luxury rural physicians cannot have.) The need to improve and update the two-year residency program should be obvious, but it does not mean adding an extra year. In medicine there is never enough training.