Aim To investigate level of neonatal knowledge and experience amongst newly qualified General Practitioners (GPs) who completed the vocational training scheme (VTS).
Method An online survey distributed via email to GPs who qualified from two GP Deaneries since 2009. The survey consisted of 24 questions, mainly multiple choice and self-rating scales, and was completed between May and June 2014.
Results There were 38 respondents. Of these, 58% had completed a paediatric placement during their VTS. Placement length varied from 3 months (1 responder), 4 months (11 responders) to 6 months (10 responders). Forty-five percent (17/38) gained neonatal experience, comprising of neonatal life support courses, neonatal ward rounds, attending high risk deliveries and completing baby checks.
Eighty percent of responders were less than 2 years post VTS qualification, with a median age of 31–35 years. Despite completing their VTS and 60% receiving formal teaching on newborn examination, 25% of responders did not feel confident in completing a 6–8 week newborn examination. In 50% of practices where our study population are currently based a dedicated health professional undertakes the baby checks.
The GPs portrayed good knowledge of common neonatal problems such as gastro-oesphageal reflux disease, and on self-rating, the majority were confident of their ability to diagnose mongolian blue spots, port wine stain and a significant heart murmur. However, over 35% displayed definite uncertainty in diagnosing naevus flammeus and erythema toxicum. Only 12% felt confident in recognising cow’s milk protein intolerance and 56% were unaware of when to diagnose prolonged jaundice.
The main information source used by the newly qualified GPs was GP notebook, with 72% identifying this source and less than 30% consulting formal guidelines.
Conclusion A significant number of GPs qualify from the VTS without completing a paediatric placement and even fewer are gaining neonatal experience. Post-qualification, there continues to be limited exposure to infants as dedicated health professionals complete their routine care. It is essential to recognise this lack of exposure and make appropriate changes to GP training to provide basic, structured neonatal experience, thereby ensuring confidence in neonatal assessment and management amongst front-line medical practitioners.
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