Learning specialist skills for a generalist discipline.

In the European Definition of General Practice, WONCA Europe defined the specialty of General Practice in great detail 1 but the strength of the definition was actually its generality. Included in this was the statement that GPs provide 'care to every individual seeking medical care irrespective of age, sex and illness.' This splendidly defines the scope of general practice as all encompassing. Implicit also in this is the challenge to our GP specialty registrars of trying to learn the breadth of medicine to the level of an independent practitioner and to apply it regardless of patient or presentation. In addition, for all GPs there is the task of keeping up to date across the same breadth of medicine. This might seem an impossible challenge but the reality is much more manageable. The expertise 2 of a GP lies not in being some HAL-like computer (the omniscient computer in the film '2001: A Space Odyssey'). Knowledge will always be important but will increasingly reside outside our heads. Our expertise is in knowing when, where, and how to look. Crucially, GPs' knowledge is demonstrated in interpretation and in making connections between people, problems, and pixels. Despite this challenge to cover the breadth of medicine through our training and continuing professional development, there seems to be a cacophony of criticism of GPs for not having greater expertise in specific areas. The Postgraduate Medical Education and Training Board (PMETB) has defined what it requires of approved curricula. These need to be a statement of the intended aims and objectives, content, experiences, outcomes, and processes of an educational programme including: a description of training structure and a description of expected methods of learning, teaching, feedback, and supervision. 3 The Royal College of General Practitioners (RCGP) fulfils all that the PMETB requires of it. The GP curriculum (www.rcgp-curriculum.org.uk) is a commendable tome but it runs the risk of overloading both trainees and educators. In this issue of the BJGP, Burke and colleagues outline an inclusive approach to developing a genetics curriculum. 4 Undoubtedly, the rapid pace of developments in genetics will lead to an increasing role in medicine. 5 As the human genome is better understood we will better recognise the genetic components of disease and, based on this, the propensity to develop disease. It is likely that our consultations will move in a short period from the current practice of discussing the family history of …