Combining UK general practice with international work--who benefits?

GPs from the UK have historically spent time abroad during their medical careers, working as clinicians in both high and low-to-middle income countries.1,2 With progressive globalisation and advances in communication and transport, there is an increasing interest in global health training3–5 and a variety of opportunities for GPs from the UK to engage in international work and global health issues.6–8 As the NHS seeks to address the challenges of an ageing population and cost effectiveness while striving for high quality health care, UK primary care is in constant evolution. The past decade has seen an emergent policy emphasis on clinical leadership, identifying competencies needed for doctors to contribute meaningfully to planning and delivering health services.9–11 These have been recently expressed in the NHS Leadership Framework, informed by analysis of NHS leadership data and literature.12 The recent acceptance of the Royal College of General Practitioners’ (RCGP) bid to extend GP training to 4 years13 reflects major changes to healthcare delivery including a progressive transition from hospital to community settings and integration of clinical services. It also highlights the shift in NHS structure whereby GPs are becoming increasingly responsible for design as well as delivery of services.14 Figure 1 Domains of the NHS Leadership Framework (reproduced with permission from the NHS Leadership Framework) . Given these developments and the dynamic role of the GP within the context of recent health reform, it may now appear reasonable to question whether international work experience is an appropriate use of time and whether it is of value to UK GPs, to the NHS, or towards improving global health. The 2007 Crisp …