Medical Education Capacity in General Practice in Scotland Working Group: interim report

Executive summary

Strengthening medical education capacity in General Practice is critical for Scotland’s ability to train and retain the workforce required to meet the evolving needs of its population. This interim report from the Medical Education Capacity in General Practice Working Group provides an updated assessment of educational capacity across Scotland. Established in April 2025, the group’s purpose is to understand and strengthen the educational capacity to deliver high-quality undergraduate and postgraduate training in General Practice.

General Practice is operating in an increasingly complex environment, shaped by an ageing population, rising multimorbidity, widening health inequalities and a continued shift toward delivering more care closer to home. At the same time, Scotland is training more learners in General Practice than ever before. Medical school expansion, increased Foundation posts and growth in General Practice Specialty Training (GPST) have strengthened the workforce pipeline but intensified demand for placements, supervision and educational infrastructure. Early and positive exposure to General Practice improves learners’ understanding of generalism and strongly influences career interest, making sufficient capacity at every training stage essential.

Our interim findings show that educational capacity in General Practice is already under significant strain. Despite financial pressures and a challenging service environment, educators, practices, universities, NHS Education for Scotland (NES), Health Boards, and Scottish Government have worked hard to sustain and where possible expand opportunities for students, Foundation doctors and General Practice Registrars. We heard consistent evidence of the extraordinary commitment of General Practice teams, and a strong desire to contribute to the future workforce. Practices described how hosting learners enriches team culture, supports retention and improves quality of care.

Drawing on extensive engagement with General Practitioners (GPs), educators, learners, universities, Health Boards and professional bodies, the working group has identified several cross-cutting themes:

1. Capacity is constrained by workload, staffing and space High patient demand, workforce shortages, increasing clinical complexity and limited consulting/teaching space directly affect the ability to supervise and host learners.

2. Expansion across the whole education pathway is intensifying pressure Simultaneous increases in medical students, Foundation doctors and General Practice Registrars create overlapping and competing demands on the same practices.

3. Training capacity is interdependent across the pathway Undergraduate, Foundation and GPST capacity are often considered separately, yet pressures in one area affect all others. A shared, system-wide understanding of these interdependencies is needed for effective planning.

4. Supervision requires protected time and skilled educators Educational supervision cannot be delivered safely or effectively in the margins of clinical work. Practices seek recognition of the real time and cognitive load associated with supervision.

5. Funding mechanisms present significant challenges Current funding structures can both enable and limit the delivery of medical education. Clarity and alignment of funding models will be essential for sustainable expansion.

6. Geographical and socioeconomic variation shapes training capacity Rural, island and high-deprivation areas face unique pressures and often disproportionate barriers to hosting learners. There is a need to ensure sufficient training experiences in these areas to meet population needs.

Next Steps

The working group will now transition to the next phase of work, continuing collaboration with stakeholders to co-design practical solutions to strengthen capacity. Key areas of focus will include:

• Modelling future scenarios: Project future capacity requirements and explore alternative placement structures.
• Highlight good practice: Identify and share successful, scalable education models across Scotland.
• Co-create innovative approaches to increase capacity: Develop ambitious, practical proposals that support sustainable expansion.
• Formulate recommendations: Co-produce short and long-term recommendations, aligned with funding, infrastructure, and professional development strategies. A final report will be published in 2026.

We extend our sincere thanks to all members of the working group for their time, expertise and commitment. As co-chairs, we commend this analysis to our partners and look forward to working together to develop final recommendations that will secure a sustainable, high-quality educational ecosystem for Scotland’s future General Practice workforce.

Professor Nitin Gambhir & Dr Ben Pearson-Stuttard Co-chairs, Medical Education Capacity in General Practice Working Group.