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This book explores the identity work and conflicted perspectives of general practitioner (GP) trainees working in hospitals in the UK. Drawing on empirical and theoretical scholarship, and privileging the analysis of social language-in-use, Johnston describes primary care medicine as a separate paradigm with its own philosophy, identity and practice. Casting primary and secondary care in historical conflict, the perceived lower status of primary care in the world of medicine is explored. Significant identity challenges ensue for GP trainees positioned at the coalface of conflict. Problematising structures of GP training and highlighting how complex historical power dynamics play out in medical training, the author advocates for radical change in how GPs are trained in order to manage the current primary care recruitment and retention crisis.

This book analyses the immediate challenges from headlong cuts, root-and-branch restructuring and the longer-term pressures from population ageing. It demonstrates that a more humane and generous welfare state that will build social inclusiveness is possible and shows how it can be achieved.