Bringing general practice education earlier: expert consensus provides guidance for teaching clinical medical students outside GP-targeted programs

General practitioners are a core part of primary healthcare systems. They provide comprehensive, continuous, and coordinated care for residents, often serving as the first point of contact within the healthcare system. As China continues to promote the Healthy China strategy and the tiered diagnosis and treatment system, medical education faces an important question: should general practice education be limited to students who have already chosen general practice as a career path?

A newly published expert consensus suggests that the answer is no.

The Expert Consensus on General Practice Teaching for Non-General Practice-Oriented Clinical Medicine Students at the Institutional Education Stage (2026), published in the Chinese Journal of Medical Education Research, argues that general practice education should be introduced earlier and more systematically into undergraduate clinical medical education. Even for students who may eventually become specialists, exposure to general practice can help them understand community-based care, whole-person health, preventive medicine, chronic disease management, and collaboration between specialists and general practitioners.

The consensus was issued by the General Practice Branch of the Cross-Straits Medicine Exchange Association, the General Practice Branch of Zhejiang Medical Association, the Medically Unspecified Disease Professional Committee of Zhejiang Society for Mathematical Medicine, and the Public Health Service Branch of the Chinese Geriatrics Society. The work was led by the Department of General Practice at The First Affiliated Hospital, Zhejiang University School of Medicine. The expert group included general practice educators, teaching administrators, general practitioners, and evidence-based medicine experts from 31 provincial-level regions in China. The consensus was also registered on the international practice guideline registration and transparency platform under the registration number PREPARE-2025CN1620.

The document responds to several challenges in current general practice education at the undergraduate stage. Although China has established a general practice training system covering institutional education, postgraduate training, and continuing professional development, undergraduate general practice education still faces uneven implementation. Some institutions lack clear training objectives. Courses are often limited in scope and may rely heavily on theoretical lectures. Practical teaching remains relatively weak, early community exposure is insufficient, and collaboration among medical schools, affiliated hospitals, and community practice bases is not always well established. Faculty development and course evaluation systems also vary across institutions.

The consensus therefore proposes a more integrated approach. Its central message is that general practice education should move earlier in the medical education continuum. This does not mean that all clinical medical students should be trained as general practitioners. Rather, it means that all future doctors should understand the principles of general practice and the role of primary care in the wider healthcare system.

For students who later pursue specialty training, this understanding can still be valuable. Specialists frequently work with general practitioners in chronic disease management, referral systems, post-discharge care, preventive health, and long-term follow-up. A student who understands general practice is more likely to appreciate how patients move between hospitals, communities, families, and public health services.

The consensus defines the overall goal of general practice teaching for non-GP-oriented clinical medical students as helping students develop a basic understanding of general practice concepts and primary care service awareness by the time they complete undergraduate education. Students should become familiar with the definition, principles, and service model of general practice, understand the functions of community health service systems, and gain initial knowledge of chronic disease management, undifferentiated illness, preventive care, and health management.

The consensus also emphasizes skills and professional values. Students should learn the basic elements of general practice consultation, doctor-patient communication, family and community health management, emergency recognition and triage, and SOAP medical record writing. At the level of professional formation, they should develop a whole-person view of health, understand the value of community-based care, and recognize the role of general practitioners in the national healthcare system.

In curriculum design, the consensus recommends that Introduction to General Practice be offered as a required course in undergraduate medical education. The course should cover core areas such as general practice concepts, undifferentiated disease management, chronic disease care, general practice clinical reasoning, emergency handling, preventive care, and health promotion. The consensus recommends a total of 32 to 64 teaching hours for the required course, with a theory-to-practice ratio no higher than 3:1. It also encourages institutions to offer elective courses or course clusters related to general practice.

The curriculum should not be limited to lectures. The consensus suggests including topics closely related to the work of general practitioners, such as family doctor contract services, chronic disease follow-up, basic public health services, electronic health records, care for special community populations, and primary-level public health emergency response. These elements can help students understand how general practice connects clinical medicine, prevention, community health, and health system management.

A key recommendation is a staged training pathway: early exposure, theoretical learning, and practice-based training. In the first and second academic years, students may participate in community visits, career talks, and narrative medicine activities to develop early awareness of general practice and primary care. In the third and fourth years, students should receive core theoretical teaching and case-based learning, gradually building a general practice perspective through common community health problems. In the fifth year, students should enter community health service centers or other primary care settings for practice-based learning, including family visits, health education, clinical consultation, and community-based health management.

The consensus also recommends diverse teaching methods. Lecture-based teaching can be combined with seminars, case-based learning, problem-based learning, blended learning, standardized patients, scenario simulation, and community health projects. General practice cannot be taught effectively only by explaining what it is. Students need to see how general practitioners approach real people in real contexts, where medical problems are linked to families, communities, work, prevention, long-term care, and social conditions.

The document places strong emphasis on community-based practice. Early community exposure can help students move beyond a hospital-centered view of medicine. It allows them to observe how primary care physicians manage chronic diseases, respond to undifferentiated symptoms, communicate with patients and families, provide health education, and coordinate care over time. These experiences are important for building a more complete understanding of healthcare delivery.

Assessment is another major part of the consensus. It proposes a comprehensive framework covering cognition, skills, and professional values. In the cognitive domain, students should be assessed on their understanding of general practice concepts, clinical reasoning, prevention, and health management. In the skills domain, assessment should focus on doctor-patient communication, general practice reasoning, and teamwork. In the professional values domain, the emphasis should be on career identity, ethical sensitivity, social responsibility, and reflective learning.

The consensus recommends combining formative and summative assessment. Process-based assessment should be strengthened and may account for 40% to 50% of the final grade. Assessment methods can include reflective writing, case analysis, simulation-based evaluation, learning portfolios, peer assessment, group projects, and objective structured clinical examinations. The aim is to shift assessment away from isolated knowledge recall and toward integrated case analysis, communication, practical reasoning, and professional development.

Faculty support is also essential. The consensus recommends that medical schools establish dedicated general practice colleges, departments, or teaching offices, while affiliated hospitals and teaching hospitals should establish clinical general practice teaching units. A collaborative teaching team involving the school, hospital, and community should be developed. This structure can help ensure that general practice education is not only a classroom subject, but also a coordinated educational experience connecting theory, clinical practice, and community care.

The consensus further calls for systematic faculty training. General practice teachers should receive competency-based training in curriculum design, teaching implementation, practice supervision, and educational technology. Community-based teachers should also be supported and included in faculty development systems. The document recommends stronger incentives for general practice educators, including recognition in performance evaluation, appointment, promotion, teaching awards, and educational research projects.

Quality management is another focus. The consensus proposes a full-chain quality monitoring system covering teaching objectives, teaching processes, practice implementation, feedback, and continuous improvement. Suggested evaluation indicators include process indicators, outcome indicators, and experience indicators. Process and outcome indicators may each account for 40%, while experience indicators may account for 20%. Through school-level, hospital-level, and department-level supervision, as well as feedback from students, teachers, and practice bases, institutions can build a closed-loop quality improvement system.

Looking ahead, the consensus suggests several future directions. General practice education should be positioned more clearly within undergraduate medical education. The idea of “early general practice” should be promoted, along with more clinical exposure and stronger community orientation. Interdisciplinary integration should also be strengthened, including artificial intelligence, digital health, virtual simulation, public health, health management, and primary care system research. The document also calls for stronger policy support to improve the attractiveness of general practice careers and to support long-term faculty development.

The significance of this consensus lies not only in its recommendations for a single course. It redefines the role of general practice education in the undergraduate training of clinical medical students. General practice should not be seen only as a specialized pathway for a limited group of students. It should also be understood as a foundational part of medical education that helps future doctors understand patients, communities, prevention, continuity of care, and the primary care system.

For future medical graduates, whether they become general practitioners or specialists, this perspective will matter. Bringing general practice education earlier into the curriculum can help students develop a more complete view of medicine and prepare them to work more effectively within an integrated healthcare system.

Article Information: 

Title: Expert Consensus on General Practice Teaching for Non-General Practice-Oriented Clinical Medicine Students at the Institutional Education Stage (2026)

Journal: Chinese Journal of Medical Education Research

DOI: 10.3760/cma.j.cn116021-20260202-02247

Chinese Journal of Medical Education Research is a monthly peer-reviewed journal sponsored by the Chinese Medical Association and hosted by Chongqing Medical University, under the supervision of the China Association for Science and Technology.
Launched in 2002, the journal publishes research and practice-oriented studies on medical education, with a focus on teaching reform, clinical teaching, curriculum development, residency training, graduate education, nursing education, educational technology, and international medical education. It also features themed columns and special issues on emerging topics and institutional innovations in medical education.
The journal is recognized as a Source Journal for Chinese Scientific and Technical Papers and Citations and is included in the Chinese Science and Technology Core Journals. It is indexed in Wanfang Data, Index Copernicus, the WHO Western Pacific Region Index Medicus, and Ulrich’s Periodicals Directory.
Journal page: http://yxjyts.alljournals.ac.cn/homeNav?lang=zh