What exactly does "general practitioner" mean?

Question

In the US, is a general practitioner (GP) a doctor who has finished a medical school and has a medical licence, but does not have any further specialization?

Answer 1

Note: I can give you a breakdown of the CURRENT medical system in the US. Naming and training used to be different some decades ago, when the term GP was more broadly applied, but I am less familiar with its history. Also note that Nurse Practitioners and Physician Assistants are also often Primary Care Providers. Their training, licensing, and ability to practice medicine independently differ; I am not including a description of that here.

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A General Practitioner (GP) is a type of physician. The term means slightly different things in different countries. The term is used frequently in Europe and other regions to refer to a physician who practices in "primary care" medicine.

The process of medical training and licensing also differs between countries, so it is not really easy to make a direct comparison. But the closest term in the USA to what a GP is in Europe would be a Primary Care Physician.

The comparison is complicated because in the USA, the term GP generally refers to a physician that has completed medical school and 1+ years of residency to obtain a medical license - but has not completed a residency or board certification in a specialty. These GPs usually practice in primary care - but it is important to note that in the USA, most primary care physicians are actually board certified in a specialty like Family Medicine or Internal Medicine.

In the USA, medical training generally goes like this:

1. Bachelor's Degree (4 yrs) including science courses
2. MD or DO Degree (4 yrs)
3. Residency (3+ yrs) which is Post-Graduate training in a specialty after which you take an exam to be "Board Certified" in that specialty
4. Some go on to do a Fellowship in a SUB-specialty, like Cardiology or Rheumatology (1+ yrs). These also have individual Board Certifications.

Specialties include Family Medicine (all ages), Internal Medicine (adults), Pediatrics (kids), Obstetrics and Gynecology, Dermatology, Neurology, Radiology, General Surgery, Neurosurgery, etc - there are many.

Sub-specialties (fellowships) include Cardiology, Rheumatology, Endocrinology, etc.

Primary Care specialties by government funding definition include:

• Family Medicine (all ages, sometimes including prenatal/delivery) (most common)
• Internal Medicine (adults only) (although most either go on to fellowships or work in inpatient hospital medicine)
• Pediatrics (kids only) (same as IM, many either go on to fellowships or work in inpatient hospital medicine)
• OB GYN
• Psychiatry

(Note that since the scope of practice of OBGYN and Psychiatry are more narrowed in on certain aspects, they are not usually colloquially referred to as Primary Care, even if US govt funding qualifies them as such.)

The first year of all residencies are termed "Intern Year." For some specialties, you are required to complete a generic intern year of residency in a "Transitional Year" or "Prelim Year" program.

In all US states, you are required to complete at least 1 year of Post-Graduate training (PGY1) and pass the final level of your USMLE/COMLEX exams to get a Medical License.

It IS possible to either (1) just do that TY/prelim year or (2) quit residency after intern year (which is obviously frowned upon), pass the final "step" exam, obtain your medical license in a state that allows it, and go into practice.

In many countries, this is the level of training of a GP. However, most of their training is geared towards that being the norm to practice as a GP, so it is not "interrupted" or "incomplete." However, in the USA the norm is completing a residency, so this might be viewed as somewhat "incomplete" training.

Also, at least in the US, most clinical practices prefer to hire board certified physicians - OR GPs with at least 5-10 years of solid clinical experience. Board certified physicians have 2+ more years of training and have proven themselves capable of passing a specialty-specific board certification. But 5-10 years of experience also carries a lot of weight.

Therefore, the vast majority of Primary Care physicians in the USA have at least 3 years of Post-Graduate training in either Family Medicine, Internal Medicine, or Pediatrics.

There are plenty of primary care physicians with different training paths than the above who have been practicing for many years. But for those who have graduated in the last couple decades, this is the typical situation.