Asthma, inhaled corticosteroid treatment, and growth.

Abstract Objective: To identify the nature and extent of any vocational training deficit within the London initiative zone and investigate the reasons. Design: Collation of statistics and postal questionnaire surveys. Setting: Thames regions inside and outside the London initiative zone. Subjects: General practice registrars, trainers, principals from non-training practices, and vocational training course organisers. Main outcome measures: Trends in numbers of general practice registrars, proportions of trainers, views on current vocational training in inner London. Results: Numbers of general practice registrars fell significantly between 1988 and 1993 within the London initiative zone and in England overall. The number of registrars within the zone fell by more than in the rest of the Thames regions, where the decline was not statistically significant. A lower proportion of principals were approved as trainers within the zone than in the rest of the Thames regions and England overall. In their responses to the survey (88% of inner London registrars responded and 81% of outer Thames registrars) registrars suggested that improving remuneration and personal safety would make training in London more attractive. Trainers and non-trainers (response rates 89% and 66% respectively) also suggested increasing remuneration for trainers together with more protected time for training. Conclusions: Less vocational training takes place within the London initiative zone than in the rest of the Thames regions and England overall, although there are discrepancies in official statistics. As well as specific recommendations for improving recruitment to vocational training in inner London, measures to tackle inner city deprivation should also remain high on the political agenda. Key messages Key messages The proportion of general practice principals who are approved trainers is lower in inner London than in the rest of the Thames regions or England Increased remuneration and improvements to personal safety are required to attract registrars to inner London Only 28% of inner London general practice registrars intend to become principals immediately on completion of their training Increased remuneration and protected time for training are required to encourage more principals to become trainers