Perceived Impact of Early On-Call Exposure on General Medical Council Outcomes Among Graduates: A Project in an English Foundation School

Background: Transitioning from medical school to Foundation training is widely recognised as a challenging stage, with new doctors often reporting underpreparedness for clinical responsibilities.Early exposure to on-call shifts during undergraduate training may help address this gap.Aim: This study evaluated Foundation doctors' perceptions of how early on-call experience during United Kingdom medical school related to their preparedness and to their development of professional knowledge, skills, and values and behaviours, as defined in the General Medical Council Outcomes for Graduates.Methods: A convergent parallel mixed-methods design was used.A survey of 71 Foundation Year 1 doctors in an English Foundation School achieved 19 responses (26.7%).Quantitative data were collected using Likert-scale questions and analysed descriptively and with exploratory one-sample Wilcoxon signed-rank tests against a neutral response, while qualitative data from open-ended questions underwent thematic analysis.Results: Of the 19 participants, 18 (94.7%)had undertaken on-call placements, predominantly in years 4 and 5. Perceptions were generally positive, with the highest mean Likert scores for knowledge (3.56) and skills (3.44), and lower scores for preparedness (3.22) and professional values (3.22); however, none of the four statements differed significantly from neutral (p = 0.057-0.235).Thematic analysis highlighted perceived benefits, including exposure to acute cases, improved confidence, and enhanced decision-making.Challenges included variability in supervision, limited teaching during night shifts, and difficulty adapting to out-of-hours schedules.Conclusion: Respondents generally perceived undergraduate on-call exposure positively, particularly for knowledge and skills, although these findings were not statistically significant and views on professional values and behaviours were less consistent.Perceived educational value varied according to supervision and context.Larger comparative studies are needed to determine whether structured on-call placements improve preparedness.