Uncertainty in general practice: a myth of uniqueness?

Abstract

Uncertainty is widely regarded as a defining feature of general practice, with its tolerance and management considered core competencies in training and professional identity formation. The effects of uncertainty have educational, economic and clinical implications for general practitioners. There is an axiomatic assertion that uncertainty is unique in general practice: being more present, more keenly experienced and of more personal and clinical consequence than in other medical specialties. This truism exists in the absence of supporting empirical evidence, potentially exposing it as a medical education myth. Understanding where the myth originates and how it is perpetuated is important, particularly for those experiencing and learning about uncertainty.To examine this claim, a review of the existing literature was conducted, followed by a historical analysis to trace the origins and perpetuation of this belief. The notion of uncertainty as a hallmark of general practice emerged alongside its establishment as a distinct specialty, framed as a humanist and relational discipline. Contemporary literature continues to reinforce this view, often positioning uncertainty as a marker of 'good' general practice. Yet, this reinforcement may be shaped by confirmation bias, rooted in the uncritical acceptance of the original claim.Interrogating whether uncertainty is truly unique to general practice, or instead a universal aspect of medical work, can help identify which elements are amenable to educational intervention. Challenging the myth may reduce the perceived burden of uncertainty and foster a growth mindset among learners, encouraging more constructive engagement with uncertainty in both undergraduate and postgraduate settings.