General Practice - working as a salaried GP

Dr Christopher Lewis qualified from the University of Southampton Medical School in 2000. He went on to train as a GP in Wiltshire, where he now works as a salaried GP for the South Wiltshire Out of Hours service. In addition, Dr Lewis is currently studying for a Diploma of Tropical Medicine & Hygeine at the London School of Tropical Medicine.

Originally, I applied to general practice because the GP rotations looked appealing, not because I wanted to be a GP.

I wanted to do all the SHO jobs that this rotation offered (A&E, Paeds, O&G, Medicine) and thought the GP registrar year would be useful. I could always be a GP in the future, if necessary. In reality, my experience of general practice has been my most worthwhile experience in Medicine.

I am currently a salaried out-of-hours GP after recently completing my registrar year and am hoping to spend a few years working abroad for a medical humanitarian organisation before coming back to the UK to do a mixture of GP, palliative care and emergency medicine.

Why General Practice?

We were told at medical school that 50% of us would be GPs. That didn’t fit our aspirations - how confusing. Most of us wanted to be surgeons, physicians or paediatricians. I thought (as many of us did) that GP was a dull, quiet job to be done when I was about to retire.

Nothing could be further from the truth. General practice is full of variety - when you call a patient in, you have no idea what clinical problem will be presented next. This huge variety also challenges your knowledge and you will often have to say "I don’t know what it is, but it’s not serious".

I believe that general practice gives you more opportunities than other careers. After a few years training, it is very possible to be a flexible GP, salaried GP, part-time GP, out-of-hours GP, GP Partner, GP with a special interest, etc, with good jobs available. It also gives you opportunities to work in different areas such as immediate care, complementary medicine, research - you can even work abroad.

In general practice, you have the amazing privilege of seeing the patients as real people - a very different experience from seeing patients on a ward round. You see people in an entirely different light when you visit them at home and you get to know your patients and their families - it makes treating them a thoroughly enjoyable experience.

Training

Following house jobs (which are starting to incorporate general practice training) you need to do four different SHO jobs either individually or as part of a GP VTS rotation before you complete the GP registrar year. Then you will work in a GP practice for a year (or six months in two practices) with a trainer to support you during this time.

To be accredited as a GP you need to pass the summative assessment during your GP registrar year, incorporating MCQ, audit, video and trainer’s report. The MRCGP (which incorporates MCQ, written paper, video and oral) is a supplementary exam which not essential for becoming a GP, although this may change in the future.

Summary

General practice is a career that enables you to have many opportunities, both in and out of medicine. It is full of variety, patient contact and down-to-earth doctors.

This career isn’t for you if:

• you need a precise answer to everything
• you don’t like patients
• you don’t like tweed jackets. (this point is flexible, I haven’t got one!)

My own opinion is that every hospital doctor should experience a GP placement. Having this opportunity would improve clinical skills and communication skills, as well as improving communication between hospitals and the community. An experience in general practice is worthwhile for everyone.