General Practice
A Career In General Practice
Introduction
Over the last decade general practice has come of age. The concept of a primary care led NHS has seen general practitioners and indeed the entire organisation of primary care take centre stage in shaping the delivery of services to patients both as providers and commissioners.
So what do we actually do?
General practice comprises the single largest branch of our profession. For each general practitioner, every day brings the challenge of managing the widest possible range of undifferentiated problems that our patients present to us. Each surgery thrusts us into roles as varied as doctor, counsellor, social worker or priest. Our central role is as the advocate of our patient in their quest for resolution of their presenting issues. Every day also brings us management problems and the challenge of developing and shaping our services according to the needs of our patients and the community that we serve.
The intellectual challenge of general practice is paramount. As the only true generalists left, we must bring a scientific rigour to our work. In this we are much aided by evidence-based on-line support systems available even within the consultation. We work in teams with each member bringing a particular strength and knowledge base. We work alongside an increasing range of clinicians and non-clinicians. Our general practice electronic patient record is the most comprehensive clinical record of any agency, assisting effective decision-making, teaching, audit and research.
You can make a difference. GPs have a unique impact on families, social groups and the community through the priveledge of being able to deliver long-term care. There are opportunities to educate patients and promote preventive medicine. You don't have to wear a tie. You have, albeit slightly limited, autonomy. You can, together with your partners, set the ethos of your own practice.
The Variety
There are many other reasons why a career in general practice is appealing. There is the ability to define one's own lifestyle and work style with a fantastic variety of opportunities and options outside of day to day mainstream practice:
- Train as a GP with a special interest (GPwSI) to offer specialist services to your PCT or community or maintain a clinical interest as a GP clinical assistant in hospital practice
- Teach medical students, Foundation Year 2 doctors and GP registrars
- Grasp the opportunities for entrepreneurial activities under practice-based commission (PBC)
- Work Out-of-Hours
- Take part in managing the service in conjunction with your PCT
- Become a GP appraiser
- Work with a BASICS organisation to deliver immediate care
- Train as an Occupational Health Physician
The Not So Good
Are there any downsides? Yes of course. General practice has become increasingly bureaucratic and repeatedly monitored. The large number of health-related organisations and personnel now delivering care in the community raises important issues in co-ordination of care. There are also massive challenges in economics and space requirements. Above all, the ever increasing rate of change gives little time for reflection and consolidation.
Conclusion
The future general practitioner can however, look forward to the most varied and emotionally rewarding job that medicine in the UK can offer. The training programmes currrently being devised under the Modernising Medical Careers initiative promise exciting innovation and a training fit for purpose. Despite political attacks on the cohesion of the profession the outlook for British General Practice is more positive than ever before.
For further information and details take a look at the following website:
> The Royal College of General Practitioners
> BMJ Careers article: Getting into GP training
Anthony Lister MB BS FRCGP
GP & Vocational Training Scheme Course Organiser, Norwich
Last updated 25/12/06
| |
