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You Said, We Listened – Your Questions Answered

We recognise that making a decision about which specialty to pursue may not be easy at any stage of your career. Sometimes conflicting advice or negative perceptions and comments you hear about general practice may be off putting. Your feedback is important so we’ve addressed a number of concerns expressed by some trainees.

There is a lot of good information on this website. If you have any questions you’d like answered or would like to speak to a practising GP to hear first-hand what it’s like to work in practice contact us.

No – although the GP selection procedures have been refined over the last 20 years in response to trainee and expert feedback, standards have never been lowered. There would be no point in risking patient safety and clinician competence but amendments to streamline the application process that allows for more flexibility and opportunity have been introduced.

It is true that a number of trainees take the opportunity to travel and work abroad after and between foundation and specialty training. Historically most of these doctors tend to return to the UK. Some GP trainees defer their start date for up to a year (minimum deferment of three months) knowing they have a job to come home to. There are also a number of Global Health Fellowships available.

Recruitment numbers across specialties may vary year on year but they largely remain the same. There has been an increase nationally in the number of GP training places to reflect the importance of primary care within the NHS.

The GMC has a responsibility to check that all doctors working in the UK have acceptable qualifications and experience. Standards are continually reviewed and revised. They will look at the registration and licensing history and request certificates of good standing to make sure all doctors comply with the very high standards expected. This is not only for patient safety, it protects doctors too. More recent changes are based on an independent review commissioned by the GMC between 2011 and 2014. Doctors with the skills we need will still be able to work in the UK.

In general practice, particularly in training, it’s recognised that maintaining a healthy work/life balance is part of being an effective clinician. Although working full time in practice will suit many qualified GPs, others may prefer the flexibility of a varied portfolio career. This means not working a full week in the surgery, choosing to spend time in other clinical, education or leadership roles or pursuing other interests.

Education providers or your supervisor may offer further insight into some of these roles during training or you can email gprecruitment@hee.nhs.uk outlining your particular area of interest. We can match your request and put you in contact with a portfolio or special interest GP who may give you a better idea of how they went about it.

This can vary between education providers but all offer the minimum of 1 year GP full-time and 6 months which may include another specialty. Trainees will do a four or six month GP post in either ST1 or ST2, and then 12 months of GP in ST3.

You will have a dedicated GP educational supervisor who will provide support throughout training and especially during the months in ‘non GP’ posts. There are protected education sessions with your peer group during the 3-year training programme.

Not all GP rotations have A&E posts but most acute specialty posts in hospital will involve some on-call commitment as part of their rota. There may be an opportunity at recruitment to select your preferred rotations, usually based on previous clinical experience. It’s important to look at individual schemes and get in touch with your intended local office/deanery to discuss ahead of your application. For example Yorkshire and the Humber almost always allocate trainees their preferred choice of speciality jobs in hospital.

When successful applicants are offered their area for training, there may be a chance to select rotations.

General practice is all about teamwork. As a GP you will be working closely with other doctors in the practice and with the wider primary healthcare team which may include for example nurses, health visitors, physios, dieticians, CPNs, counsellors and social workers. Most practices hold regular multi-disciplinary meetings as well as frequent educational sessions. Days are varied and many GPs develop special interests or a portfolio career undertaking additional work in a range of different community settings.

As a trainee you are well supported from day one with someone to ask questions to during surgeries. You will have regular debriefs to discuss cases as well as scheduled education time.

The majority of patients with coughs and colds tend to treat themselves or can be seen by other practice staff. General practice is a world of infinite variety. Patients will continue to present with a range of symptoms. Some are due to simple illness but many are medically complex and require a high level of skill to not only manage pathology but to see the patient in the context of their lives, their family, home environment and personal beliefs.

To give you a better idea. In a single 3-hour surgery, it’s possible to see an array of different presentations – a child with a high fever and acute otitis media, a bereaved widow with a pathological grief reaction, a woman with newly presenting breast cancer, a manual worker with a rotator cuff injury, an elderly man with a new onset AF… any number of conditions can walk through that door and although it’s a big challenge for any clinician, it’s an endlessly stimulating and greatly rewarding experience. Later on the same day, you could find yourself performing minor surgery procedures or be the lead GP running the diabetes clinic, attending a CCG Board meeting or safeguarding case conference. Opportunities for sub-specialism are endless and you will never be bored!

There are over 270 NICE and 150 SIGN guidance documents (for England and Scotland respectively) almost all with a primary care element as well as other national and local guidelines. GPs practice evidenced based medicine. Knowing where to find and how to implement the most relevant and up to date guidance is a skill and the art of general practice is applying the knowledge and facts to individual circumstances to deliver holistic patient care. Increasingly this means dealing with a combination of preventative care, acute illness and multiple long term conditions. British general practice is known for providing a leading source of knowledge and research into patient lives, in cities towns and villages. Academic general practice involving GP trainees and post -CCT fellows contributes many articles to the BMA British Journal of General Practice and other international journals.

Most patients value the personal relationship with ‘their GP’ which brings your working life added rewards right from the beginning of your career.

You will be well supported and receive one to one supervision to enable you to acquire the necessary knowledge and skills to diagnose and manage the diverse conditions encountered in general practice. You will gain confidence through review and observation and the natural history patterns of disease. Supervision continues during your ‘out of hours’ training too.

Many practices have now moved to a range of appointments up to 20 minutes long. Doctors in training will start with longer appointment times and fewer patients in each clinical session. In many cases, GPs and practices have ongoing relationships and continuity of records which means it is not necessarily a 10-minute consultation but more often one in a series.

Practices continually review their access and provision of appointments and trainee GPs are encouraged to take part in this process. Some problems are easily managed within a shorter appointment time.

Don’t forget to contact us if you have any other questions you’d like answered

Updated August 2017