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GPs go forth

A successful return to general practice

Dr Sue Booth retired from general practice after a bout of depression following involvement in the Shipman case. Seven years later she is back with a vengeance

Dr Sue Booth retired from general practice after a bout of depression following involvement in the Shipman case. Seven years later she is back with a vengeance

In February 1998 it was suggested to me and my partners in general practice that Dr Harold Shipman, who was in a neighbouring practice in Hyde, was murdering his patients. The next ten years were to prove to be extremely difficult as we endured the trial, the Shipman enquiry and the GMC investigation. I felt disillusioned, as my practice had commissioned an investigation into Shipman by the local CID. Nothing untoward had been found, and yet here we were being investigated by the GMC. We were cleared of any wrongdoing, but in 2000 I was diagnosed with clinical depression and retired from general practice.

At the time I had no intention of returning to medicine. But a friend said to me one day: 'You were a good doctor - you're being wasted'. So in 2005, with some trepidation, I decided to have another go.

Although I gave up my partnership I kept my registration with the General Medical Council up to date and I would suggest that anyone thinking of taking a break from medicine do the same.

Initially I was approached by a local practice to work one session a week for them and so began the process of reinstating myself on the local PCT performers list.

Since I had retired on ill-health I had to undergo an examination by the Occupational Health Department to ensure that I was fit enough to practise. I also obtained a report from an Independant Occupational Health Physician as a back up, but this is not necessary.

As well as completing the necessary forms for the PCT, I also had to undergo a Criminal Records Bureau investigation, this takes several weeks to be completed and so I would advise anyone contemplating a return to medicine to apply for this as soon as possible, at present it is taking approximately 8-10 weeks!

During my retirement many different procedures and protocols had been introduced such as QOF and appraisals; most practices had become computerised and some were completely paperless! Whilst I was waiting for approval I therefore familiarised myself with the common computer systems in use, read QOF and NICE guidelines and learned the new hospital referral protocols, including 'Choose and Book!'

I had thought that returning to general practice would be daunting but after a short time I settled back in, after all patients still complain of the same illnesses! I was fortunate in returning to work in the same PCT and it wasn't very long before requests from other practices for me to work as a locum began to come in.

When I was working as a principal I had very little desire to work out of hours, but now working sessionally I decided to register with 2 local providers and soon was working shifts for them as well.

Prior to retiring from practice I had done some work for the Department of Work and Pensions, now ATOS and so I applied for and received re-training in various Benefit Examinations, since ATOS also provide Walk-in centres this enabled me to work in these areas as well.

After a few months I decided that I would like to be involved in teaching medical students, (my practice had previously taught 3rd and 4th year students), and so I approached the local university and community based medical education department. I did not think that I would be able to teach as a locum since practices are obviously paying you to see patients!

As luck would have it, the university was looking to employ educational facilitators, liasing between the university, the gp tutors and the students. And so I began this job, 2 sessions per week. Gradually the university invited me to do some small group teaching for 2nd and 3rd years. So now I teach approximately 1 session per week.

Attending various courses organised by the university has enabled me to become an OSCE (objective structured clinical examination) examiner and a PBL (problem based learning)/debrief tutor, all of which have added to my working week.

Approaching my first appraisal was a frightening experience and developing a portfolio a steep learning curve but my appraiser was very supportive and helpful and suggested that I might consider becoming an appraiser myself! I attended the appropriate course and am now an appraiser for Manchester PCT.

So from originally working only 1 session per week, I am now working virtually full time, the work is varied, I have patient contact, OOH experience, feel challenged by my teaching and I hope to support others in my appraisers role.

On the negative side I still have to plan and arrange my work from month to month and so do not have total job security. On the plus side I have the freedom to arrange my own working week, can take my holidays when I choose, finances permitting and was able this summer to take three months out and travel to Bolivia on an expedition (see Pulse October 17th).

So while I would not have chosen to be involved in the whole Shipman case, and had certainly not planned to have five years out of medicine, my return to medicine has been an interesting and rewarding time. Had I remained in my practice I would certainly not be enjoying the varied and challenging job structure that I have at present.

So if you have chosen or been forced to take a break from medicine do not despair the road back is certainly difficult but not impossible.

Dr Sue Booth is a portfolio GP in the North-West. She also teaches at Manchester medical school, is a clinical mentor for third-year medical students, an interviewer for prospective students and a GP appraiser for Manchester PCT

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