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Boxing day in... Basrah

Jetting off to trouble hot-spots at short notice and braving overflowing Portaloos are part and parcel of life as an Army GP, but the pros still outweigh the cons. Lieutenant Colonel Antony Willman reveals

Jetting off to trouble hot-spots at short notice and braving overflowing Portaloos are part and parcel of life as an Army GP, but the pros still outweigh the cons. Lieutenant Colonel Antony Willman reveals

I am often asked what it's like being a GP in the Army. Like all things in life, it is neitherfabulous nor dreadful, but for me, the good still outweighs the less good.

I am currently a Senior Medical Officer in Germany, working in a group practice of three GPs serving a population of approximately 4,800 soldiers and dependants. The other two GPs are civilians. We also have three general duties medical officers. One of these is my registrar ­ the other two are in Iraq.Our population is young single males and young couples with young children. Paediatrics, family planning, sexual health and mental health are common issues.

Regular separation of families can put undue stress on young mothers who may feel isolated, so we have a very good mental health team. Quite a lot of our work is occupational health. The Army is asked to do a job that requires a certain medical standard in difficult locations. We advise on whether a soldier can be deployed and in what role.

Training on this is provided during the initial Entry Officers Course (EOC).Operational deployments are occurring more frequently. I have been to Iraq twice and Afghanistan once in the last three years. This is in addition to medical support for exercises to locations including Poland, Canada, Jordan and Kenya. Generally deployments are for two to six months and involve providing medical support for soldiers on the ground.

Facilities are basic and immediate medical support not always accessible. They can also be dangerous ­ I spent Boxing Day 2004 under mortar fire in Basrah. This is the 'fun' part but increasing frequency and short-notice deployments are curtailing this. Depending on the security situation, you may also get involved in local clinics. This is not possible in Iraq now but it was in Afghanistan, where a significant cause of morbidity is cutaneous Leishmaniasis. We had no experience managing this condition but using local medical knowledge managed to obtain supplies of sodium stiboglutamate in order to run injection clinics.

The three services have a thriving GP trainer cadre. Along with CMP trainers, we are involved in training registrars to the same standard as in the NHS. All services offer the chance to develop your career and obtain further postgraduate qualifications. Diplomas in dermatology and medical education are popular as are masters in general practice and injury prevention and rehabilitation.

Funding is granted provided it is to the benefit of the service. In addition, some GPs become occupational or public health physicians that in most cases allow a management career pathway. My own interest is education and family planning so I am starting a certificate in medical education and aim to obtain MFFP. Some of my senior colleagues are examiners for the RCGP.

Pay and perks

As far as the 'green stuff' is concerned, one gets the opportunity to play with big boys' toys and get muddy as much as one wants to, and it is almost expected of the 'Doc' to join in. They even give you a gun ... and occasionally bullets.

Your role as a regimental medical officer (those joining as a qualified GP are likely to end up as this) involves acting as a medical adviser to the Commanding Officer as well as normal GP duties, in peacetime or on operations. He (or she) has ultimate responsibility for the overall health and welfare of the troops in his/her command. This sometimes presents conflicts between one's role as patient advocate and the overall good of the service (for example drug misuse).

If you fancy a break for three years (six if sponsored through medical school), enjoy travelling to exotic locations and are happy using a Portaloo that hasn't been emptied for a week, the Army can provide a great challenge. Do not do it to help pay your way through university. Do have a close look before signing up. It's not for everyone.

Career stages

  • Introductory first year, including five months attending the Entry Officers Course. Then you may serve in one of the Ministry of Defence's hospital units to do six months as a SHO in A&E·
  • Second and third year ­ a tour of duty as a regimental medical officer or general duties medical officer (GDMO) treating soldiers and sometimes their families. This period can be prefaced or combined with general practice vocational training
  • A period of postgraduate training and specialisation, eg. general practice, hospital specialisation, army public health and occupational (incl aviation) medicine

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