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Independents' Day

Career taster - GPSI in ENT

This week, as she searches for her niche as a salaried GP, Dr Ruth Chapman shadowed an ENT GPSI

This week, as she searches for her niche as a salaried GP, Dr Ruth Chapman shadowed an ENT GPSI

Why it's on my job menu

Having spent a significant time in a hospital specialty myself before seeing the light, I was interested to see how a GP with a special interest fitted into the grand scheme of things. The GP I shadowed works one session a week at a local community hospital equipped with ENT instruments and microscopes and so on. She felt that being a GPSI was rewarding as it was ‘something to get good at'. Hospital waiting times have been brought down considerably by the ENT GPSIs in my area.

Skills or traits needed

Previous hospital experience of the specialty is useful. A GPSI needs to be motivated to keep up to date with the specialty's advances and if necessary attend update courses. The GPSI I spent time with vets her own letters and has agreed with a local consultant which specific conditions she can treat. Appointments are 15 minutes long and any difficult cases are saved for a joint teaching surgery with the ENT consultant once a month.

Necessary training

In theory a GP could set up as a GPSI without any extra training or qualifications but this is unlikely to go down well with the local consultants in that specialty. There are now a number of postgraduate diplomas and certificates to achieve for GPSI wannabes – see list of websites below. The postgraduate diploma in ENT (run by Rila) takes nine months to complete and costs £3,000 pounds – which may be paid for by your PCT. Yearly appraisals by the specialty consultant are expected.

Avoid if...

You would feel isolated working out of your surgery and on your own – although circumstances do differ. GPSIs are not always popular with hospital consultants – some feel that the ‘bread and butter' of the specialty is being creamed off by the GPSIs and this leaves less for the specialty's juniors to experience. The relationship with the local consultants can become ‘uncomfortable', setting primary and secondary care against each other.

Pay rate

Varies considerably and is negotiated locally. Local rates seem to be about £300-450 per three-hour session plus paperwork. My colleague also has a £350-a-year educational course budget.

Job satisfaction rating


The pay is relatively good. There are fewer targets to worry about (except for discharging patients efficiently) and fewer audits to do, as the PCT runs most of them. My colleague felt that her work was a ‘nice change from general practice', away from her usual environment of the GP surgery and enabled her to ‘dip her toe into a bit of hospital medicine'.

Find out more

• From your local PCT

Association of Practitioners with Special Interests (watch out for the talking doctor!)

Department of Health



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