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Choosing the salaried option

Dr Andrew Thomson looks at the opportunities in locuming or working as a salaried GP

Dr Andrew Thomson looks at the opportunities in locuming or working as a salaried GP

You've finished training, passed your exams and you have your certificate. If you're like me, you realise the comfort zone of continuous employment has evaporated. Now you have important choices to make.

Currently the jobs market resembles a desert, and chewing on those lean GP classified advertisements can significantly aid weight loss. But history teaches us that today's famine can become tomorrow's feast, so we need to be prepared to act whenever job opportunities arise.

Locum work

Although being a locum after you have qualified is daunting and lacks job security, it offers challenges and opportunities to develop as a GP. You see a wide range of patients, you enhance your clinical skills and you learn to adapt to different methods of working, to different environments and to different styles of practice management.

Being a locum also gives you time and flexibility, so you can develop your skills, for instance with GPSI training. Your options are limited only by your imagination. You should target skill development to areas valued by practices, enhancing your employment prospects while improving patient care.

The salaried GP

Some locums miss continuity of patient care, which is after all one of the cornerstones of general practice, and they long to settle down in a practice. This does not mean you have to become a partner. Salaried service is a viable and attractive alternative, with the benefits of employment without the partnership strings attached.

There are several advantages to the salaried option:

• clinical work minus corporate responsibility

• predictable and stable income

• contract flexibility

• portfolio career possibilities

• practice-based work experience before you commit to partnership

There are also disadvantages:

• lower remuneration compared with partnership

• short-term contract and limited job security

• limited input to practice development.

Choosing a salaried post should be a positive choice, not one taken through nervousness about job security.

Salaried jobs come in various guises. They include posts in nGMS partnerships, PCT-run centres, work for private providers and post-VTS jobs that offer opportunities to develop special interests.

When applying for a position, research is critical. Talk to doctors who have done the work – they will provide valuable insights that are not available in any job description.

Always visit a practice and meet the team. Ask questions, get a feel for practice organisation, and speak to the doctors. Present yourself as employable. This is a precursor to an interview, so plant the seeds for success and work on the soft sell.

After visiting, trust your instincts. The job may not feel suitable for you for no reason you can put your finger on. Or it may feel just right.

Your CV

Stand out from the crowd. A CV capturing the imagination of prospective employers is essential.

• The front page is vital so include more than biographical detail.

• Present the CV clearly – it's your publicity.

• Keep it short and precise.

• Tailor your CV to the job. No one size fits all.

• Keep important information up front – things get lost in the middle.

• Include your career aims.

The referee is important. Unless otherwise stated, the maximum number of referees should be three. Include someone you have worked with recently and your trainer. Always obtain referees' permission before you use them. Remember that referees can also provide valuable advice.


Interviews can be unpredictable. Your style needs to adapt to the interview. Get details of interviewers when you visit the practice.

Before the interview you should:

• prepare thoroughly

• know your CV

• rehearse answers to obvious questions

• sell your strengths

• prepare thoughtful questions

• be on time

• bring relevant documents (including your application).

Contract and pay

You have been offered the job. Congratulations. Now you must clarify your contract, your duties and your pay. A model contract exists that nGMS practices must use when employing salaried GPs ( These should be your minimum terms and conditions.

Minimum suggested salary bands exist (£51,000 to £77,000). Negotiating your salary depends on several factors – there is no specific formula. These factors include:

• previous experience

• qualifications

• type of work

• hours of work

• market forces.

If in doubt about your contract, get it checked by the BMA. Try to finalise your contract before starting work so you have protection if your duties or hours are changed.

What if you didn't get the job? Ask for feedback. This is vital, helping you learn from the process. Most of us are unsuccessful first time as competition is fierce. Stay positive – there will be other opportunities.

Starting work

Try to understand as quickly as possible the way the team works. Aim to fit snugly into the machinery. Improve the practice's efficiency. Demonstrate that you were the part they missed all along.

Teething troubles are common, so recognise and talk about them. They are often easily resolved.

Salaried GPs are not just another pair of hands. They bring fresh ideas and enthusiasm, working with partners to benefit practice and patients alike.

Dr Andrew Thomson is a member of the GPC and former chair of the GPC's registrar committee

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