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Do you have a masterplan for your career?

Most GPs have some sort of plan for their career. Dr John Couch suggests some of the things that ought to be taken into consideration

Most GPs have some sort of plan for their career. Dr John Couch suggests some of the things that ought to be taken into consideration

GPs have now become acclimatised to annual appraisals and find this is a useful exercise to reflect on the year past and the one to come. However sometimes such a focus can provide a rather narrow picture in terms of a whole career. At intervals it is essential to pan out the reflectoscope to ensure that longer-term plans are being addressed.

Most of us have the ingredients of a career masterplan, whether consciously or subconsciously. Those who still believe in fate can simply follow opportunities as they crop up. For the many of us who prefer a more proactive approach, it is useful to write down what we hope to achieve during our medical career. We can then measure up opportunities and actions against this.

There are many criteria that can be included. Some of the more common are job satisfaction, level of income, skills development, family circumstances, working environment, working hours and planned retirement age. This list is certainly not exclusive and you can add or subtract your own items.

Clearly, as it is unlikely that you will find a perfect match, you would be wise to make provision for compromise and also weight your list.

Next, take a reality check about market forces. Ten years ago, partnership in a GMS1 practice was the main career route with jobs relatively easy to find. Much has changed since then. Choices range between partner, associate, locum and GPSI, including some interesting mixtures. Part-time GPs are increasingly common. Practices can be GMS2, PMS or APMS. There are also increasing numbers of GPs employed by private companies providing APMS services. Finally, of course, the job market is currently extremely competitive.

Market forces will inevitably modify a career masterplan, especially for younger GPs. For instance, given the tight job market and expansion of primary care work, extra skills will be a major key to finding work. If I were a young GP now, this would be high on my own plan.

For those aspiring to partnership, either now or later, GPSI skills and some knowledge or experience of practice administration and business are also likely to be major criteria in the selection process. It is important to choose a skill in which you are interested, but do also check which ones are most in demand. Dermatology, rheumatology and ENT currently rank high on the practice-based commissioning list.

GPs in mid-career will be at peak demand from family expenditure, so maximising practice income and minimising the downward financial pressure from PCTs may be more important factors.

Older GPs may attach more importance to pension planning, reviving jaded clinical skills and avoiding extended opening hours.

Of course, it is your masterplan. Age will not be the only modifier. What we should all be doing is using the plan as a personal tool to measure up every opportunity, access training, and reassess our situation at regular intervals. In an ever-changing NHS, compromise and changes of emphasis are certain: but at least your ultimate direction will be as self-determined as possible.

Dr John Couch is a GP in Ashford, Middlesex

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