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How I combine research with general practice

I believe it’s vital for real GPs to lead research that is based in, and relevant to, general practice. For far too long, research has been done by specialists in selected secondary care populations, but in the NHS around nine in 10 patient contacts happen in primary care. We need to understand more about what kind of medicine works in this population. That is why it’s important for our profession that there is an academic GP workforce able to generate relevant evidence to help guide practice and improve patient care.

Being an academic GP combines research and teaching with seeing patients. No two days are the same, which is part of the pleasure, but a typical day might be meeting a research team, attending a PhD supervision and completing an ethics application in the morning, followed by home visits, leading an anticoagulation clinic and treating young and old patients during a GP session. I might also do some academic writing in the evening – for instance, preparing a paper for submission to a journal.

I started my academic GPST3 training in Birmingham in 2007 and for the following two years I combined clinical and academic training. Since qualifying in 2009, I have stayed at the same inner-city practice and continued to work at the University of Birmingham researching cardiovascular disease. I work full time, have started a PhD in heart failure, have a few teaching and mentoring roles, and I am also a member of the Society for Academic Primary Care executive committee.

Why I chose the role

I was a swot at school – I loved school work, even homework, and was eager not to miss a day even if I was ill. I went to the University of Cambridge to study medicine, where the course was science- and research-heavy, and I was surrounded by amazing people far more clever than me, which I found both frightening and inspiring. But what I loved most about medical school and my hospital years was working with people, hearing their stories and taking on the challenge of sorting out the ‘whole person’.

Challenges

Being a GP, I have first-hand experience of patients with heart failure. Still, when I present my research to colleagues, audiences can start hostile. GPs have an understandable distrust of academics in ivory towers, and often throw out tricky questions. Luckily, once they realise I’m a ‘real’ GP, they are usually on board.

The tension between academic and clinical time is difficult. I am a GP first and a researcher second, but I can’t be there all the time. But I have learned that explaining to patients what I spend the rest of the week doing helps them to understand why they can’t always see me. Most patients are interested by the idea of their doctor working at a university and often ask me about it. They understand that on days I am not in the practice they can see a colleague, and we use a buddy system to follow up cases we are worried about. Nevertheless, time management is key. It’s also important to take time off. Academic work can be done at any time so setting boundaries for relaxation is important.

Advantages

I lead the masters module in primary care heart failure at the University of Birmingham, and I love teaching. Many of the delegates are full-time GPs, so it’s a great opportunity to bridge the gap between academic work and clinical practice. I enjoy presenting my own research and discussing the relevance to real patients, but the best thing about academic general practice is the variety. I get to do statistics, see patients in their homes, contribute to team meetings, make patients better (or at least try to), write papers for journals, teach, travel to conferences, work with amazing people and, best of all, try in my own small way to make things better for patients.