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At the heart of general practice since 1960

I’m considering training in general practice. But don’t go spreading that around, okay?

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I’m halfway through my medical school career at the moment, having finished two years’ pre-clinical medicine and a one-year intercalated degree in bioethics, but unlike my peers I’m also pretty sceptical about the view that general practice is a ‘cop-out’ or a ‘safe option’ for tomorrow’s doctors.

Like many other medical students, I find talking to patients comes pretty naturally. It’s the one part of medical school that I don’t have to Google (it might be more accurate to say – shamefully - Wikipedia), look up in a textbook or guiltily seize the precious time of an enlightened qualified doctor to do well.

My GP placement in the first two years at medical school provided an early opportunity to practice taking a history and examining patients outside of the busy ward environment. The GPs tactically ‘pick’ patients whose symptoms could have been drawn directly from a textbook. I saw classic examples of ‘pink puffers’ and ‘blue bloaters’ on the respiratory placement, heard a heart murmur on the cardiology placement and practiced a cranial nerve examination on a man with Bell’s palsy during the neurology placement. Not only did these patients reinforce scientific teaching but they were also keen to help students learn and forgiving when we didn’t get things right first time.

Yet despite many of my peers having similar positive learning experiences in general practice, many of them still have an aversion to general practice. A fellow medical student told me: ‘Certainly there are those who see it as a back-up job if their attempts to get into other specialties fail. You often hear of people saying, “Oh, if that doesn’t work out I’ll just be a GP.”’ Many of my non-medic friends wonder why I would want to be a GP; pretty 20-somethings view GPs as their ‘go to’ for the morning after pill or antibiotics when their glands are up because they’ve overdone it at university.

Personally, I see a lack of appreciation for what you might call our ‘front-line’ doctors. Maybe it’s because general practice doesn’t seem as glamorous as the specialties; there’s no denying that there is certainly a difference between working in a GPsurgery and working on a hospital ward. Even so, it seems to me that both jobs come with different (and equally valid) pressures.

I’m no Debbie Downer though. I can see that attitudes are changing. A student-led primary care conference organised by Bristol GPSoc earlier this year revealed that you can be ‘more than just a GP’. GPs with special interests such as sexual health, academic GPs and GPs who work abroad gave talks that challenged the misconceptions that many of us – perhaps ignorantly - had about a career in general practice. Despite this, and the existence of ‘gutsy’ movers and shakers in the GP world like Prof Clare Gerada, you’ll still meet many more medical students who declare that they’d rather be a paediatrician or orthopaedic surgeon than a GP.

If medic ‘street cred’ exists then, am I surrendering mine by still liking the idea of a career in general practice?

Chantal Cox-George is a medical student at Bristol University. She is currently undertaking a two-week work experience placement at Pulse. 

 

 

Readers' comments (16)

  • Two years in hospital medicine usually focuses the minds of many a young graduate - they see the reality and welcome the opportunity to choose GP.

    Having said that, life out here is becoming increasingly grim so it's worth thinking carefully about what you enjoy and where your skills lie.

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  • DON'T DO IT.......MARTYRDOM THAT IS.........GO FOR A HOSPITAL NON-PATIENT CONTACT SPECIALITY....LIKE PATHOLOGY

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  • Speaking as a 40 something GP i can't wait to get out but unlike some of my other colleagues who've taken early retirement i'm stuck.Those rose tinted glasses fall off pretty quickly when you enter the real world.Unless you have a real Mother Teresa like vocation and don't mind being a puppet on a string for your political masters i would stay well clear of general practice.Stay in hospital medicine and be respected by all.

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  • When my son announced that he wanted to go into medicine I didnt feel that I was in a position to put him off. Now that he is also half way through med school I am encouraging him to go abroad even just for a short period after his F1/2 jobs to experience the world beyond the NHS. What ever occupation you enter makes a job enjoyable is being creative. You can no longer be creative in GP, you are directed, controlled and micromanaged at every turn. Think hard before you make the wrong decision to enter GP and then find you cannot get on hospital speciality training scheme.

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  • I agree with the comments above. I entered GP after several years in hospital and passing relevant exams. General Practice is demanding, unrewarding and relentless. I would not recommend anyone to go into it these days. Stay away, keep your street cred and happiness intact.

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  • I know that I'm very near retirement after more than 34 years in general practice but it used to be both enjoyable and globally rewarding (not specifically in monetary terms). The health service bureaucracy seem to feel that if we actually enjoy our work as GPs then we're not being worked hard enough but this is based on crass ignorance.
    If you young GP hopefuls can start to get general practice back into reasonable order where NHS management and patients keep expectations and demands in perspective and back on planet earth then maybe, just maybe, there could be a long term future for NHS General Practice. And saying that takes some courage since I got a gold medal in cynicism at the 2012 Olympics!!

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  • If you're planning on staying in the UK then DON'T DO IT!

    If not then milk the system get GP trained and work somewhere else in the world where you will be appreciated.

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  • Good for you chantal. When I first went into GP training it was all about becoming a gpsi, however as the training developed, I really did just enjoy standard practice and didn't feel the need to be validated as being a GP with special interest. I tell you this for nothing, patients don't care of you have a special interest. They want someone who listens and cares, pick up their significant illnesses and help them to navigate an increasingly complex healthcare system. Once you get that right, doors will open for you that you never even knew existed!
    - anonymous salaried!

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  • David Bush

    Don't stay anonymous (anonymous salaried). We need to hear more positive comments like yours. Whatever happened to the tradition of the younger generations deciding to change the world? We need to retain our talented and enthusiastic younger doctors and encourage them into General Practice. If you want any autonomy GP is the place to be, and you do have the power to influence and change the system over the next 10 years. The system has to change, so get in at the start and build a system that you feel is better than at present. Look for partnerships, not salaried jobs. With responsibility comes power

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  • General Practice is by far the most interesting and intellectually challenging of all the medical specialties . If you can ignore fools like Jeremy Hunt it's a great life .

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