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The waiting game

Top 10 'real world' tips for GP trainees

Dr Shaba Nabi

Despite the negative press, general practice is still a rewarding and stimulating job, but there are many things that the curriculum does not cover. Here are my tips on how to enjoy the moment and make the most of your VTS and beyond.

1. Small groups are your lifeline

I know it feels like you’ve entered a tantric yoga session, but there is a reason we focus on the dynamics of small groups during training. These guys will be your study buddies and will hold your hand through rota issues and patient deaths. They will be friends for life.

2. Be super-organised from the start

There are far too many training hoops, but let’s not go into that. To survive, you need to dedicate weekly time to the ePortfolio and sending tickets for evidence as soon as you start a new job. If you fall behind, don’t go under. Get support at the first opportunity.

3. Spend no more than 10 minutes reflecting on each clinical encounter

Focus on what’s important – how you felt, what you learned and how it will change your practice. If you’re looking for inspiration, watch Carrie Bradshaw reflecting in Sex and the City.

4. Take advantage of all training opportunities

It’s not a sprint, it’s a marathon; and don’t miss out on amazing training opportunities along the way. From scholarship posts to out-of-programme international experiences, the world is your oyster. You won’t have this chance again.

5. Strive for ‘good enough’

You were top of the class, achieved the best A-level results and were accepted for the most competitive degree. But this high-achieving perfectionism has little relevance in general practice, and may lead to burnout.

6. Remember who’s the boss

By all means, work with patients for shared decision-making, but remember who is signing the prescription. Make sure the management options you offer a patient are reasonable to you before you share them.

7. Have something to go home to

It’s too easy to stay late checking notes and second-guessing your decisions. A life outside work, whether it’s dinner with the kids or a Spanish class, will give you a deadline and ensure you are not over-serving your patients.

8. Embrace complaints

A good doctor is always a nice doctor, but a nice doctor isn’t always a good doctor. You may face complaints, but don’t be afraid of them. Embrace them as validation of good practice (assuming they are unfounded).

9. Embed the day job before diversifying

Lots of GPs ask me how I have achieved a portfolio career. I worked full time for 12 years before seeking other roles. Exiting training is the start of the real learning and this needs time to bed in.

10. The bottom line isn’t the only line

If you are being offered a higher than market salary, it will be for a reason. A good team, equitable workload and protected breaks will ensure you will last longer than your probationary period. Reflect on how important pay is in your wheel of life and develop your career according to your values.

Dr Shaba Nabi is a GP trainer in Bristol




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Readers' comments (9)

  • Vinci Ho

    I wonder what Helen would say after reading this list??
    I would add:
    S**t happens everyday but the new world can still be brave
    And read PULSE?
    Declare of interest : I am not an employee of PULSE , what so ever .....

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  • Vinci Ho

    And if you have the patience , read my long comment titled 'To Madam , with Love'.

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  • Azeem Majeed

    Thanks Shaba. Excellent advice.

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  • Great article.

    I think much of this is relevant to all of us as GPs, not just for trainees.

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  • look at number 3 and 5 together. That is the key for getting through the tedious learning log stuff.

    As much as the powers in charge say it is really important to do good quality log entries, the key is getting the correct balance. You are much better off writing 3 average log entries per week each taking 5 minutes, then 1 excellent entry taking 20 minutes.

    Learn how to make an entry look reflective and you can fire out 'good enough' log entries at 12 an hour if you really wanted.

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  • Vinci

    Any chance you could put your comments together on a blog..I'd sign up for the doses of wisdom.

    I've actually started to cut and paste your comments and quote from them!

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  • Great stuff, work life balance is important to consider. Life's too short to flog yourself working crazy hours - trainees should consider the extra work involved as a salaried or partner e.g. Reports, results, letters, tasks - the more sessions you do the more of these you have to deal with

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  • Mithu Rahman

    Good article Shaba - It's really important that new and experienced doctors avoid burnout by seeing the whole picture of being a successful doctor. I might add a few points I've picked up over the years
    1) Learn to value your time NOW, don't wait til you've completed training. Yes right now you need to do as you're told for the most part, but be clear that there are things that are not part of our duties that you can be roped into, and without being disciplined now, this will get stuck all through your career.

    2) Make sure you have time in your schedule for eating and taking breaks. One of the first things that gets forgotten in the work day is 'did I have lunch?' but without adequate nutrition, you just make poorer and poorer decisions as the day goes on. Cutting out meal time is not time-saving in the long run, nor even in the short run

    3) Value your hobbies. When the workload feels heavy, hobbies and enjoyable activities start taking a back seat then ignored altogether. But these are vital in keeping mind and spirit together, and in reducing burnout. Make sure time is kept in the week for pastimes, schedule them and don't let anything encroach it

    4) Have friends outside of medicine. It doesn't help if you all you think or talk about is medical stuff. Keep the mind fresh - join a club (I recommend cycling!)

    5) Meet a financial advisor 4 times a year. Way too many doctors complain about money (or lack thereof) and don't have the first clue of where their money goes. Rich people don't necessarily earn more, they just know how to keep more. Isn't the cost of paying an IFA (say £400/yr) worth it if they save you £1000 in tax or interest payments? Do the maths

    Best of luck all you trainees!

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  • The first step in any emergency is to check your own pulse

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