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GPs buried under trusts' workload dump

What's my best career option?

How do the pros and cons of being salaried compare with those of being a principal for a newly-qualified GP?

In my experience, either option can satisfy individual needs depending on temperament and time of life.

Freelance locums have the great advantage of flexibility. This is a useful option for doctors who wish to get a feel for a locality and develop relationships with prospective partners.

It can appeal to those for whom variety is the spice of life. You can pick and choose working hours, take leave whenever you want and often haul in pretty good rates of pay. This is great if you are young and healthy, or semi-retired and not needing the income. The big disadvantage is unpaid leave for holiday, maternity or sickness.

Doctors in salaried posts are in a more favourable position in this respect, but at the sacrifice of career flexibility. Both locums and salaried non-principals can feel like they are on the fringes of the team. No interest in practice profits can result in lack of interest in practice development. Both salaried and locum posts can be attractive to those with family commitments.

Profit-sharing partnership offers a secure and stable platform on which to build a career. It is perhaps best suited to main breadwinners wishing to put down solid roots in an area. As an integral team member, you are in a position of leadership with all the opportunities and responsibilities this involves. There can be tremendous sense of satisfaction and self-esteem as you inspire ideas and follow projects through to completion.

This environment is undoubtedly the best for really getting to grips with patients' needs and addressing them in a meaningful fashion. Financial advantages include a share in the partnership profits, maintained income during periods of absence due to holidays, maternity or sickness, and probably an income boost on the heels of the new GMS contract. A portfolio career remains possible by agreement with the partners.

There is currently more incentive to keep abreast of developments within the profession, continuing medical education. Out-of-hours work is the main drawback, although this is likely to be optional under the contract. At present it will be pretty difficult to meet the criteria for revalidation if you are not a principal.

Questions from GPs in the early stages of their career

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