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Gold, incentives and meh

Why I chose the Navy for my first job in general practice

A full-time partnership was the least attractive and most restrictive option after moving from hospital medicine to general practice.

I noticed an advert in the BMJ for a qualified GP to work as a civilian medical practitioner (CMP) on a naval base in my area. CMP posts exist throughout the country in all the armed forces to cover the shortfall in medical services. The job would allow me to remain in my area and receive a stable income of about £50,000 while I looked at my career options.

During my interview at the Ministry of Defence in Bath and found I was up against 16 other applicants. There was a rigorous security clearing process that took several weeks. But I was delighted to learn I had been offered the position at HMS Raleigh in Cornwall.

What the job involves

The full-time post includes a one-in-four on-call rota, which means remaining resident at the base. My day starts at 8am and finishes promptly at 4pm. The frequent on-call rota almost caused me to turn the job down as this was exactly what I had been trying to get away from. But it turned out on-call at Raleigh is not particularly busy. Often I only see three or four patients in an evening and then I have the following afternoon off in lieu.

I deal predominantly with young people undergoing arduous training and who travel extensively. I have greatly improved my knowledge of travel medicine, orthopaedics, occupational health and health promotion.

We are a 24-hour dispensing practice so most medications I prescribe are readily obtainable. We have a 16-bed inpatient ward that bears no resemblance to a hospital ward as it is mainly for patients with viral illnesses, cellulitis or fractures who require basic nursing care.

I have received formal training in submarine and diving medicine so I can perform medicals on this group of patients. If I had been stationed on an air base I would have received training in aviation medicine.

As a CMP I am lucky to work with young, motivated people of a similar age to me in a constantly-changing population. I am an active member of the officers' mess, participating in social events and sporting activities and have forged rewarding friendships with non-medics. I am also allowed a reasonable quota of study leave that is generally funded for courses relevant to general practice.

This post has enabled me to take a step back from the bustle of NHS medicine while earning a good enough salary to plan and structure my future career. This is a rare opportunity in medicine and it has given me time to make measured choices.

I am fortunate to have been in this post during the new contract negotiations without being affected directly. However, I believe the recent pay negotiations will be applied to CMPs at some future point.

Like any job there are downsides and after being in the post for 12 months, the main disadvantage turned out to be the one-in-four on-call rota.

Also, as the medical centre has such a continually changing staff population, bureaucracy makes it difficult to implement and follow through changes you may wish to make.

The MoD is a large organisation with a lot of red tape. It offers a good career structure to many civil servants, especially in management areas, but I'm not really sure this applies to doctors.

Another downside is the practice population. I miss treating elderly patients and see far fewer babies and children. However, I am not asked to do any home visits as all the patients attend the medical centre ­ if they are not able to do so under their own steam they are retrieved by Royal Navy transport.

Career plans

My plan is to return to NHS medicine, probably as a locum GP, until an attractive partnership becomes available. My ideal job would be to practise medicine

part-time while having a second career

in a medically-related area.

I have decided against joining the Royal Navy although fully qualified GPs are currently offered a £50,000 golden handshake in return for five years' service in the armed forces. The annual salary during this time is in the region of £70,000 depending on experience.

Despite the good financial deal on offer I do not wish to be tied to the Royal Navy in my mid-30s, having just started a new relationship and bought a house.

However, for some people it may be ideal.

Key points for


career in Navy

 · Salaried income

 · Good study-leave allowance

 · On-call rota (differs greatly between bases)

 · Total break from the NHS

 · Friendships with non-medics

 · Wealth of sporting opportunities

 · Working day finishes at 4pm prompt

 · May become out of touch with the NHS if in post for more than five years

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