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Independents' Day

Why variety is the spice of my GP life

Creating the perfect portfolio career takes gritty determination, financial sacrifice and commitment to the work ethos. Is it for you? Dr Owen Dempsey lays bare the life of a portfolio GP

Creating the perfect portfolio career takes gritty determination, financial sacrifice and commitment to the work ethos. Is it for you? Dr Owen Dempsey lays bare the life of a portfolio GP

There was a time in the late 1980s when I loved full-time practice life and had great partners. We summarised, built premises, computerised, resisted fundholding and had shared values. We taught medical students, on-call was one-in-three, and I knew no different. Then I hit 40.

The next phase in my professional life included an MSc in health sciences and clinical evaluation, three years pursuing a primary care research agenda at the practice, teaching evidence-based medicine and mentoring nurse practitioners.This culminated in the breakdown of the partnership and an end to research funding. Enter phase three.Following a spell as a locum, passing the MRCGP and a few months working in New Zealand, I returned to the UK and actively pursued a portfolio career that would include salaried GP work, an educational qualification and teaching experience.

Disillusioned with partnership

By now I knew partnership was not for me. I was bored with practice meetings, discussions about who has half-term holiday, arguments about how much to pay the nurses ­ and there are GPs out there much better at all that than me.

My search for the perfect portfolio led me to Bradford City Teaching PCT, where an exceptional team has developed a superb salaried GP scheme with a commitment to continuing professional development and sufficient flexibility to match my needs exactly. Every portfolio GP has a different mix of activities and individual reasons for their choices. If my portfolio sounds rarefied, enriching and demanding it is. It can also turn your brain to spaghetti.

My diverse professional roles include:

  • caring for patients and health professional colleagues
  • contributing to the teaching philosophy at the PCT
  • tutoring clinical sciences students at the University of Bradford, teaching medical students in practice
  • examining on MRCGP preparation courses
  • organising a medical humanities module for medical students ­ enabling them to develop the humane side of their consultations through studying the arts and literature
  • conducting PCT-funded research into the humanities in medical education and interdisciplinarity, the way we communicate through the arts.

The 19, mostly younger, GPs on the Bradford scheme are making an important contribution to primary care in the city. We meet weekly for a half-day seminar and mutual peer support, which is much valued. As a salaried GP I work two full days in inner-city Bradford (four sessions), which gives me a supportive friendly team and continuity of care with patients, but without the aggravation of practice business.On the teaching front, one day a week (two sessions), I am tutoring and supervising a group of clinical sciences students on an essay on childhood obesity. I teach medical students in the practice, and am setting up a medical humanities module for second- and third-year medical students.This latter work has involved developing links with local resources to deliver interactive workshops on creative writing, film studies, art therapy and the visual arts. For my fourth day of the week (another two sessions) I am taking the PGCE course, enabling me, among other things, to focus more skilfully on the teaching programme.

The pitfalls of portfolio

There are prices to pay for my varied life. The work spills over into out-of-hours activity ­ preparing teaching, assignments ­ and often involves burning the midnight oil. I deliberately work an eight-session week with a weekday off, but this is often taken up with at least some work.

This wouldn't suit everybody. My income is £52,000, and I get 30 days' holiday plus bank holidays, bearing in mind that two of my sessions are also continuing professional development. To make up income I have the option of out-of-hours work or a locum, which can bring in another £10,000-£15,000 per annum based on an average of one-two sessions a week. The work is intellectually demanding, and this can become anxiety provoking if confidence levels are low. This package isn't for everybody but it suits me. It requires considerable commitment and wouldn't suit somebody with a young family. It does require self-starting skills, independence and good time management and the ability to keep the workload under control. It also requires supportive, talented, intelligent and sensitive colleagues, which I am deeply grateful for.

Owen Dempsey is a portfolio GP in Bradford

Portfolio success tips

  • Be able to enjoy variety and thinking about several issues at the same time
  • Be able to prioritise, delegate and manage time efficiently
  • Be able to network with and offer support to colleagues so that you have support yourself
  • Be prepared to go the extra mile in all areas of your work ­ you'll get out what you put in
  • Prefer job satisfaction to maximising income

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