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Widen your skills aND prosper

Add another professional string to your bow, not only to keep up to date but also to boost your career prospects, says Dr Melanie Wynne Jones

General practice is changing rapidly and is under threat from private providers. GPs who wish to prosper, whether principals, salaried GPs, freelance GPs or those 'resting', need to review and possibly increase their skills. This will make them more marketable and also make their careers more fun.

These reviews are probably best done annually and should include:

·making sure the must dos are covered,


·a market assessment

·a plan (call it a learning plan or a business plan as you prefer)


All GPs should reasonably expect to maintain their knowledge of the following (this is not an exclusive list):

·Cardiopulmonary resuscitation skills (to be checked annually)

·GMC guidance

·Quality and outcome framework

requirements ­ to identify/meet patient needs and practice targets

·Other nGMS contractual requirements and enhanced services

·Immunisation and screening schedules

·NICE guidance

·Drugs and therapeutics

·Department of Health directives

·Health and safety issues, including new directives ­ for example on avian flu

·Employment law, discrimination law,

disability law and other areas of law that

affect day-to-day work

Keeping documentary evidence provides useful support for (compulsory) annual GP appraisal and eventual revalidation.


Whether you are a genuine portfolio GP, or simply want to add another string to your bow, the first step is to ask yourself why you are looking for other things to do. Common reasons include:

·Professional challenge and satisfaction (you want to do the job better or rekindle your enthusiasm)

·Practice needs (the partner who

does the minor surgery may be about to retire)

·A special interest (in dermatology say)

·Money (to pay for essentials, to boost your pension, to enable you to follow your dream)

·A wish to improve your work-life balance (some work can be fitted around the family)

·Improving your CV (more skills make you more attractive as a partner or non-


·Practice-based commissioning (you want to become better at commissioning services, you want to reduce referral

rates or you want to become a provider yourself)

·A desire to diversify (for instance into medicine-related areas such as

management or journalism)

The next step is to draw up a list of your current skills and aptitudes. Your partners, practice manager, GP appraiser, personal mentor or other trusted colleague may be willing to help you to do this, and may provide a more objective evaluation of areas such as your team-working or leadership skills.

More formal ways of appraising yourself include doing a learning needs assessment or a Myers-Briggs assessment.

These should help you to answer three key questions: what job can I do, what job could I do and what job would I like to do?

Market assessment

This should include an appraisal of the time, money and effort you will need to invest in order to meet the requirements of the job. Also an appraisal of likely rewards (financial and non-financial).

Timescales for any training, local availability of work, retirement plans and support from your colleagues and family may also influence your decision. Opportunities include:

·Out-of-hours work

·Becoming a GP with a special interest ­ more in demand as an alternative to

hospital referral, thanks to practice-based commissioning; might include endoscopy work or minor surgery

·Medicolegal work ­ insurance reports or provision of ethics/medicolegal advice,

either freelance or working for specialist companies

·GP care for the prison service or armed services

·Sessional work for the Department of Work and Pensions ­ incapacity for work


·Sessional work for the police

·Family planning, sexual health and young people's health

·GP appraiser

·QOF visitor for PCT

·Palliative care

·Clinical trials

·Cosmetic surgery

·Teaching ­ GP registrars, Foundation Year 2 doctors, medical students, day-release course organiser, tutor, lecturer or community clinical teacher; teaching other health professionals is often less well paid

·Occupational health

·Aviation medicine

·Sports medicine including diving

·A crowd doctor at public events

·High-altitude medicine including

mountain rescue

·Complementary medicine (acupuncture is very popular)

·Sessional work for private companies

offering medical screening or private

medical care

·Service commissioning for your own

practice or local GP groups

·Medico-political work ­ LMC, BMA and the like

·Media work, both medical and non-

medical ­ print journalism, radio/TV,

internet, pharmaceutical and other

promotional work.

Drawing up a plan

By now you should have enough information to decide what you could do and what you want to do.

It may help to draw up a list of pros and cons, or a matrix to see which of the available options match your personal aims and objectives.

Melanie Wynne-Jones is a GP in Marple, Cheshire


Many courses can be studied part-time or by distance learning

1 Learning Needs Assessment ­ BMJ Learning

2 Using the Myers-Briggs type indicator for career development Anita Houghton BMJ

Career Focus. Jun 2000; 320: S2-7248-27248

3 Diploma in Practical Dermatology, University of Cardiff.

4 Diploma in ophthalmology ­ Royal College of Ophthalmologists

5 Diploma in Child Health ­ Royal College of Paediatrics and Child Health

6 Diploma in Geriatric Medicine

7 Diploma in otolaryngology ­ head and neck surgery, Royal College of Surgeons

8 PMETB has useful links to deaneries, royal

colleges and faculties and other sites


9 British Medical Acupuncture Society

10 Faculty of Occupational Medicine, Royal College of Physicians

11 Tim Albert Training

12 Society of Medical Writers

13The Association of Broadcasting Doctors

14 Diploma in Mountain Medicine

15 The Immediate Medical Care Generic Crowd Doctor Course, Royal College of Surgeons of Edinburgh ­ contact Ms Millar at

16 Diploma in Business Administration or Masters Degree (MBA)

17Medicolegal courses

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