This site is intended for health professionals only


Detective, economist, gatekeeper… and comic relief



Dr Ishani Patel, our fourth ‘GP to be’, is discovering that training as a GP requires her to wear many hats


I am a GP registrar at the Lonsdale Medical Centre in North West London in the final stages of metamorphosis – a necessary three-year evolutionary process that transforms caterpillar trainees into winged independently practising GP butterflies – as part of the St Mary’s training scheme.

Darwin wasn’t just talking about animals when he described ‘survival of the fittest’ in his book On the Origin of Species. GP trainees are an emerging unique breed of doctor where survival is not just about clinical competence and learning how to diagnose and manage a clinical problem. It also requires self-awareness, reflective practice, professionalism, management skills, embracing political change, an insatiable appetite for the job, out-of-hours commitments, not to mention RCGP membership exams and maintaining an electronic portfolio to demonstrate these skills while somehow achieving a healthy work-life balance.

I entered GP training fresh out of the South-East Thames foundation programme (having graduated from GKT) and needed a fresh playing field so moved to west London. I must confess I was naïve at the beginning of my registrar year. I was misguided in thinking that being clinically competent or even excellent was a good-enough platform to launch a successful GP career.

In the last six months I have recognised that being a good GP (trainee) demands so much more – perhaps almost requiring you to have a split personality:

I am the intern working on developing professional relationships.

I am the detective exploring patient’s ideas, concerns and expectations.

I am the student learning how to read my patients and trying to tease out what they are NOT saying.

I am the friend to the lonely.

I am the gatekeeper to secondary care.

I am the teacher of medical students/more junior doctors.

I am the comic relief when everyone is having a bad day.

I am the chancer when you are just not sure where to start.

I am the judge when mistakes are made.

I am the economist learning how to commission.

Did I mention I am also a doctor?

I would like to spend the next few months blogging on how to get the most out of your GP registrar year, ranging from how to obtain constructive feedback to recognising and learning from mistakes to the infamous QOF – perhaps with a few clinical encounters thrown in the mix.

All in all I have observed you can make as little or as much of your registrar year as you wish – it all depends on how hungry you are.

Blog you soon.

Dr Ishani Patel is a GP registrar in north-west London.

Click here for more from GPs to be Dr Ishani Patel