GP training equips you to deal with a multitude of medical problems, but does not prepare you for the reality of becoming a doctor. While the CSA might teach useful consultation skills, it won’t give you any practice at saying ‘no’ to secondary care or managing patients and their expectations. And perhaps the biggest challenge of all for a newly qualified GP is to step beyond the watchful eye of your trainer and work on your own without their support.
Overcoming the challenges
You will sometimes feel patients and colleagues are judging and watching you – and they probably are. My way of dealing with this is to arrive early when working at a new practice to familiarise myself with the surroundings – identify where the emergency equipment is, or where to find the toilets.
In a typical day, when being bombarded with tasks or questions, it’s important to think systematically so you reduce your chance of missing things. Trying to practise evidence-based medicine is good for patients and makes your decision-making more secure and defensible, while asking colleagues questions shows that you take the patient’s problems and the job seriously. They begin to see you as one of the team.
Before I qualified, I had used only the one IT system and came to regret not using my study days to train across various systems. I would recommend all trainees get this experience. To overcome this initially I’d arrive an hour early for a crash course from staff at the surgery and found, when this is pre-arranged, most practices are pleased to help.
New GPs will also become aware that public sympathy is low and the ‘complaint culture’ is alive and well, resulting in many of us practising very defensive medicine. To prevent complaints, try to defuse situations before they get out of hand – for example, I am always quick to let the practice manager know if I notice something wrong at the practice. Recently I met a patient who was convinced a serious infection had returned, but I could find no evidence that it had. By having the duty doctor join and support me, we were able to deal with the situation together and prevent a formal complaint. It also helped to reassure the patient that they were being taken seriously.
Reaping the rewards
I am just starting out but, even as a locum, I’ve built a positive relationship with entire families. As a GP, I can employ a holistic approach, using time as a tool and letting the illness evolve and getting trust as the reward. Every stand-out experience so far has reminded me why I chose general practice. To have an impact on someone’s life and be acknowledged for it is a privilege.
Dr Farah Jameel works as a sessional GP in Surrey and Sussex and is a council member at the Medical Women’s Federation, a member of the GPC and of the BMA Equality and Inclusion Committee.