So you have passed your PLAB 2 OSCE examination and successfully gained full GMC registration. What next? Which speciality should you choose? These are the very important life changing decisions that you will no doubt have to make once you have crossed the line and have a licence to practice within the U.K. One such speciality is General Practice – often referred to the speciality where you have to know ‘cradle to grave’ medicine. No 2 days are ever the same in terms of what pathology you will need to deal with and more importantly the relationships with patients and their families that you will inevitably build. People will trust you and you are ‘their’ doctor.
It’s not uncommon for patients to come in to discuss a procedure or a treatment that they have been offered by a Consultant in Secondary care, who is no doubt an expert in that field, and they will seek your opinion whether this is the best thing for them; such is the level of trust that patients place in you.
General Practice is also one of the few specialities where you can decide where, how and when you work. There are opportunities to work as GP partner (or principal) where in addition to your clinical responsibilities you are responsible for the staff that work within the practice and delivering your contractual responsibilities within the NHS. You can choose the format of your appointments, whether you offer additional services and whether you can take on additional services within the practice such as offering minor surgery, offering sexual health/family planning services, anticoagulation, looking after additional nursing homes – there are multiple opportunities where you are effectively running your own business. You can also work as a locum GP or a salaried GP if being a GP Partner is not something you wish to do.
Being a GP isn’t without its challenges – the days can be long with lots of administration and clinical decisions have to be made without the readily available access to blood tests and imaging that there is in hospitals. Often you are the person that people are referred back to in chronic illness and can be challenging when secondary care outcomes have been exhausted.
A typical day….
08:10: Arrive at the Practice – check emails and tasks that need actioning before the start of clinic
08:30: Clinic starts – 14 routine appointments of 10minutes duration, you inevitably over run due to the complexity of some illness. You also see 4 urgent patients at the end of your morning clinic
11:30: You check all the blood results that have come through overnight and action any urgent messages including calling patients if needed to discuss blood results/further investigations.
12:30: Go out on home visits – can be up to 3 visits on some days
14:30: Lunch and time to start signing prescriptions and dealing with prescription queries
15:20: Start afternoon clinic which are a mix of routine and urgent appointments
18:00: Start paperwork – referrals, dealing with letters about patient care from Consultants/hospital. Call patients or relatives
20:00: Time to go home if its been a busy day – sometimes practice business such as Partner meetings are done after surgery
The Good Bits
All of the above, the need to continually update your knowledge about every single speciality.
The variability of the situation keeping the job interesting.
Options to develop a specialism such as minor surgery, dermatology, diabetes, cardiology or endocrinology etc.
The Bad bits
The days can be long with lots of administration
A typical full time salaried GP will be paid equivalent to a newly appointed Hospital Consultant – approximately £79,000 – £81,000 per year with the cost of medical indemnity and NHS pension usually provided by the employing Practice – a total package of approximately £90,000 per year.
Within the UK a GP partner’s average salary was £105,500 (2016/17 figures UK average -BMA). These are averages and the amount depends on the practice/where you are in the UK/type of contract held/whether additional services are offered/whether you own the practice building etc.
So in summary: A great but challenging career but also one which offers independence, variability and rewarding.
A note to bear in mind – WH Medical Course tutors will support you in the future with advising on career choices even after you have attended the PLAB 2 OSCE preparation course and successfully gained full GMC registration and having passed all of your medical exams to be able to practice within the U.K. You will be able to attend a free course on how to get into Specialist training.