National Association for Patient Participation

Student Shadowing 2018

10 July 2018

Throughout June 2018, RCGPNI shadowed four fourth year medical students from Queen’s University Belfast as they participated in electives in general practice in Northern Ireland.

General practice provides exciting and diverse career paths. Across Northern Ireland, GPs are working in their practices, providing local specialist services in areas such as dermatology, joint injections and minor surgery, caring for patients in hospice and hospital clinics and leading the strategic development of policy in order to shape the future of general practice. Recognising the significant opportunities for a stimulating and exciting career, each of the medical students taking part in GP electives were keen to learn more from their GP hosts and get as much experience as possible treating patients and working as part of the healthcare team.

The students each spent one or two weeks in practices in Newry, Belfast, Carryduff and Lisburn and took the time to share their experiences and thoughts on why they are keen to be GPs in the future. Here is what Jennifer, Adam, Fionnuala and Eimear had to say…

Why are you attracted to a future career in general practice?
"I enjoy the array of conditions you manage on a day-to-day basis. I also like getting to know people and managing their care over time. GPs can have a hugely positive impact on patients' lives - people like to see their own GP" Adam
"When you have a consultation and can pinpoint what needs treated or supported there is real job satisfaction. It's great to see you have helped someone and made a real difference to their lives. I also like that you get to know families over time - about their lives, their interests and their health & social care needs. I've loved watching GPs engage with patients they clearly know well" Fionnuala
“You get to build real relationships with your patients. I also love how everyone works together so closely to give patients the best service and care - the reception staff, nursing team, practice manager, GPs and others work together as one team” Eimear
 “My first GP placement was in Lisburn and now I’m in Belfast - I’ve really enjoyed them both and they have lots of similarities. GPs day-to-day is so busy - but the long days and hard work don’t put me off! I really like the variety it offers. You get to see different people, from young children to elderly, and build relationships with individuals and families over time” Jennifer

What experience have you gained during your placement in general practice?
"I've done so much in the past two weeks. I have been assigned to a different GP most days. I have my own room and get to carry out consultations with patients and then review with the GP after. In addition to lots of one-to-one consultations, I sat in with the community midwife and shadowed the diabetic specialist nurse. It's useful to see how clinics work and to learn about condition management from the patient notes. I think you have more freedom and better learning when you see patients by yourself in the first instance." Fionnuala
"So far on placement, I have spent time with the reception team, learned about Quality Outcomes Framework and clinical coding from the practice manager, shadowed GPs in consultations, saw patients in clinics, worked in the treatment room and spent time with the diabetes nurse. It's been a very busy fortnight" Eimear
“I’ve been on home visits over the past few days - it’s great to get experience in different patient settings. I’ll also get to do travel clinic and minor injuries this week.” Jennifer

How has medical school been so far?
"I have loved my time in medical school in Queen’s. When on placement you feel more like you are working than at university. I've learnt so much this year on placement in general practice, paediatrics, psychiatry and cancer studies in the cancer centre." Fionnuala
 “I’ve really enjoyed medical school so far. I’ve had good exposure to GP but there could always be more - no matter what specialty you end up in, there’s so much learning in general practice, seeing your own patients & various conditions every day” Adam
“I’ve had a great time - both in terms of education and my social life. So far I have had good exposure to general practice but I’m looking forward to more in my final year” Jennifer
"It has been great – I’ve loved it. Exam times can be a little stressful, but I can't imagine doing anything else. Each year gets better - I've enjoyed each one more than the last! I do think general practice could have a longer placement as part of our core learning. You learn so much - taking histories, assessing patients' social situations, doing examinations - so GP exposure helps develop so many skills no matter what career path you choose" Eimear

What challenges do you think of when you look towards your future career?
"I think growing GP workload is a challenge. Patients have an increased number of conditions that need to be managed, particularly with our ageing population. GPs also seem to have more paper work which could be taking away from time with patients. Recruitment is also a challenge. We need to make sure we have enough GPs in Northern Ireland in the future. The GP programme can get a bad rap - some people say it's an easy or back-up option but this isn't the case." Adam
"Things are shifting more and more towards primary care - and GPs are already so busy. I think managing the number of consultations, prescriptions, home visits etc is a big challenge for all GPs. They have to be properly supported. Specialist nurses & other health professionals working in practice and in the community do great work and reduce GP pressures. The right professionals in the practice will provide a better service for patients and they will really feel the difference." Eimear
"Some of the biggest challenges are managing patient expectations and the long secondary care waiting lists. Patients want more info about referrals and timeframes. It is out of the GPs hands and it can be frustrating for both doctors and patients." Fionnuala
“I’d like to see longer consultation times so GPs can spend more face-to-face time with patients. Many people come in with multiple issues and it’s hard to prioritise and deal with everything in such a short time” Adam

What about your long-term career aspirations?
"I'm fairly confident I want to be a GP. My last placements have pretty much confirmed it for me. I also like obs & gynae so I'd like to explore options for having a special interest and doing other things too." Fionnuala
“I am attracted to general practice but would like to explore how I could have a diverse career and maybe specialise in something in addition. I really enjoy obstetrics & gynae and had a great time on placement in Craigavon. Balance is so important and general practice is so busy. To do your job well, you need a life outside of work and to look after yourself so you can look after your patients." Eimear
“I hadn’t really considered GP as a career until this year. After my first GP placement I really enjoyed being based in the community, seeing such a variety of presentations and the opportunity to build relationships with patients. I want to work in NI in the long-term. I have an interest in exploring academic options - it would be great if there were more opportunities in general practice. Lots of clinical research projects seen to be in secondary care" Adam

A huge thank to all four students for sharing their perspectives. We wish them the very best in the rest of their studies and in whatever future career they choose!

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