Career Pathway of a Newly Qualified GP
Earlier this year Dr Niraj Patel finished his specialty
training for general practice during which he was an Associate in
Training of the RCGP and received a distinction in the MRCGP exam.
Based at a Greenwich surgery, his job as a junior GP is to assess,
diagnose and treat registered patients.
How would you outline your
role?
GPs are true medical generalists when compared
to hospital doctors who typically specialise in one field, for
instance respiratory or cardiac problems. Patients I see could
present with any medical, social or psychiatric problems. In
getting to know my patients and their families really well I can
take a more holistic view of what could be causing their symptoms.
There may be influencing factors I am aware of, such as family
medical history or a recent increase in stress.
What are your main
responsibilities?
Patients visiting the surgery have not been
referred by anyone else. So my initial job is to assess patients,
give advice and treat their illness. If additional treatments or
assessments are needed, I refer them to a specialist.
What hours do you work?
I work weekdays in the surgery, running a
morning and afternoon clinic. GPs see on average between 7,000 and
8,000 patients a year, up to 40 patients a day. Each appointment is
allocated 10 minutes. I fit in home visits to housebound patients
and paperwork in between clinics. All prescriptions and patients
notes are computerised, but I have to verify and sign documents for
many purposes – insurance applications, gym membership, social
capacity benefits, sick notes, passport applications, jury
exclusions and travel medication. I also rotate working weekends
for an out-of-hours clinic.
What is your working environment
like?
It’s very team focused. Doctors cannot work
effectively without the support of receptionists, practice nurses,
health visitors and district nurses and pratice managers. What is
very different for GPs is that we make important management and
financial decisions. Budgets are allocated according to the number
of patients treated. We decide how best to spend it, from hiring
nurses, renting the building and dealing with pharmaceutical
representatives. There are many ethical choices.
What skills or qualities do you
need?
GPs hold a position of trust in society - it’s
what drew me to the job. So you must have the interpersonal skills
to put people at ease. The same is true when working in a close
team. Dealing with ill people can be stressful, so you need to
understand and communicate with colleagues, recognising when and
why things are getting to them. Share your problems as well. If
aware of your own limitations people respect you more.
What did your training
involve?
Medical school, which lasted six years,
involved two years of theory and academic study followed by three
years of clinical training attached to a hospital. This gave me
exposure to all sorts of different medical disciplines, and I
studied towards a medical BSc in the middle. Then I completed two
years of Foundation training (F1 and F2), giving me insight into
many different specialities. Provisionally registered with the GMC,
for the final three years I could have chosen surgery, hospital
specialisms, but opted for the GP route.
Why did you choose to specialise as a
GP?
Mainly because it was patient-centred and I
could establish long-term relationships with my patients. We don’t
just deal with clinical conditions and prescribe medicines. Often
people talk to their GP because they feel lonely, stressed or low.
It is quite amazing how much people trust their GP.
What are the main
challenges?
It can be emotionally draining constantly
taking on everyone else’s problems. It is important to be
interested in all your patients and provide the best continuity of
care.
How do you see your
future?
I would like to become a practice partner or GP principal.
Although I can make suggestions to improve our service, it would
mean having more influence over how our budgets are spent. There
are many options. I’m interested in having greater political
authority, representing local GPs and responding to the wider
community needs. Educating and mentoring GP trainees is something
else that personally appeals.
Niraj’s route:
- GCSEs
- A levels
- Medical training at Kings College
- Foundation year 1 and 2
- Three years specialist GP training
- GP
Niraj’s tips:
- Stick with the training - it is a long haul
but you will get there
- Right from the beginning of training always
put the patient first
- Practise communication techniques to get in
touch with people’s feelings as you’ll encounter lots of different
personalities
- Don’t take everything on yourself. Utilise
other colleague’s skills
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