General practice allows you to combine clinical practice with other interests such as politics, research, and medical education. Or, perhaps you wish to develop an extended role by providing an additional specialist service in your community, or go further afield in a wide range of clinical areas from cardiology, dermatology, and minor surgery to mental and sexual health.
Developing a portfolio career
"Portfolio GP" is a term which commonly describes a GP who holds multiple roles. Most GPs will have a primary clinical role - as locum, salaried or partner GP - and it's becoming common to see members taking on additional roles alongside this to diversify their skills and experiences.
Hosted by Dr Sophie Lumley, a First5 salaried GP and Training Programme Director in Shropshire, the GP+ Careers podcast is a series of short interviews with a standardised format. It's designed to point people in the right direction and showcase what’s possible. Sophie will ask a series of questions to each of her guests about what their role entails, how they got into it, and any top tips they have for those considering a similar path.
You can look forward to the release of a new podcast episode each month, available exclusively here and through all main podcast platforms. Browse this page to explore and listen.
Latest episode: GP+ Palliative Care
In this episode Sophie interviews Dr Tarana Hafiz, a GP with an extended role in Palliative Care. The interview explores the practicalities of her split week between general practice and specialty work, the benefits of pursuing a special interest, and advice for other GPs on how to develop a similar career, emphasizing the importance of mentorship and hands-on experience over formal qualifications like diplomas.
“A highlight of the role is having the privilege to work alongside some of the most caring and kind individuals has been an absolute honour, and the way I see them work and go above and beyond for every single patient is wonderful. I truly believe those core beliefs that align with why I went into medicine”.
Top tips
Prioritise finding mentors and building your network
- Finding mentors is considered essential. Look for someone who is willing to invest in you, take the time to train you, and be part of your career journey, informing you of opportunities.
- Engage with consultants: Tarana states that Palliative care consultants are notoriously friendly and very approachable. Don’t hesitate to reach out to them, especially during your GP training, to spend some time with them and build relationships.
Gain direct clinical experience before investing in qualifications
- Tarana emphasises that gaining experience is key. Instead of immediately investing time and money in expensive diplomas or courses, focus on practical exposure first.
- Shadowing and short contracts: Tarana suggests speaking to your local team, having shadowing days, or taking on a short-term contract with the local hospice to determine if the specialty is truly for you.
- Attend clinics: Ask local community or hospital teams if you can go to clinics to see if this is an area where you want to invest more time.
Start locally with enthusiasm and Quality Improvement
- The most important requirement is having enthusiasm and interest to be part of the specialty. You can begin developing your interest right within your current general practice setting.
- Utilise Daffodil Standards: A great place to start is by looking at the Daffodil Standards. This is a framework/toolkit that GPs can use for a quality improvement project within their own practice, focusing on areas like early identification, bereavement, and care after death for patients with advanced serious illness and end-of-life care.
- Join projects: Reach out to local teams and ask them to be part of quality improvement projects.
Engage in diverse learning opportunities
There are a variety of ways to build your knowledge in the area such as:
- E-learning: Spend time doing e-learning to understand what palliative care is about. Resources include e-learning and GPwER Framework available through the RCGP website.
- Workshops and courses: Attend local training and courses available from organisations like the Royal Society of Medicine (RSM) or Royal College of Physicians (RCP) on topics such as symptom control, advanced communication skills, and advanced care planning. Also, some local hospices nationwide sometimes run affordable communication workshops.
- Reading: Spend time reading around the subject, including insightful books from authors like Kathryn Mannix, who writes about terminal illness from a patient's perspective.
Be open to varied job titles and focus on the opportunity
When looking for paid roles, remember that opportunities may not always be advertised specifically as "GP with a special interest".
- Look broadly: The role Tarana obtained was not a GP with a special interest position initially; she took it on as a Clinical Fellow, which later developed into a speciality doctor role.
- Satisfy your cravings: Focus on finding an opportunity that allows you to manage more complexities and satisfy the craving for a more varied work week.
- Job titles are secondary: Tarana stressed that the job title was not the primary concern; the opportunity to embark on a different venture and manage medical complexities is more important.
GP+ Gambling Harms
In this episode of the GP+ Careers podcast, Sophie interviews Dr Emma Ryan, a GP partner and Clinical Director, and also serves as the lead GP at the UK's first national primary care gambling harms service, established in 2019. She discusses her dual role, the holistic mental health assessments offered by her service for individuals experiencing gambling harm, and the service's evolution from self-referrals to increasing GP referrals. The episode also covers Dr Ryan's journey into this specialized field, the importance of raising awareness among healthcare professionals, and advice for GPs interested in diversifying their careers into similar areas of special interest.
“A highlight of the role was meeting Wes Streeting, to discuss gambling harm, but at the same time being able to sneak in some other GP issues that I'm also passionate about because as a GP partner, I probably would have never got that opportunity in my core role. But because I have this extra role, I was able to meet him and talk about gambling harm but also talk about other things that I feel passionate about in the system as being a GP."
Top tips
Educate yourself thoroughly
Begin by reading the latest NICE guidelines on gambling harms (2025), which recommend GPs ask about gambling harms in certain consultations, especially mental health consultations. Make extensive use of the RCGP Gambling Harms Hub, which offers e-learning modules, podcasts, and resources to help you understand the field and necessary GP skills. Consider working towards practice accreditation by the RCGP to gain resources and valuable patient-facing posters.
Connect with established services and networks
Reach out to the Primary Care Gambling Service, as they are keen to expand their network of interested GPs and have links across all regions. Also, explore the National Gambling Support Network, run by Gamble Aware, to find information about services available in different areas. It's also beneficial to visit existing voluntary (third) sector treatment and support services to understand their long-standing work.
Leverage your existing GP skills and embrace opportunities
Your core GP skills, such as being interested in patients and their stories, are highly valuable, and you shouldn't let imposter syndrome hold you back. Your role primarily involves identifying patients and conducting initial holistic mental health assessments, not necessarily providing the specific therapies like Cognitive Behavioural Therapy (CBT). Be open to saying "yes" to new experiences, as an initial interest can lead to significant career development and opportunities.
Understand the evolving landscape and funding
Be aware that increased funding is now being directed towards the NHS for gambling harm treatment and support, making this a timely opportunity for GPs to get involved. Recognising gambling harm as a "hidden addiction" that patients often suffer from for many years before seeking help highlights the crucial need for easy referral pathways and GP awareness.
Develop strong organisational and leadership skills
If you balance multiple roles, you must be highly organised and excellent at time management. Clearly separate your "gambling harms days" from "GP days" to ensure focus in each role and prioritize your main tasks over checking emails first to prevent getting side-tracked. Leadership experience can be very valuable in setting up or developing services.
GP+ Minor Ops
Minor operations (minor ops) refers to small-scale, low complexity surgical procedures that can be safely and effectively performed in outpatient or primary care settings. Examples of minor ops include ingrown toenail surgery, skin biopsies, excision of skin lesions (skin tags, moles, cysts) and more. These are performed by a GP who has additional training, skills, or experience in performing minor surgical procedures. These GPs typically offer procedures that would otherwise be done in hospital outpatient departments, helping to reduce waiting times and improve access to care in the community.
This month, we hear from Dr Pim Dhahan, a GP in Birmingham with a special interest in minor surgery. He shares his journey into minor operations, emphasising the importance of accredited courses and hands-on experience gained through observation and supervised practice. He also outlines several benefits of the role such as providing a practical and engaging alternative to GP work and reducing hospital wait times.
Patients do really appreciate the work we do... they're always very thankful about coming in and having something done, something removed that's really irritated them or they've been worried about for a little while.
Top tips
Observe and get involved in your local area
If your practice already offers minor surgery, Pim suggests that you go and attend a session to see what is involved. If your practice does not perform minor operations, find out who does within your local Primary Care Network (PCN) and see if you can observe them. Observing others will help you determine if you truly have an interest and will enjoy this type of work.
Complete an accredited course
To carry out minor procedures in practice, you must first complete an accredited course. Look for courses run by the RCGP or through the Association of Surgeons in Primary Care. Pim, for instance, used his study budget to do the RCGP minor surgery course. These courses may include a small assessment, potentially involving practical elements like removing a paintball pellet from pig skin or assessing your suturing skills.
Gain hands-on experience with supervision
After completing an accredited course, do not immediately start performing procedures on your own. Pim advises you sit in with or assist someone who already performs minor surgery so they can observe you and ensure you are comfortable. Start by performing small procedures with a supervisor to build your confidence, then gradually move to doing them independently. It is important to build up your portfolio of accreditation and experience.
Explore funding opportunities
If you are a GP trainee and interested in minor ops, consider using your study budget to attend RCGP-accredited courses. However, if you are an established salaried doctor or partner, present a case to your practice. Highlight that minor surgery is beneficial for patients and can bring in funding that will surpass the cost of the course itself.
Commit to regular practice and continuous auditing
Minor surgery is a skill that needs to be performed regularly to maintain proficiency. Continuously audit your work, checking for complications like infections, and assessing the accuracy of your diagnoses. Pim noted that he gets about 70% of his differentials correct, which is acceptable as long as no cancers are accidentally removed.
GP+ Academic
An academic GP refers to a GP who is involved in not only clinical practice but also academic activities such as research and teaching. They play a key role in primary care in advancing evidence-based practice and therefore better outcomes for patients in the future.
In this episode, Sophie speaks with Dr Tom Purchase, a First5 GP and a Health and Care Research Wales NIHR Doctoral Fellow at Cardiff University. Tom describes his career journey into his doctoral fellowship, where to look and how to secure some funding opportunities, and the benefits of the role.
A highlight for me over the last few years has been that on two occasions I've been able to go to Geneva to support work with the World Health Organization. I got to meet world experts in patient safety, attend a global expert consultation, and see how global issues are prioritised. It was a really valuable and enjoyable experience and something I don’t think I’d have done working purely clinically.
Top tips
Be curious and ask questions
Tom’s journey began by simply asking a GP colleague what she was doing in her academic GP role. Don’t underestimate the power of curiosity and conversation, as most people are happy to share their experiences and may connect you with others or current projects.
Seek early opportunities even without prior research experience
You don’t need formal research qualifications to start. Tom didn’t have any before his postgraduate certificate. He built experience by joining projects, showing interest, and asking how he could get involved. Take initiative and look for small roles on existing studies.
Apply for small-scale research funding early on
Start small and go from there. Tom received a grant from the RCGP Scientific Foundation Board which is perfect for early-career GPs wanting to trial an idea. These short-term grants help you develop a track record and build your portfolio for larger funding later (e.g. National Institute for Health and care Research, Health and Care Research Wales etc).
Be aware of the challenges
The role is not without some challenges such as:
- Job security: Early academic roles are often fixed term.
- Financial hit (initially): Academic salaries may be lower than full-time clinical GP work.
- Juggling roles: You need flexibility and resilience to balance deadlines with clinical responsibilities and personal life.
Appreciate the benefits – variety, impact and autonomy
Academic GP work brings a number of benefits such as:
- Variety: Every week can be different, for example, teaching, research, and conferences.
- Autonomy: You can shape your projects and personal development based on your interests.
- Wider impact: Your research can change policy or clinical practice nationally or globally.
Tom’s experiences even led him to the WHO in Geneva—a unique opportunity to contribute to global health initiatives.
Master organisation and time management
Academic work can involve different demands to clinical work, including project planning, literature reviews, participant recruitment, writing, and meeting deadlines. Being organised and managing your own time becomes a crucial skill.
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