Diversify your GP career

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+ Humanitarian Health

In this episode, Sophie is joined by Dr Hareen De Silva who has a special interest in Humanitarian and Global Health. Hareen describes how he got into the field, how you can find out if it is the right role for you physically, emotionally and morally and the benefits and downsides of the role.

A highlight of the role for me was when I was working in Gaza and we were vaccinating children against polio and they were watching and laughing. It was at that point I realised I hadn't seen a child laugh for about four weeks and I become emotional thinking about it….to see laughs and smiles during probably the worst time they will experience. That is one small moment that stays with me and keeps me going back to deploy in various countries.

Top Tips

Gain Relevant Clinical Experience and Skills

Broaden Your Clinical Scope: Try and gain experience in areas often neglected in high-income settings but critical in humanitarian contexts. Just because you may deploy as a GP you may have to step into other situations. Hareen has gained skills over his career. Some of these can be obtained free or paid. Consider using your GP training study budget.

Emergency Medicine: ACLS, PALS certifications - paid for by CADUS.

Trauma Care: Even basic trauma stabilisation

• Have a look at cheap/free courses organised by a UK charity called CitizenAid that have a free app to download.

Mental Health: Basic psychological first aid (PFA) and recognition/referral of common mental health conditions.

• There are websites such as Coursera that offer free certification in PFA

Procedural Skills: Minor surgery, suturing, wound care, basic fracture management, IV insertion.

Resource-Limited Settings: Consider volunteering locally within the UK using your skills. Crisis at Christmas is where he started volunteering and then locally in homeless healthcare clinic in Doncaster. The UK Government website has a database of opportunities.

Understand the Humanitarian Aid sector

Research organisations: There are so many organisations that you could work with. Each has their own individual identity. CADUS is different to other organisations Hareen has worked with. When you interview for a position, make sure your personal values line up with those of the organisation.

Humanitarian principles: Stress the importance of understanding and committing to the core humanitarian principles: humanity, impartiality, neutrality, and independence.

Contextual awareness: Stay informed about global crises, geopolitical situations, and the specific health challenges in different regions. ReliefWeb has a jobs board and collates information from all around the world.

Networking: Connect with doctors already working in the field. LinkedIn, professional associations, and humanitarian aid conferences are good avenues. Hareen is happy to take on mentees via RCGP Mentoring.

Realistic expectations: Prepare for challenging conditions, long hours, emotional toll, and potential ethical dilemmas. This work is not for those with a saviour complex.

Essential training and qualifications

Specific humanitarian training:

• Pre-deployment courses: There are plenty of free online resources to help you understand the basics. DisasterReady is a free online resource which Hareen uses every year to increase his knowledge.
• Tropical medicine/public health diplomas: These are highly relevant and often required or preferred by some organisations. But think about the financial impact on yourself before paying for courses. Will it help you get a volunteer position or a paid job.

Language Skills: Proficiency in languages other than English (especially French, Spanish, Arabic) can be a significant asset and sometimes a requirement for specific deployments. Even just having a few phrases will help to generate rapport with beneficiaries of the project.

Security Training: Consider something like a HEAT (Hostile Environment Awareness Training) Course. CADUS offers a free course. The United Nations also has a free course called BSAFE.

Practical steps to get started

Initial deployments: Your first deployment might not be your "dream" assignment. Starting with shorter deployments or less complex contexts can be a good way to gain experience. Be warned that the smaller organisations may ask you to cover your travel and accommodation costs. Please do not be exploited for voluntourism type projects.

Application process: Be prepared for a rigorous application process, including interviews, assessments, and background checks.

Financial planning: Humanitarian work, especially early on, may not be highly paid. it is advisable to have some financial stability or savings.

Health and wellness: Stress the importance of maintaining their own physical and mental health during and between deployments.

Long lasting effects: Hareen has deployed to multiple conflict zones and now has to apply for visas to travel to countries as a tourist. He also holds two passports to avoid questions at the border - one for work and one for tourism. Consider where you want to travel in the future as some countries do not allow travel if you have been to another country.

It may not be for everyone

You may realise it is not for you, and that is fine. Within the UK we have so many health inequalities and this is how Dr De Silva's humanitarian career started. Consider joining the RCGP Health Equity SIG working group and contribute locally.

GP+ Lifestyle Medicine

The British Society of Lifestyle Medicine (BSLM) define Lifestyle Medicine as 'evidence-based, clinical care that supports behaviour change through person-centred techniques to improve mental wellbeing, social connection, healthy eating, physical activity, sleep and minimisation of harmful substances and behaviours'. It's important to understand that there are socioeconomic determinants of health and health inequity, and often people don’t have much choice or influence in the situation they find themselves in.

It was not about the choices people make, but the options they had to choose from.

Lifestyle medicine focuses on preventing, treating and even reversing chronic diseases through evidence-based lifestyle interventions rather than relying primarily on medication. General Practitioners are uniquely positioned to make an impact on their patients through lifestyle medicine interventions.

It's amazing if you pursue your interests and passions where things can go. General Practice has that flexibility that allows us to pursue areas we are interested in. If there's one thing people can take away from this podcast, it's that enthusiasm goes a long way.

Top Tips

This month, Sophie interviews Dr Callum Leese, a First5 GP based in Aberfeldy, Scotland with an extended role in Lifestyle Medicine. Callum shares his journey into the field and signposts to a number of helpful resources if you are interested in finding out more in this area.

If you think Lifestyle Medicine could be the right fit for you, here are some top tips to help you find out more:

Connect with other Lifestyle Medicine Professionals

The BSLM is the primary professional body for lifestyle medicine. Callum suggests the BSLM is a great place to start to build those connections through their in-person events, online webinars and networking at the BSLM annual conference.

Research if there are any local lifestyle medicine groups and if not, why not initiate one with like-minded colleagues. Callum set up the 'Healthiest Town Aberfeldy' initiative with colleagues to inspire change and address some of the social determinants of health to inspire healthier lifestyles.

Start small and strategic

Figure out what aspect(s) of lifestyle medicine interests you and begin with part time or low commitment roles alongside clinical practice. For example, Callum led on some group patient consultations in his practice for conditions such as diabetes and prostate cancer. This helps him to remain energized and enthusiastic about his role trying out different styles of delivering patient care.

Research funding opportunities

Callum suggests look at your local deanery first for potential funding opportunities in lifestyle medicine. If you are a GP registrar, consider the study budget to cover some lifestyle medicine courses such as the BSLM Core Accreditation in Lifestyle Medicine or Red Whale. Callum had previously secured funding from the Claire Wand Fund for some courses in the past. He suggested also checking out NHS Trust charities as his 'The Movement Prescription' podcast was part funded to support these ideas.

Learn more about Lifestyle medicine initiatives

Spend time to do some community mapping in your local area. Callum suggests becoming familiar with existing initiatives and help to shape and support initiatives that already exist. If you identify a gap, thing about what you can do but try not to reinvent the wheel.

GP+ Training Programme Director

Training Programme Directors (TPDs) in general practice play an important role in overseeing the education and training of GP Registrars within a defined geographical region or NHS Trust. The main responsibilities of a TPD typically include support and mentorship, GP curriculum delivery and oversight and providing leadership within the training programme, helping to foster a culture of learning and continuous improvement.

In short, the role of a Training Programme Director is to ensure the effective training and development of future GPs, maintaining high educational standards and supporting GP Registrars throughout their learning journey.

In this month's episode we hear from Dr Irene Afreh-Mensah, a First5 GP whose work week is a variety of clinical work as a salaried GP, TPD and one day of Undergraduate teaching at the local University. Irene shares her experience in medical education to date, skills and qualities needed to be a TPD and advice for those hoping to follow a similar career path.

A highlight of the role for me was when I received an email from one of my doctors in training to say thank you for helping her to get through. She had faced some challenges and needed an extension for her exams. Getting that email of appreciation was a real 'pinch me' moment knowing that I played a small role in supporting the start of her career journey.

Top Tips

If you're aspiring to become a TPD, there are several key steps and tips that can help you prepare for this leadership and educational role.

Build a strong network

Networking is powerful as it gives you access to opportunities you may not be aware of otherwise e.g. job vacancies. Engaging with local and national training committees will help you to better understand the challenges and developments in medical education and training. Attending courses, conferences and workshops related to medical education will help you expand your networks and opportunities.

Enhance your leadership skills

TPDs have a significant administrative and leadership role, so understanding how to manage teams, projects, and resources is essential. You might want to pursue leadership or management courses to strengthen your skills. 

Irene advises that you consider what you do in your role now and the transferable skills. Could you within your clinical role maybe lead on a tutorial or give a teaching session where you can receive feedback? This demonstrates you are collating evidence of your commitment to education.

Be Passionate About Medical Education

TPDs are often chosen for their passion for medical education. Demonstrate your enthusiasm for shaping the future of the profession through continuous learning, participation in teaching activities, and contributing to educational discussions.

Irene states she has always been passionate about medical education. In her opinion, education is sharing of knowledge, and she's always wanted to give back and help others along their educational journey and help them to learn and develop.

Carve your career path early

Irene advises that Post Graduate doctors take a step back from the idea that training is three years and focus solely on exams and CCT. She urges you to consider what your ideal career looks like and is there anything you can do during training that can help you work towards that.

Before Irene started GP Training, she researched various job adverts options to supplement the training. Between ST1 and ST2 she undertook a clinical teaching role. This was a huge springboard for her while training to understand the field of medical education.

GP+ Migrant Health

Migrants - whether they are refugees, asylum seekers or undocumented individuals often face distinct challenges and barriers when accessing healthcare. These challenges can arise due to language differences, cultural barriers, legal status, lack of familiarity with the healthcare system, or prior experiences of trauma or displacement.

Working with migrants requires emotional resilience, understanding, and the ability to address their unique health needs while providing comprehensive and compassionate care.

In this month’s episode we hear from Dr Sarah Clark who works one day a week as a clinical assessor for Medical Justice. Medical Justice are a charity who work to support the health and legal rights for people who are held in immigration detention. Sarah outlines how she got into the role and what it involves and where you can find out more information.

"A highlight of the role for me is hearing back from the client afterwards about the positive impact my medicolegal report has had. Sometimes the impact is that they have said they felt really listened to and that hasn’t happened before, or maybe it’s made a difference to the outcome of their remaining detention, or it's helped them to gather evidence for their asylum claim."

Top tips

Provide Holistic patient care

When working with those held in immigration detention, it is important to consider the whole person in front of you, addressing both the physical and psychosocial aspects of your patient’s health. Migrants may face multiple stressors, including housing insecurity, lack of social support, or financial difficulties, which can affect their mental health too.

Manage the emotional impact

Working with migrant populations, especially those facing trauma can be emotionally taxing. Take time for self-care and seek professional support when needed. Sarah recommends taking some down time after the assessments. Medical Justice also offer groups with a psychotherapist that you are welcome to attend. They also offer six funded sessions of psychotherapy per year to support your mental wellbeing as a GP.

Explore uncharted territory

If you are interested in getting involved, Sarah recommends attending one of the Medical Justice basics training days which are advertised on their website, usually held twice a year. Sarah encourages you to sign up to their mailing list to find out first about upcoming training dates. The training provides an overview of the work involved and an opportunity to decide if it is for you. There's no commitment as you can try a few assessments to see if it's something you want to pursue a career in.

Do your research

Research the main charities websites who do this type of work such as Medical Justice, the Helen Bamber Foundation and read through statements from both patients and doctors who work for these charities. Some of the organisations host webinars where you can stay up to date on their website and social media channels for upcoming events to attend to get more information.