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+ Gastroenterology
This episode of the podcast features Dr Charlie Andrews, a GP Partner in North Somerset who has developed a diverse career as a GP with an extended role (GPwER) in gastroenterology. His journey began after a personal experience with inflammatory bowel disease as a history student, which inspired him to enter medicine via the graduate entry route. Charlie highlights a new, fully funded national training programme he developed with NHS England, offering GPs a structured two-year pathway into the specialty. By combining clinical sessions in secondary care with a 12-month educational curriculum, the programme aims to provide career variety and improve patient access by bridging the gap between primary and secondary care.
A highlight of the role for me was that I’d previously been a patient with inflammatory bowel disease and had overcome quite a few physical hurdles... and now I'd actually come to a point where I was supporting pathway design and development to improve the care for people just like me... supporting the roll out of something that potentially could really impact lots of people.
Top Tips
Explore the National Training Programme:
Charlie developed a fully funded, two-year national training programme with NHS England. This structured pathway provides a "one-stop shop" that includes one session per week in secondary care under a supervisor, paired with a 12-month intensive distance learning curriculum.
Engage with the Primary Care Society for Gastroenterology (PCSG):
This society is a key hub for primary care-focused education, offering annual meetings and webinars. Charlie also recommends their educational podcast, Ingest, which provides specialist knowledge specifically for the primary care setting.
Consult the National Competency Framework:
To understand the formal requirements of the role, review the national framework co-authored by the PCSG and the British Society of Gastroenterology. This document formalises the pathway by outlining the curriculum and specific competencies needed to thrive as a GP with an extended role.
Prioritise relationship building:
Developing these roles often depends on personal relationships and "cross-pollination" with secondary care colleagues. Charlie suggests starting conversations with local gastroenterologists, as these links are essential for clinical support and discovering local opportunities.
Leverage your GP skill set:
GPs possess fantastic skills honed through GP training (and beyond), including the ability to take a holistic approach to patient care, strong communication skills, and a deep understanding of how the community fits into the wider healthcare system. By leveraging these skills and uniting them with enhanced gastro knowledge, GPwERs can enhance the care of patients within the speciality. For example, GPs are uniquely positioned to manage functional diseases, celiac disease, and specific inflammatory bowel diseases while keeping care closer to the patient's home.
Take an incremental "Building Block" approach:
Building an extended role requires motivation and time and often includes small 'steps' towards your goal - developing your interest, gaining 'in-clinic' experience, seeking opportunities to deepen your experience and understanding (e.g. RCGP clinical champion roles) and building your knowledge through educational activities. The GPwER in gastroenterology programme is unique in that it brings together the educational and in-clinic training to support the development of this role.
Further reading
- Dr Andrew's Ingest podcast: www.pcsg.org.uk/ingest/
- RCGP One Day Essentials course on Gastroentereology: https://elearning.rcgp.org.uk/enrol/index.php?id=1222
- RCGP Clinical Topic guide on Gastroenterology: www.rcgp.org.uk/mrcgp-exams/gp-curriculum/gastroenterology
- RCGP Mentoring: www.rcgp.org.uk/your-career/gp-mentoring
- GPwER Framework PCSG: www.pcsg.org.uk/the-gpwer/
- GPwER in Gastroentereology course: www.pcsg.org.uk/gpwer-portal/
GP+ Medical Journalism
In this episode of the GP+ Careers podcast, host Sophie is joined by Dr Rammya Mathew, a GP in Northwest London and a borough medical director in Brent. Alongside these leadership roles, Rammya is a regular columnist for the BMJ and a GP appraiser. The episode explores her journey into medical journalism, from her early days being active on social media to being headhunted for one of the most prestigious journals in medicine. Rammya shares her tips on overcoming imposter syndrome, finding your voice, and the practicalities of balancing a varied portfolio career.
My highlight is looking back and seeing the engagement with the pieces that I've written. On the BMJ metrics function, I can see columns from five or six years ago with 10,000 to 20,000 hits. It’s made me realize the writing is used in course materials and supervisions... that sense of helping to shape the next generation and the thinking around medicine is the most fulfilling part for me."
Top Tips
Just give it a go and practice
Rammya's primary advice is to simply start writing, as she believes medical journalism is an iterative process where skills naturally improve through practice. Instead of waiting for a formal role, you can build your skills by writing informally for blogs or smaller platforms. Over time, the process becomes easier as you learn to identify which daily observations are most valuable to share with others
Build a professional profile on social media
Being active and vocal on platforms like X can help you engage with senior leaders and other medical writers. A visible profile ensures that your work reaches an audience, as having the networks and the connections is often how you get noticed or even headhunted by major journals.
Be bold and authentic in your writing
To truly engage readers, you must put yourself out there and be "unapologetically you" and willing to share brave, honest opinions. People engage most when you avoid being "dry and boring" and instead bring your personal self and clinical experience into your pieces. To maintain professional standards, ensure your tone remains constructive and present both sides of an argument before clearly weighing in with your own perspective.
Study the work of others
Read established columnists to understand how they structure their arguments and manage tight constraints, such as a 450-word limit. This helps you learn how to make it flow better and include multiple points efficiently.
Keep a notebook for daily inspiration
Use your clinical practice as a primary source of material by continuously observing what you see around you. Keeping a dedicated notebook helps capture ideas immediately so you have a bank of topics when it is time to sit down for your scheduled writing days.
Seek out informal opportunities
Look out for 'taster weeks' at medical journals to see how they are put together and how editors decide which topics are currently topical. Alternatively, offer to summarize discussions from medical events or online forums to get your foot in the door.
Further reading
- The British Medical Journal website: www.bmj.com
- Rammya's first accepted BMJ article on childhood obesity: https://blogs.bmj.com/bmj/2016/08/25/rammya-mathew-it-is-time-for-doctors-to-put-their-public-health-hats-on/
- British Journal of General Practice (BJGP): https://bjgp.org/
GP+ Urgent Care
Join us this month as Sophie speaks with Dr Maisun Elftise, a GP and Consultant in Integrated and Community Care working in an urgent care setting in Coventry. She highlights the improved work-life balance she gained in a shift-based model that eliminates traditional administrative burdens like practice lists and blood result follow-ups. Maisun also discusses her passion for tackling health inequalities and provides practical advice for GPs looking to explore this career path.
"I felt fulfilled. I felt everyone was happy with the care that they were provided. I felt like I saved lives. I made people better. This is my highlight and that's why I want to be a GP. That's why I want to continue to be here working in urgent care. We're making a difference. We should be proud of who we are as GPs."
Top Tips
Try the role before committing
Do locum shifts or shadow at an urgent care centre to see if the fast-paced environment and variety of walk-in cases suit your style of practice.
Leverage your existing GP training
You do not necessarily need a specific diploma or advanced training to begin working in urgent care; however, you can build confidence through resources like the RCGP “One Day Essentials in Urgent Care” or the Diploma in Urgent Care from the Royal College of Surgeons in Edinburgh.
Focus on the work–life balance benefits
The shift-work model allows you to leave on time, and without a practice list you avoid accumulated admin such as blood results or letters to follow up.
Utilise professional networks
Join the RCGP Urgent Care Special Interest Group (SIG) to find mentoring, support, and connect with a community of GPs working across diverse settings.
Appreciate the clinical safety net
Working in a setting attached to a hospital provides added security, with specialist teams and emergency equipment readily available if a patient becomes higher risk.
Protect your well-being
Remember that “no is a full sentence”. Ensure your roles fit your current stage of life and avoid feeling pressured to take on every opportunity at once.
GP+ Dermatology
In this episode of the GP+ Careers podcast, Sophie interviews Dr John Diamond, a GP based in Northern Ireland as he shares his journey of developing an extended role in dermatology to tackle Northern Ireland’s multi-year secondary care waiting lists. Drawing on his experience with the Cardiff diploma and the GPECs elective service, he provides practical advice on finding a clinical "spark," collaborating with colleagues, and starting small within your own practice.
"The satisfaction I get comes from helping patients I know would otherwise face long waiting lists, and actually fixing the problem and making them better. I can think of dozens of patients where that’s happened: people with severe eczema, acne or psoriasis, or a rash no one else could diagnose. Because of my additional knowledge, I’ve been able to identify the condition and treat it. That gives me huge satisfaction."
Top Tips
Establish your foundation first
Spend your first four or five years in general practice settling into the business of partnership and getting to know your patient population before pursuing a specialised niche.
Invest in formal, high-quality qualifications
Pursue specialised education, such as the Cardiff diploma in practical dermatology, but be prepared for the time commitment; a rigorous academic diploma can require approximately 10 hours of study per week for a full year.
Observe secondary care clinics voluntarily
Before investing heavily, reach out to local consultants and ask to sit in on their clinics. As dermatology is highly visual, this firsthand exposure helps you determine if the discipline, which offers a "clean" break from complex social or mental health issues, truly suits you.
Collaborate to build services
Avoid working in isolation; instead, gather a group of like-minded colleagues. Pair with those who have complementary strengths, particularly those skilled at lobbying for funding and navigating administrative hurdles, as their persistence is often what gets a service off the ground.
Start small and focus on patient impact
You don't need a regional service to be effective; simply enhancing skills for your own practice list is invaluable. Addressing inflammatory conditions locally provides immediate relief to patients who might otherwise face secondary care waiting lists as long as six or seven years.
GP+ Child Health
This episode of the GP+ Careers podcast features Dr. Amina Al-Yassin, a First5 GP who has built a dynamic portfolio focused on child health. Dr Al-Yassin details her experience balancing clinical sessions with strategic leadership roles at Barnardo’s and as a Clinical Lead for local children’s services. Listeners will discover how to navigate spin fellowships, engage with community Child Health Hubs, and leverage their unique GP skills in specialist settings like CAMHS.
"The highlight of my role is the ability to transform systemic failures into proactive solutions that improve care on a population level. For instance, after a tragic childhood asthma death in my borough, we were able to use our strategic position as a borough clinical leadership team to develop a locally enhanced service (LES) to ensure such gaps are closed for other families. It is incredibly rewarding that when we identify a problem in the system, we have the platform to find creative ways to make a difference and launch clinics that directly benefit our community."
Top Tips
Leverage spin fellowships for protected time
If you are early in your career, look into spin fellowships. These schemes are designed to improve GP retention by providing protected time (usually one or two sessions a week) to develop a special interest or an extended role. Dr Al-Yassin used this to work within a Child and Adolescent Mental Health Service (CAMHS), gaining frontline experience in neurodevelopmental assessments and medication management. This protected headspace is helpful when first developing a new area of expertise.
Prioritise practical experience over formal certificates
While additional qualifications like the Diploma in Child Health or the Diploma in Child and Adolescent Mental Health are available, they are not always prerequisites for extended roles. Dr Al-Yassin emphasizes that the skills you already possess as a GP i.e. being well-versed in both physical and mental health across all ages, are unique and highly valuable. Learning on the job, showing enthusiasm, and maintaining a holistic perspective often count for more than a certificate.
Engage with local Child Health hubs
Investigate whether your local area or Integrated Care Board (ICB) has established child health hubs. These are community-based clinics where paediatricians and GPs work together in the same room to provide specialist input for families. If you cannot work in one immediately, ask to sit in on clinics or participate in their virtual Multi-Disciplinary Team (MDT) meetings, which often include health visitors, school nurses, and therapists.
Connect through Special Interest Groups (SIGs)
Networking is essential for discovering opportunities that may not be widely advertised. Joining RCGP Special Interest Groups, such as the Adolescent Health SIG, connects you with like-minded colleagues who share insights on vacancies, projects, and educational opportunities. Other helpful networks include groups focused on health inequalities or neurodiversity. You can also seek further support through the RCGP mentoring programme.
Blend strategic leadership with Clinical Practice
A portfolio career allows you to balance "big picture" strategic work with direct patient care. Roles in organisations like Barnardo’s or as a Clinical Lead for a borough involve looking at population health needs and designing systemic solutions, such as asthma care pathways. Maintaining some clinical GP sessions is beneficial because it keeps you connected to the realities and hardships of patients, which in turn informs and improves your leadership decisions.
Establish firm professional boundaries
One of the primary challenges of a portfolio career is "overspill," where work from one role leaks into another or into your personal time. Strategic and leadership roles often require more time than the paid sessions suggest. To avoid burnout, it is important to be self-aware and block out time for downtime and family, ensuring that your varied interests do not encroach on your personal life.
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