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+ NHSE Clinical Advisor

In this episode of the GP+ Careers podcast, host Dr Sophie Lumley is joined by Dr Maria Mastrantonio, a Clinical Advisor to NHS England's regional team in the south west. Maria explains her specific role overseeing a team of GP reviewers who handle patient complaints made directly to NHS England about primary care services. The episode also covers Maria's career path to this leadership role, the flexible nature of the reviewing work for other GPs, and advice for those interested in similar portfolio careers and leadership positions within NHS England.

“A highlight of the role for me is doing a clinical review and feeling that you were fair to the doctor, fair to the patient and feeling job satisfaction and a job well done from doing that”.

Top tips

Just say yes to opportunities

Maria strongly recommends adopting the mindset to "just say yes" when an opportunity arises, even if you doubt your ability to do it. Saying yes allows you to build up a body of experience that will help you move into new roles. Her own role as Clinical Reviewer began with a chance email that was sent to GP appraisers, and she thought "why not" go for the opportunity.

Actively hunt for opportunities

Be aware of your emails and bulletins because job opportunities frequently appear in them. For formal NHS England roles, Maria advises checking NHS jobs. You can also use word of mouth to find people working for NHS England or the Integrated Care Board (ICB).

Gain practical experience in leadership and complaints

Acquire relevant experience under your belt first. For those interested in review roles, Maria suggests a great starting point is getting involved in complaints within your own practice to learn how medical defence organisations suggest responding. Additionally, seeking out any leadership roles (within or outside the practice) or becoming an appraiser can provide helpful supportive skills.

Leverage existing skills and education

Recognise that you bring all your prior experiences into new roles. For example, having an educational background can help frame clinical reviews around learning needs rather than just right or wrong answers. Even if a new venture (like a medical school role) doesn't work out, the failures become your best learning experiences and are great to discuss in an interview.

Network regionally and seek mentorship

Find out who the Clinical Advisors are in your region because processes and roles differ regionally and ask them for mentorship or for details on how they entered their positions. If finding clinicians proves difficult on websites, look for programme managers within the regional offices, as they are excellent contacts who can signpost you or provide clinician contact details.

Be flexible and try new things

Nothing in career diversification is "set in stone". If a new role isn't what you expected, you can step down and try something else. Start by trying roles like medical school teaching or offering a session at VTS (Vocational Training Scheme), as these can be stepping stones to leadership roles.

GP+ Population health and health inequalities

This month, podcast host Dr Sophie Lumley interviews Dr Rachel Steen, a GP focused on health inequalities. Dr Steen discusses her work running the National Trailblazer scheme, a post-certification fellowship offering professional development and project time for GPs working in areas of deprivation. The episode covers Dr Steen's career journey, the value of leadership fellowships and professional coaching in developing her interest, and practical advice for other GPs interested in tackling health inequalities, emphasising peer support, local project involvement, and networking.

"Seeing the motivation and projects of the Trailblazer GPs is such a privilege and a highlight to my work. By doing those things, I'm seeing those GPs feel more motivated, have more sense of belonging, and feel more connected to their local communities, which in turn leads to healthier, happier GPs. What could be more motivating and inspiring than that, really?"

Top tips

Seek opportunities that offer protected development time

Fellowships and funded programmes can create the space needed to explore new interests, build skills and step into leadership roles. Rachel highlights the Trailblazer fellowship as one example and encourages interested GPs to look at what is available locally through training hubs, academic units of primary care, Primary Care Network (PCNs) or Integrated Care Boards (ICBs), as well as national programmes.

Make use of coaching to clarify your direction

Coaching provided a space for Rachel to reflect, challenge unhelpful assumptions and explore her personal values that guide her work e.g. fairness, integrity and inclusivity. Understanding what matters most to you can guide career decisions and help you recognise when something feels aligned or not.

Build and maintain supportive networks

Post-CCT, the support networks of training often fall away. Rachel recommends actively rebuilding this through joining peer groups and leadership programmes e.g. Next Generation GP leadership programme. Staying connected with colleagues can spark new ideas, provide motivation and create a sense of belonging, especially for those exploring emerging or less traditional roles.

Reach out to people who inspire you

Rachel emphasises that many opportunities start with a simple conversation or reaching out via email. Contacting clinicians or leaders whose work interests you can open doors to new ideas, collaborations or mentoring relationships. Don't be afraid to ask as most people are happy to share their experiences and give you advice.

Start with local projects and apply a health-equity lens

Inclusion health doesn’t require formal accreditation. Rachel recommends beginning with what's happening in your own practice or PCN and considering how interventions can better reach the people who are most in need. Small, thoughtful changes can be the foundation of a meaningful and sustainable interest.

GP+ Career Coaching

In this episode of the GP+ Careers podcast, host Dr Sophie Lumley is joined by Dr Sarah Goulding, a portfolio GP and career coach for medical professionals. Sarah shares her journey to becoming a coach, which was fuelled by her own experience with burnout and a desire to support others, and details how her coaching work fits into her flexible portfolio GP career. Furthermore, the episode addresses practical considerations for aspiring coaches, such as the value of obtaining a coaching diploma, the importance of supervision for self-care and professional development, and the entrepreneurial challenges of setting up a private coaching business.

I find it an incredible honour to sit with people and let them realise what is important to them and help them basically become happier and give themselves permission to look after themselves. I've seen how transformative coaching can be and I find it incredibly satisfying because as doctors we are very skilled at having these interactions with people.

Top Tips

Experience coaching yourself first

If you are considering becoming a coach, the single most important initial tip is to have some coaching yourself so that you understand what it actually is. It is important to know what you are getting yourself in for, as there is a very diverse range of coaching available.

Training and Development

• A qualification is not mandatory, but learning the basic coaching techniques is highly recommended. Coaching is not a regulated industry, which can be uncomfortable for medics who often like a piece of paper to validate their skills.
• Personally, Sarah recommends training, noting that it provides a wider range of tools, a more academic approach, and helps with disciplines like knowing how to ask useful questions and how to leave space.
• When choosing a course, look for one that "speaks to you" and fits how you learn best, such as an experiential course in Sarah's case. 
• Coaching training at the diploma level often costs between £2,000 and £6,000 or more, so it is a significant investment.
• Explore funding options, potentially through a limited company as a form of CPD (Continuing Professional Development). You might also access funds through local resilience funding if you can pitch how using coaching skills will benefit your local workplace.

Find your niche and community 

• Find your "tribe" - either an aligned organisation or group where you can ask questions, get advice, and speak to experienced people. 
• Consider working out who you are really passionate about working with; this passion often dictates how you form your business. 
• Look into the three main accredited organisations, such as the International Coaching Federation (ICF), which offers links to various training providers. 
• Listen to podcasts and immerse yourself in the coaching space to see if it is something you would enjoy.

Prepare for the business and entrepreneurial side 

• If you plan to work independently rather than for an organisation, you must be prepared to set yourself up as a business entirely from scratch.
• This involves learning new entrepreneurial skills, such as:
  • Creating your own website and developing branding.
  • Being very organised (e.g., using tools like Calendly)
  • Working out how much to charge and how to send an invoice.
  • Getting comfortable with charging people money, which is often difficult for those comfortable only with the NHS model.

Prioritize self-care through supervision

• Engaging in supervision is strongly recommended once you begin coaching.
• Supervision is a safe space (unlike appraisal) to address issues concerning your skills, worries you may have about clients, or techniques you want to practice. It is a necessary practice because coaching involves working very intimately with people, and you need to look after yourself as part of it

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.