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+ 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.

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.