Sunday, 24 February 2008

The GP Inside

This week was the last of my 8 week community (GP) placement, given that my foundation years don't include a GP placement I might well have spent my last days in a GP.

When I started medical school the one thing I was sure of was that I didn't want to be a GP - under any circumstances. I'm not entirely sure why I felt this way, but I was determined, despite the fact that about half of us would ultimately end up as GPs, that I would pursue a career in hospital medicine. During my first GP placement in 3rd year my opinion changed for a few short weeks but this was mainly due to having a brilliant GP supervisor rather than me uncovering a hidden love for coughs and colds. My 4th year GP placements only reinforced my original thoughts that general practice wasn't for me. I was therefore dreading 5th year and its 8 week stint of general practice. 9 weeks ago, I was looking for any excuse to avoid as much time in GPs as possible, I volunteered for every meeting possible to avoid a morning or afternoon here and there. In fact, I'd rather have spent 8 weeks tied up, naked, covered in scorpions.

Why is it then, that I sit here 8 weeks later, rather sad that my time in GPs is over? Maybe its the dictaphones (I'm still not bored of them), or maybe its a new-found love of general practice. Perhaps love is too strong a word, but I've definitely mellowed towards general practice. Not so much that I'm not destined for a career as a GP but I can certainly see why the lifestyle appeals.

I've thoroughly enjoyed this 8 week placement, helped by the fact I was at a nice practice with a lovely supervisor but I think its more than that. I enjoyed having my own surgeries, my own patients and my own room, its a rather nice feeling when a patient comes back to see you when they're feeling better. Maybe its the novelty of having my own patients that made the experience so interesting and useful - a novelty that would rapidly wear off as 'heart-sink' after 'heart-sink' patient knocks on the door and sits down with a list.

I've learnt a lot in the last 8 weeks and it will undoubtedly be useful when I'm in the position of looking after my own patients in hospital.

I'm still fairly sure I don't want to be a GP but I can see it definitely has its benefits, and perhaps I shouldn't rule it out to the extent that I did before I'd even started medical school.

Next we have 4 weeks in A&E, something which i'm really looking forward to. So begins the last 8 week block of 5th year, where has this year gone?


Anonymous said...

I quite enjoy my GP placement (though it's probably nothing like yours). I did get to interview a patient in an empty GPs office the other day which was pretty awesome though.

A&E sounds a million times more exciting though. I can't wait to get out of this medicine in the community malarkey and observe something a little more exciting...

Medically Brunette said...

I am perpetually surprised by the lack of regard people hold for GP jobs..I can't understand why it is still unfavoured.
My clinical friend tells me its boring, the same 50 or so conditions over & over (but wouldn't that be roughly true, give or take the numbers for any speciality?)
Hmm I haven't ruled it(or anything out) yet.

Anna said...

I came in to medical school set to be a GP, and I'm leaving it determined not to be. (Although I still have my final GP block to get through, so maybe I'll have an epiphany! Seems a lot of my year have been swayed by final year GP block... I'm hoping I won't be one of them!). The lifestyle is appealing, but it's really hard to be a good GP, and I think that I just don't care enough. I don't want to play the long game, I want to play very short ones.

dr_dyb said...

Put simply, if I wanted to run my own business, be responsible for the employment of 10 people and worry about balancing the books every year, while the government claimed to want to set us free, but introduced more regulations, and more competition, I'd have opted to be a dentist.

The GP market I can see headed down the dental model, and how many people do Not have dental care now, yup....lots..

Calavera said...

So far I've not had many GP placements, but I think we do some in our final years as well.

I'm actually not too bothered. Like you, I vehemently opposed ever becoming a GP, but I can see some of the attraction in it.

You're gonna be a doctor soon!

ditzydoctor said...

wow last 8 weeks! :) have an wonderfully exciting time! :D

PhD scientist said...

From the medics I know, many change their minds multiple times post-graduation about career choice... although how easy that is going to be to do under the new specialty training system remains to be seen. Anyway, while I have known some doctors who always knew they were destined for GP, I also know a good number who went into it after several years at SHO level in hospital medicine or surgery, up to six or seven in some cases. I know ex-medic GPs, ex-ENT GPs, ex-A&E GPs, ex-psychiatry GPs, an ex-anaesthetics trainee GP, etc etc.

I think most of these would tell you the attractions were (i) patient continuity and actually feeling you could do something for the patients' health; (ii) be your own boss; and (iii) ability to choose the number of weekly sessions you work. {For women with families, or likely to want them, the last of these is often especially significant).

However, a lot of these people would tell you that how they saw these reasons (in terms of importance) was quite different for them aged 26-30 to how it was for them aged 22-23. People change with age and experience, and their views change too.

Whether these sort of reasons will remain the deciders in the Brave New polyclinic World the Govt has planned for general practise is an interesting question. (i) and (ii) above are obviously going to be affected by a move away from traditional GP practise to polyclinics and the like.