Wednesday, 19 November 2014

The transition to ST3

David Lovell, a GPST3 in Portlethen has kindly penned this article on the transition from the hospital component on the program in ST2 back into the GP phase in ST3

“I passed my ARCP!”

“Me too!”

Katie and I high-fived one another in our dingy wee doctors room. We were definitely not going to miss that room, and we were especially not going to miss the enormous pile of dictation that was still waiting for us.

“So we are GP registrars now?”

“I guess so!”

There was a brief pause. At that point I think we were still thinking about the dictation, or preparing for the ward round later on, or chasing another set of needless bloods, or the multitude of other little tasks that we had accumulated that day.

“Does it feel any different?”


A few days later I was back in the practice where I had been in ST1, and somehow seemed to start more or less exactly where I had left off a year before. Of course, it had helped to keep my hand in by spending a few days here and there visiting the practice and doing some surgeries along the way. Moreover, it was the warm welcome from the practice staff on my return that helped ease me back into the way of things.

Anyway, I was up and running and consulting again and it felt great.

One thing that surprised me when I returned to the practice was the amount of trust that the team were placing in me. When I had been in ST1, there had always been very close clinical supervision from the GPs and I was encouraged to talk through my surgeries after each session.

Now I had much more autonomy. And with that came a great deal more responsibility to come up with appropriate management and follow-up plans for the patients I was seeing. Of course, I still felt supported, but now the onus was on me to seek help when and where I needed it. The act of taking this on has given me a lot more confidence in my day-to-day work.

The pace of life has picked up a lot since then as I have continued to take on increasing levels of responsibility within the practice. I am now independently running busy on-calls (albeit somewhat inefficiently) with all the stresses and pitfalls that are entailed. I am also working on an audit and few IT projects that I am hoping will help make certain admin tasks a little bit less cumbersome.

Of course the big thing looming on the horizon is the CSA exam. The nice thing about preparing for this is you get to focus on what is at the heart of general practice, the consultation. It is a delight to explore the intricacies of this complex, rich and endlessly varied interaction between yourself and the patient.

I just hope I pass!

David Lovell GPST3


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