I gave a talk a few months back to some 1st year medical students about careers in medicine. I told them that there are many ups and downs, twists and turns, and that no career is 100% straightforward. They were all politely disinterested until I said I was switching from Renal Medicine to General Practice.
The temperature in the room dropped about 3 degrees.
If you’re unfamiliar with the sound of 50+ Phones and laptops suddenly going quiet it’s like crickets, then an eerie silence.
The first question I was asked in the Q+A that followed was simply “Why?”
I went directly from FY to CMT having written off GP as “boring” or “too simple”. Through the breathless training pathway that followed I struggled with the high workload and high pressure; in particular trying to fit in family life and the need for MRCP revision in only a 2 year time period (although IMT is now 3 I believe). I often felt isolated, lacking in a solid community of practice to bounce off of in times of stress.
The decision to move was a very personal one, with both push and pull reasoning.
I should add the training I received to that point was not the reasoning, but I never really “clicked” with the esoteric nature of renal medicine. I found myself gravitating towards the holistic, enjoying clinic environments over wards, and relished dealing with more “general medical” complaints - much to the chagrin of my trainers and consultants. The narrow focus of specialist consultation and practice began to frustrate me, more so than the usual work/life balance dilemmas. I decided late into my training (ST5), after an OOPE in Medical Education, that a change was in order. I thought back to my FY2 placement and saw GP in a different light.
At first I was apprehensive, as many of my colleagues and peers shared the same flabbergasted disbelief in my change of tack that the students portrayed.
“Isn’t it a waste?”
“You’re so close, why not just finish?”
“You’re wasted there, you’ll just get bored”
It was amazing how the perception of GP in hospital differed from my later experiences. I contacted the GP training team (special thanks to Dr Vicki Guthrie) who were more than helpful in answering and queries or concerns I had.
Even from the very first days at induction, I was warmly introduced to both the team my peers and given clear outlines of my roles, responsibilities and representatives to contact. Our named and approachable individual trainers were understanding, flexible and fair with all questions and concerns – much more so than their hospital counterparts in my own personal experience. We were actively encouraged to network within our peer group, even being encouraged to facilitate peer group learning sessions and social events.
In practice, I have found GP to be a varied mix of cases – from simple holistic, to psychosocial concerns, to complex “puzzle patients” wherein challenging co-morbid cases need unpicking. Despite my “experience” from being a Medical Registrar – I have
lots to learn!
All in all I’ve been a trainee in Aberdeen for 13 years now – from medical school to ST5, from Clinical Teaching Fellow to GPST1. The benefit of working in the North-East, especially in GP training, are the opportunities on offer for both integrated City practice and remote and rural experience, the close links with under- and post-grad training, and the enthusiasm of the people that work here.
I wouldn’t recommend following my winding career path – but I would recommend the destination.
Dr David Wandless,
GPST1, Fyvie Oldmeldrum Medical Group
