1. GENERAL PRACTICE: TRAINING, OPPORTUNITIES & LIFESTYLE
Dr Mark Attah MBA, MCMI, MRCGP
GP Partner & Commissioning Lead,
Bretton Medical Practice, Peterborough
Programme Director, GP Speciality Training,
North Cambridgeshire

2. AIMS To provide an overview of General Practice and the role of GPs
To discuss General Practice Training
To identify the various opportunities available in General Practice
To understand the lifestyle of GPs

3. “An approach orientated to the individual, their family and their community; provision and co-ordination of care from birth to death; and promotion of health and wellbeing.” So in addition to “general” interest in the body and mind, there must in these circumstances be an overriding interest in the person rather than the illness, a commitment to continuity of care through the life term, an ability to manage the boundaries of different forms of care and support, and an understanding of the health needs of the wider community.

4. ‘Generalist practice is decision-making which is person-, not disease-focused, which is continuous and not episodic, which integrates the biographical and the biotechnical knowledge … all with a view to supporting health as a resource for living and not an end in itself.’
Joanne Reeve, NIHR Clinical Scientist in Primary Care, University of Liverpool

5. ‘The difference between generalists and specialists is important because it depends which lens is in front: the disease lens or the patient’s lens. Young doctors need to decide (and both decisions are legitimate) whether they are more interested in the science of disease or the way in which disease affects individual people.’
Iona Heath, President, Royal College of General Practitioners

6. GPs are unique
Simultaneously manage physical, psychological and social problems
Offer care in the patients community
Manage undifferentiated symptoms & uncertainty
Expertise in risk management
Simultaneously manage acute & chronic problems and multiple problems
Address both individual and public health issues
Co-ordinate the patients overall care and offer advocacy
Personalised, focused individual care founded on mutual trust also family care

7. GP Speciality Training
Selection process
Training
Assessment
Certification

8. GP ST Selection Based on criteria needed to make a successful GP
Assessment of criteria by-
Stage I (Long-list) Online application
Stage II (Short List) MCQ- Clinical, Situational Judgement and Professional dilemma paper
Stage III (Selection) 3 Communication Skills Scenarios (Patient/ Patient Relation/ Health professional)

9. Qualities needed for GP
Clinical competence
Communication skills
Organisation and planning
Problem solving
Able to cope with pressure
Professional integrity/ Probity
Empathy and sensitivity
Team working, managing conflict and negotiation
Professional development

10. GP Speciality Training
Currently 3 years (4 years from 2014)
Minimum of 18 months F/T GP training under supervision of a GP Trainer
Rotation through various Secondary care and community departments (4-6 Months each) e.g. Med, A&E, O&G, Paeds, Palliative care, Public Health, Psychiatry
Innovative posts- Combining GP practice + clinics e.g. Ophthalmology, ENT, GUM
Protected teaching times

11. Assessment Workplace-based Assessment- WPBA e-portfolio
Applied Knowledge Test- AKT Computer based. Clinical 80%, Critical appraisal/EBM 10%, Admin/IT 10%
Clinical Skills Assessment- CSA Consultation skills 13 patients encounter
Regulars assessment by clinical & educational supervisors

12. Certification/ Licensing
MRCGP
CCT General Practice
PCT Performers list
Annual appraisal
Revalidation

13. What does General Practice offer as a career?
An opportunity to have a real impact on people’s lives
The chance to become directly involved with patients and families
Flexible working practices
Independent working patterns and autonomy

14. General Practice as a career II
Involvement in teamwork with other health professionals
Scope to develop specialist interest within general practice
A key role in decision making
Direct involvement in health at the grass roots level
A rewarding career with an involvement in people and medicine

15. Career options Full Time/ Part- Time GP Partner/ Salaried/ Locum
GP Practice/ Community/ Hospital/ OOH
Portfolio careers- becoming increasingly popular

16. GP Career Options
Within the practice-GPWSI- Diabetes, Minor Surgery, Dermatology, Sports Medicine, Education
Outside practice- Hospital Clinical assistant e.g. Endoscopy, Community Services e.g. Dermatology, FME
Academic/ Legal, MDU adviser, Journalism, Occupational health
Management- PCT, Commissioning

17. Case Studies RD Part time Salaried RS P/T Portfolio Management
KW Locum Education
JL Locum OOH

18. ROLE OF A GP Carer Employer Teacher Leader Team member Advocate
Gate keeper (navigator)
Researcher
Health promoter
Resource allocator
Public Health Practitioner

19. Role of a Partner Business owner Employer NHS Manager
Public Health Physician
Diplomat
Investor-(property, staff, Risk)

20. Becoming a Partner PROS Stability Own boss Decision making
Financial reward
Flexibility
CONS
Hard work
Long hours
More responsibilities
Financial risks
Joint and several liability
Tied down

22. Partnership Case Study: Bretton Medical Practice
Suburban GP practice 12,000 patients
4 partners (6 WTE) GPs
Premises practice owned with 12 consulting Rooms, Large treatment Room, Operating Theatre, Pharmacy and Dental Surgery
Various provider services using different models of strategic partnerships, commissioning and delivery

23. Bretton Medical Practice
Full GMS (GP) services
Contraception, Child Health, minor surgery
Education /Training Practice
GP Registrar, Cambridge Medical students, Paramedics, Nurse Prescribers
Research-RCGP Accreditation, Level 2 PCRN
DECISION, EUDREGENE, PACE, 3CS

24. Bretton Medical Practice Commissioned / Ext Services
Upper and Lower GI Endoscopy
No Scalpel Vasectomy
Plastic & Aesthetic Surgery
Ultrasound Scan Services
Physiotherapy
Counselling

25. Lifestyle 4 day week- No on calls / OOH optional
Flexibility- Career options / portfolio
Job security & Career prospects with good income
Opportunities- Business, Ext interests, hobbies, transferrable skills
Sabbatical
Case Study

26. ?