After I qualified as a GP in 2017 I was lucky to be able to do a health inequalities fellowship, funded by NHS Education for Scotland. This involved being attached to the Access Practice, where I now work as a permanent GP.
I had clinical commitments which I found challenging and a great development opportunity after CCT but having some protected learning time during the fellowship was also the first time in my career I had the chance to step off the training treadmill and think for a time about how I wanted to develop in my practice as a GP and what I found interesting. I started reading more about health inequalities and the social determinants of health and felt I was really getting a new perspective on issues that had troubled me during my training but which I had been unable to explain.
Wanting to get more research training and experience I started a Masters in Primary Care from the University of Glasgow and went on to do a further academic fellowship and to complete several research projects focusing on people experiencing homelessness or other forms of social exclusion. I also had 2 babies in that time which somewhat curtailed my academic and clinical interests with family commitments but taught me a lot about time management!
I think I probably talk about this too much in the podcasts and the previous blog on bjgp living but for me projects like WiseGP that promote scholarship in primary care are important for several reasons. First is the fact that in an increasing technologized society there is a sense that anything important can be measured and quantified. Much of the value in primary care is difficult to measure as it’s about building a long term relationship with a patient and care over a period of time. I think it’s important we remind ourselves of the importance of this because if we don’t value what we do, there is no way governments and politicians (or the public) will do. Secondly there is the challenge of health inequalities, rising multimorbidity and an ageing population. It is increasingly clear that more technological advances in healthcare won’t solve some of these problems. We need realistic pragmatic medicine, that can discuss risks and quality of life honestly with patients and I think that can only really happen involving generalists, who are able to take a broad view of the whole patient, not just a single condition, and have the skills to come to a shared understanding with the patient of the best way forward. Health inequalities will only be improved by care that is accessible for all and for me that must be primary care, based in the community where the patients are and understanding how that community works best. Promoting GP scholarship means attracting passionate medical students and junior doctors into general practice but also means a profession which can lead on some of these important changes and future proof our NHS.
Ongoing I hope to be adding more podcasts and resources to the WiseGP page and am looking forward to helping to produce a MOOC about GP scholarship in the next year so please sign up to the newsletter for updates if you are interested.
Dr Johanna Reilly