GP in Salford and Chair of the RCGP Overdiagnosis group.
WHAT WiseGP WORK DO YOU DO?
I am an RCGP clinical advisor, so a weekly request for comments on draft guidelines (anyone can apply to RCGP if interested). I chair the RCGP Overdiagnosis Group, an email group mainly (anyone can join online). I am RCGP rep. to UK SMI, standard microbial investigations, as we want to join up testing from lab to GP (I am not involved in COVID-19 developments). I undertake faculty RCGP updates and for other GP educational companies in a voluntary capacity. I am on a NICE guideline committee at present. I enjoy the variety of general practice and am passionate about improving patient care. I like space to think and have authored a couple of books, one for GPs/health care professionals and one for the public about general practice, as an extension of my educational interests, the latter with help from our practice’s staff and patient participation group. I like to move information about and see how it can be best used. Having undertaken a lot of education it is a natural progression to try to improve the paucity of primary care knowledge, so I have undertaken a small amount of GP research, on insect bites and oropharyngeal cancer. I undertake reviews of submissions to journals or research bodies if asked. My views and experience below are frank to help you make contextual decisions for yourself.
HOW HAVE YOU DEVELOPED YOUR KNOWLEDGE WORK SKILLS FOR THESE ROLES?
I have had no set career path beyond my practice, family and teaching and feel this is common for GPs of my age. Academic careers were very unusual when I qualified, I am not sure I would have taken one up either as I did refuse an unexpected PhD offer early on as there is a limit to what could be done well as a full-time GP, including nights and weekends, whilst improving the practice with my husband partner and young children. It was a step too far then. However, I have been stopped from activities because I lack a PhD in medical school life and met leader discrimination because of being a GP. A career path might have offered me an authoritarian post to facilitate best practice, but the trade-off is a very happy family and GP life with a massive amount of clinical experience. Anyway, over time opportunities pop up and I am still improving.
I developed my skills by teaching individual undergrads in practice and postgrad GP trainees, then increased experience to group work. I was a primary care medical educator for a day release course and medical school group tutor, including MRes supervisor, then invited to a curriculum year lead post with some lecturing and an assessment year lead post. I was also a GP appraiser and on the local clinical senate. I left these because I couldn’t do them all at once. I left others as I couldn’t develop my role, skills and was unhappy. I have developed skills in literature searching, statistics, critical thinking, assessment, curricula development, facilitation of individuals and teams and a small amount of research, undertaken as an individual GP.
I went on deanery courses but got most pleasure from my certificate in medical education online at Dundee which encouraged me to author for the first time and in which I realised my skills and thinking were similar to others. GPs are quite isolated in their work compared to hospital workers. I undertook an MA in teaching, not just for medics, which was very interesting, meeting a group that didn’t make their mind up every 15 minutes or feel they should stick to it!
WHY DOES BEING A WiseGP MATTER TO YOU?
I am a GP with wisdom, no one is wise in all aspects, and it has helped me improve health care in lots of important small ways for myself, other professionals and the public. It has taught me not to accept second rate relationships and output. I have kept standards high and done my best in all my roles which has led to meeting lots of amazing medics, mainly GPs but not fully. I have lots of lovely supportive colleagues who are undertaking amazing work. As an example, in the past couple of years I took on the cumbersome error strewn process for individual GP research (I am not in a research practice as such but my colleagues and patients support me in looking for truth as we know it now) and found lots of people willing to help me, from practice to NIHR to HRA. For most researchers though it is easier to do it from a university stance with funding than as a voluntary activity! CCGs nowadays and NIHR are open to funding requests from you so get in touch, I have not yet tried the funding route as it has not been a priority.
WHAT TIPS DO YOU HAVE FOR OTHERS TO EXTEND THEIR WiseGP SKILLS AND ROLES?
Decide your values for practice for about 3-5 years at a time. You can change them later but opportunities, if looking for university careers, will only come early on. If that is your desire then there is something about gaining a PhD (just as a qualification, though it has other benefits too!), knowing people in institutions and being there for a long time which is valued.
Apart from this route then I suggest you enjoy yourself, offer great clinic care, take up work which improves your knowledge naturally, value your friends and colleagues and enjoy the similarities and the differences. Accept you wont be first at everything, life is an experience rather than a race. People are much more aware of you than you think. The number of people who say to me, ‘you wont remember me but’… well, like most people, even if I don’t remember the name I do remember enormous detail about them and there are no lost memories, just friends, amazing colleagues and a great career. The insect bite research was amazing, it grew from numerous emails in the Overdiagnosis group to creating an output as there was no primary care research on GP practice in insect bites in this area so100s of GPs helped and a group of 9 (librarians, student to GPs), co-authored a really good survey of practice. It is a tiny thing, but we were highly delighted when it was used as a part of a NICE evidence review.
Make sure you have time to complete projects before taking them on. If things don’t go well, step back a little and re-find the areas you enjoy with teams you enjoy. Be intolerant of bullies, life is too short.
Be patient, be honest, stick with your patients, quality is everything. Decide your ethical life and stick to it.