Like a bunch of my colleagues this time of year, I gave a lecture recently for the local hospital RMOs about the GP Training Program (Applications are opening next week!). It got me thinking about how I landed in GP, and my perceptions along the way.
For years, General Practice was seen by many as the job you landed in if you couldn’t make it in the world of specialty training (in a lot of ways it still is now). This always conjures up in my mind lines of downtrodden and inadequate docs, trudging slowly away from the hospital before dejectedly hanging up their shingle, quite literally, and disappearing into a life of mundane obscurity. Dramatic? Exaggeration? Hyperbole? Maybe… But think about some of the conversations you’ve experienced as either doctor, or patient, and it may not seem so excessive. Two of my favourite stereotypes of life in General Practice have always been the glib catchphrases ‘Tears and Smears’, and ‘Coughs, Colds and Sore Holes’.
(Are you counting how many holes can be sore right now?)
Certainly, my experience in med school of my GP Rotation was sitting in the corner of a consulting room, observing what seemed to me to be a frighteningly mundane job. I’d love to say I looked forward to the automatic blood pressure that my GP Teacher at the time (bless his cotton socks) would ‘let’ me do once a day or so… but I didn’t. I crossed GP off the list, firmly and definitely, and was sure I’d never look back. Every other specialty seemed more appealing, more prestigious, more stimulating, more… sexy!
And so I strutted into the hospital system, traipsing about as a promiscuous resident, courting surgical training, physician training, ED, ICU. I’m not ashamed to admit that I even had the gall to string a couple out of that list along at the same time. The options were positively titillating… The adrenaline-fuelled adventure of surgery, the deep intellectual connection I felt with internal medicine, those wild ED nights, and that heady mix of tactile procedures and serious communication that only an enigma like ICU could provide. The fact that these four were all siblings under the same roof only made it all the more exciting. That is, until I met their stern parent – Hospital Administration. How could I ever manage to have fun with my four prospective lovers under such circumstances? Erratic hours, irrational requests, ever-changing rules and goalposts, I couldn’t handle it! So I cracked. Forget it, I’m leaving behind these highly advanced and advantageous opportunities, and putting myself out to pasture in search of a better lifestyle. Sure, GP wouldn’t be as adventurous, or intellectually stimulating, but sometimes you just need to compromise.
But, as you might have guessed from the subtle name of my blog, I’ve experienced something of a turnaround since starting life as a GP. I’ve found it more complex, more rewarding, and with more possibilities than I ever could have imagined. It’s where in the medical world I can feel MOST like a doctor, and most capable to handle whatever wanders in through my door, like a true generalist. This provides a good chance to reflect on some of wide and varied things my own GP colleagues and friends have been up to in the last month or so (and for some, the ‘Partialists’ they’ve rendered obsolete in the process!):-
- Middle of the night Emergency Caesarean Sections (O+G)
- Intubating and stabilising a young child in Status Epilepticus (Anaesthetics)
- Complex flap repairs of advanced facial skin cancers (Plastic Surgery)
- Vasectomy (Urology)
- Diagnosing and stabilising neonatal sepsis (Paediatrics)
- Performing and interpreting X-rays (Radiologists)
- Working adolescent mental health (Psychiatry)
- Managing major road trauma patients (Emergency)
- As well as roles in education and teaching, the media, politics and governance, research and academia!
All this on top of the daily bread and butter of General Practice – primary and preventative care, chronic disease management, and providing a real medical ‘home’ for the patient to feel safe bringing any problem at all…
And to finish, because you’re wondering, over the last week or so I’ve seen at least seven different types of sore hole… how could that ever be boring?!
*Disclaimer – whilst I may support the re-branding of Specialists as Partialists, I certainly wouldn’t want to live without them, and thank my (albeit less enlightened) Partialist colleagues for helping me in many different ways on a daily basis!