In her last column, our columnist Laura Davison, talks about her experiences of being a new GP
So, 18 months have passed since I qualified as a GP. It’s been a varied time; going from locum to salaried to expedition doctor, back to salaried then acting up as partner for maternity leave cover and back to salaried again. I’ve joined the Ministry of Justice to sit on their social entitlement appeals panels and I’ve been keeping the Practice Matters
editors busy correcting my grammar. This is the marvellously eclectic menagerie of possibility that is a career in general practice. It’s also been challenging, tiring and stressful.
Being the new doc on the block is a shock to the system, with the jump from sheltered registrar to self-sufficient, autonomous, fully-qualified GP being a much darker change than I anticipated. It appears I am not alone; my fellow “First Fives” on the whole are having similar experiences. MPS surveyed 246 GPs who had qualified in the last three years. The survey took place in August this year. MPS’s new GP survey showed most of us “newbies” are going through the same pressures, feeling overworked, unsupported and overwhelmed by the depth of the task. 78% of us struggled with heavy workload and 59% struggled with long hours.
Our new doctors are also feeling the pressure regarding preparation to deal with modern legalities and defence medicine. My boyfriend freaks out if he thinks he’s going to get a complaint for running ten minutes late – imagine the stress if he was faced with a real complaint! Only 25% of us surveyed felt prepared for writing reports and a mere 23% felt equipped to handle a claim.
The burden of an increasingly litigious society is obviously a concern for new doctors and I worry if we are not prepared during our registrar training, the way we practise medicine will head in an ever increasingly defensive direction, changing what is good practice into overly-cautious, potentially unnecessary practice. I’ve found the MPS Advice app incredibly useful this year, being easily accessible on my phone, hidden in my office drawer, for any quick reference and reassurance.
The RCGP’s CSA examination on the consultation and rapport skills needed to be a GP has evidently boosted new GPs’ confidence, as a whopping 91% surveyed by MPS felt well prepared with interpersonal and communication skills and 91% felt well prepared for obtaining consent from patients. But I feel that this area should be more of a natural asset of a trainee rather than a taught one, and having such a heavy focus on this area is overlooking gaps in our training covering other essential bases. Triage, business and service procurement, safe repeat prescribing, complaints and conflict handling, staff management and efficient knowledge updates are a few that I’ve struggled with during my apprenticeship so far.
Who knows where general practice is heading, but we are clearly not alone in our worries and struggles as newly-qualified GPs. Being a registrar was just a glimpse of what was to come in the real world.
Although this is my last column under this title, there is so much still to learn and experience; it’s going to be a long time before I feel like anything other than an apprentice.