A recent article in Pulse indicated that medical school deans are smearing general practice and indicating that it is a second class choice - do it if you can’t do hospital medicine. The phrase “how very dare you” comes to mind.
Sir John Oldham, chair of the Independent Commission on Whole-Person Care and a GP in Glossop, wrote on Twitter that a medical school dean told a new intake of students last September that “We work you hard because we don’t want you to fail and become GPs”.
Now this distorted image has been around for a long time; I recall hospital doctors 30 years ago being very ready to elevate their own status by being derogatory about their GP colleagues.
But one would like to think this has changed in 2015 - not least because the percentage of graduates becoming GPs is the highest it has ever been, and there is a massive recruitment crisis in general practice requiring all hands to the wheel to demonstrate its many advantages as a career, assuming you are suited to it (if you are not suited to it then you are entitled to state its not a great career for you personally but you can’t say it isn’t for those who love it).
What is not needed is medical students being brainwashed in their tender years that becoming a GP is somehow a second-class career option.
However, what i would say is that merely singing the praises of general practice is also not enough, though its a good site better than criticising it. What is really needed is individual career plans worked out with those medical students who are ready to face such things. In a workshop I ran on career planning to a large group of medical students a few years ago, those that had turned up were absolutely ripe for career discussions, and in fact some of theme appeared literally starved of it.
A few comments such as “why have we not been told this before” popped out, and my overall impression was that medical students still come in all sizes and at all stages of personal growth. Some didn’t turn up because they were not ready, but others might have done if they had realised after hearing those that did come sing its praises and state how useful it was to have a straight talking and informative approach to career planning.
A careers fair isn’t careers advice
Did the university invite me back? No, despite feedback of “please can we have more” being almost unanimous. The question is, why didn’t they?
I have several answers to this, most of which are unprintable but in summary they think they are already providing career guidance. In my view they are not. Yes, they may have a nominated careers advisor. Yes, there may be the odd careers fair thrown in. But these do not mean that proactive, inspiring, tailored and realistic career guidance is being given.
Hospital medicine and general practice are different, and I have seen hospital doctors who should have been GPs, and vice-versa. To compare them as “better or worse” is really a very egotistical standpoint, and not helpful to anyone in career planning terms.
Call to arms
I would like to see all those who love general practice to “come out” about it; to write blogs about how they enjoy their challenging, sometimes frustrating but rewarding and flexible career; to proactively share in some way with medical students why they chose it and how they get what they want out of it; to show how it can be combined with other complementary roles such as BASICS emergency work, or indeed totally opposite interests like jewellery making or being a musician or a media doctor, and how it can be used as a stepping stone e.g. into something completely different.
And those that don’t feel like this to instead seek some career planning support so that they can either change direction, or find a way of working that ends up filling up their cup to overfloweth rather than leaving them running on half empty.
We need to be happy in our work. If we are not, we need to know why and help each individual do something about this as well as listening collectively to the genuine concerns GPs have about the way in which they are expected to work.
This article first appeared in The Sessional GP magazine April 2015