Starting out as a qualified GP

Now the 'L plates' are off, Dr Louise Jourdier explains how to survive your first year in the job.

It is acceptable to refer to online resources if you are unsure about something during a consultation (Photograph: Rex Images)
It is acceptable to refer to online resources if you are unsure about something during a consultation (Photograph: Rex Images)

As you ponder your qualification as a fully-fledged GP, there may be a part of you that wonders if you are ready for it.

Perhaps you suspect that you have miraculously slipped through the net unnoticed at each training hurdle. Perhaps your fear is that at any moment, someone is going to discover that you do not really know how to be a doctor.

Do not panic. You have got to where you are today because you do know what you are doing. This article discusses how to survive life after training.

Make friends with your colleagues
Getting on with the people you work with is the key to enjoying your new job. You are now an integral part of the practice team whatever the size of your surgery, and it is likely that you will be part of the team for a long time.

Bring biscuits, make tea and be nice. Not only is this the key to enjoying your work, but it is also the key to surviving it. It is likely you will need your colleagues' help as you settle in.

You will want to feel able to ask your GP colleagues about difficult patients, you will need to get your practice nurse to teach you what you did not learn about dressings and you will rely on your receptionists to keep your days stress free.

Use online resources
I spent a while wondering whether it was acceptable to use the internet during a consultation. Now I do not think twice about it. Saying 'I'm just going to double check the latest guidelines' to patients is quite acceptable and is a much better option than guessing your management plan. However, it is vital to use reputable websites.

Never be afraid to admit that you are unsure about something, if in real doubt, ask the patient to come back the next day when you have had time to do some research.

Write good referral letters
It is important to create a good reputation for yourself among your hospital colleagues.

With the learner plates off, and that comforting 'GP registrar ... ' beneath your signature gone, you will now be judged on the basis of your letters.

Remember the bad GP referrals you read as a junior doctor in hospitals and try not to emulate them. Instead, keep in mind the information that is most important and, perhaps most importantly, keep the letters short.

Keep learning
It goes without saying that CPD is a must (see box below), and it may take time to adjust to self-directed learning without the help of your trainer. Make sure you keep up to date with the latest research and clinical advice by subscribing to journals and medical newspapers.

Understanding the appraisal early on is also essential. It is a good idea to set up an account on an appraisal website straight away to get an idea of what is required. You also need to find an appraiser. Your local PCT should send you a list of options but, if it does not, ask it for one as the responsibility for appraisal organisation lies with you.

Finally, keep an eye out for useful courses and conferences.

They do not all have attendance fees and are a great way of getting up-to-date knowledge from the experts.

Be QOF ready
Depending on the type of practice you have trained in, you may or may not be familiar with 'March mayhem'. This is what happens if you do not update your patient's smoking status when they present with a verruca, or never quite get round to doing your mental health and vulnerable elderly reviews.

This can result in absolute chaos for the whole practice come February or March and is definitely something to avoid.

If you can keep on top of QOF all year round it will make your life easier, your colleagues will appreciate it and your patients might even benefit too.

These simple rules can help your transition from GP registrar to a polished and confident GP.

A last piece of advice; amidst the throes of back-to-back consultations, QOF, appraisal and professional development, you run the risk of neglecting life outside of medicine.

So whatever your passion, remember that your job is just one part of your life.

  • Dr Jourdier is a is a part-time GP in London

Reflect on this article and add notes to your CPD Organiser on MIMS Learning


These further action points may allow you to earn more credits by increasing the time spent and the impact achieved.

  • Identify some clinical areas that you are unsure of and spend some time researching and making notes on diagnosis and management. If necessary, ask one of your GP colleagues for advice.
  • Set aside some time each week to read the latest journals and medical newspapers. Make notes and think about how you can share relevant information with patients.
  • Attend relevant courses or conferences. Share your learning with colleagues in a practice meeting.

Dr Louise Jourdier recommends

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